HI there, Just wondering if anyone has used Lantus injection for their basal and then bolused with the pump before meals?
I have had T1 diabetes for 20+ years and did not start on the insulin pump until abut 6 years ago, at times taking a “pump vacation” and going back to injections completely. My biggest issue with the pump is my post workout lows ( I work out vigorously and will have lows 5-6, sometimes 8 hours later, no matter how I adjust my basal rate). I don’t seem to have this issue when I use Lantus. It also gets tricky with the pump and finding the right basal rate when I don’t work out one day versus when I do.
Just wondering if others have kept the infusion set connected and then just plugged it in before a meal to get a very accurate bolus rate? I am also very insulin sensitive, not sure if this has anything to do with the issue or not.
I have tested combining the use of basal insulin and using a pump for meal boluses. It works fine.
The post-workout lows may be because exercise increases the absorption rate of the insulin that is used by a pump. Since a pump uses rapid insulin, exercise can increase the rate your body is putting it to use. Basal insulins are not affected by this in the same way.
Lantus uses higher order aggregates of insulin hexamers, and Levemir binds to the albumin in the blood, so their rate is less affected by exercise.
The only downside to this approach - once you take a Lantus shot, you can’t stop it or reduce it, you gotta ride it out.
An alternative might be to more aggressively adjust your basal rates post-workout.
I use Lantus for 75% of my basal needs, the remainder basal via pump, plus boluses.
This means I can take the pump off for a few hours while exercising, and have a much better chance of not being high or low. The 75% seems to work well for my exercise (aikido - with lots of weapons work).
I don’t think I’d like to use Lantus for 100% of my basal, I’d go low too routinely during training.
I keep my original pump settings as my option A so if I forget my Lantus I can convert quickly to 100% pump.
