Technical question - splitting Lantus

I’ve been curious…
Many of you say that you take your Lantus twice a day. Do you take 50% of your original dose morning and evening? Or the original amount twice? Or some other variation?
I’m trying to get my mind around the fact that, if it’s supposed to last 24 hours, how can you take it twice a day and still have enough without having too much.

I started splitting mine up about a month ago. I take half my full dose in the morning and half in the evening before bed. It seems to last the full 24 hours that way. (It just didn’t seem to make it before.) And I have a lot less Hypo episodes. When I took it all at night, I was getting readings of anywhere from 45 to 31 at about 4am but was reading in the 200 range in the afternoon. I tried this split on my own after hearing others talk about it on here. i wouldn’t go back to taking it all at once if someone paid me. Hope this helps.

Hi, I also started splitting mine a bit more than a month ago. I initially started off with half a dose in the morning and half at night (just realizing that I forgot my morning dose!!! not setting a good example! - just done it…was wondering why I was higher than usual before dinner…) though I kept still on being high at 2-3 pm, the opposite of what the textbooks say. Hence now I am on 65-35% eve/morning Lantus. Also during the day I have bolus injections to cover my meals, so the need during the day is much lower.

I have had a discussion about this matter with my diabetic nurse, and have been told that it is rarely that people will be able to survive with one shot of basal during the day. Though Lantus has no peak and should last longer than Levamir, it seems it is true for both of them that they are rarely lasting for the full 24h

Hope this helps.

I started splitting my dose severral months ago when I finally figured out that it wasn’t lasting me a full 24 hours. Right now I take half in the am and half in the pm. But I have tried different dosing. My endo is one of the co-authors of Using Insulin and although the book doesn’t talk about splitting doses he has given me pretty much free reign to do what ever I need to do. He is more interested in seeing my A1C less than 6. I think you just need to experiment a little and see what is best for you.

Lantus doesn’t last 24 hours for many people, regardless of what the pharm literature says. It also has peaks & there are many here who had lows attributed to Lantus. I had a terrible time with Lantus & am doing better on Levemir, but everyone’s chemisty is unique.

When I started splitting my Lantus dose, it was 50-50. Same with Levemir. I took half immediately before bed because I have dawn phenonmenon & the other half before breakfast. I’ve never taken large doses.

Basal doses can be checked by not eating & seeing how level BG stays.

Thanks, everyone, for the info. We’ve tried everything else we can think of to stop the lows - short of not taking the bolus for the carbs. Somehow, I don’t think that would be the right approach.
I’m going to the US in 4 weeks, leaving V here on his own, and we really want to get things leveled out by then. I appreciate any and all help!

I started splitting my Lantus exactly one month ago, on the advice of my endocrinologist. The problem was that if I went to bed with a sugar of less than 10 mmol/l (180 mg/dl), I would wake up low. The doctor saod that splitting the Lantus dose would allow me to go to bed with a more normal sugar without waking up low.

My normal dose was 12 units at bedtime, now I take 6 units at 8:30 am and another 6 units at 8:30 pm.

I am experiencing more lows than ever–especially first thing in the morning and in the late afternoon. I am considering reducing my nighttime dose to 5 units in hopes of preventing the early morning low. After taking 6 units last night, I went to bed with a sugar of 6.7 (120) and woke up at 2.4 (43).

If anyone has any advice on going to bed with a normal sugar (i.e., 5.5 mmol/l [100 mg/dl]) and not having any lows, I would be very happy to hear it!

The only other thing I can tell you that I do is I always eat 1 or 2 graham crackers with peanut butter before bed. If I have a normal BG at bedtime, I just know I have to have a snack so I don’t wake up low.

That’s exactly what I eat before I go to bed. Funny.

My endocrinologist really seems to think I should be able to go to bed with a normal blood sugar and wake up . . . well, alive. Whenever I try extra hard for good bedtime sugars, I wake up in the morning with low blood sugar. It’s not a fun way to begin my day (not that I need to tell any of you . . .).

Dear Katie.

You split the dose in two. Actually if it really did last exactly 24 hours no more no less then it would not make any difference.
In most people it last anything but 24 hours so then splitting the dose is better.

Dear Molly.

In addition there is an old Slovak saying that if you have to die may it be on a full tummy. It is a good idea to have a light snack.

I did it 50/50… for some of us it doesn’t quite last 24 hours. The less of it you take, actually, the shorter DIA it has.

Regardless of when you take or even if you split it, as long as the total dose remains the same (say, 18u once a day, or 9u twice a day) it’s still having the same general effect.

Thanks for all your help. We took the first step last night… And he woke up high. Which is better than low, but he was not pleased. More tweaking…

What was V’s BG before bed? How high was his fasting? What times did he take Lantus?

He took the Lantus at 7:30. He was at 166 1 hour after eating, before bed (we eat late), 209 an hour later and 269 this morning. I’m thinking he should go from 10 to 12. Unfortunately, he got a set of pens with his last Rx that only inject in units of 2… How ridiculous!
He did 8 this morning at 7:30 and he’ll test in about 20 minutes

It’s hard to tell what V’s evening dose of Lantus should be because of eating so close to sleeping. He could be going up some after two hours & the Lantus is keeping him at that same stable, though higher rate. It’s no fun at all, but him waking to test to see what’s happening during the night would be helpful.

That is ridiculous! Best to raise or lower doses by just 1 unit (not that he can do this with those pens!) & stay at that dose for three days to get a better idea of a pattern.

Hope the split doses help.

I like that old saying and agree whole heartedly.

Well, there is on the one the one hand what the endo says, and the other hand, what your body is telling you… I have had good luck taking a snack of nuts at bedtime if I’m lower than 180.

yeah, my CDE told me to split it, which I did for a few months, and then when I saw my endo, he said at my dose level, it was just as good to take one shot, which I am now doing (31 to 32 units at 7 PM). It was harder to remember to get the timing correct with the two doses; I am not a person with a clock in her head; and in fact I set my cell phone alarm so I remember to take the PM dose. (I don’t ever forget my Novolog before a meal–it’s just the Levemir that is the challenge for me.)

I have two kids, a dog, two part-time jobs, and a husband who works late a lot, so there are a lot of balls in the air around here!