@JessicaD another possibility..I think lantus is used for diabetic pets, so maybe a shelter or some organization would use it?
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@mike_g Great idea, I hadn’t thought of that at all. Another item to stuff in my brain!
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I use Lantus but that is solely because that is what I was on with MDI so it was easy to get the prescription. More important I use pens because they are more robust (my wife has a Lantus pen in her Tardis-like purse).
When I was SCUBA diving I regularly swapped back to MDI for periods of a week or so. When I did this I used approximately my pump basal but I did it twice a day; all long acting is peaky but pump basal is completely flat-line as it is injected every 5 minutes. I found 6IU twice a day for Lantus worked just fine vs my 10-12IU/day pump basal. I assume that any long acting would work just as well.
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@mike_g and @TomH – great ideas. Mike, I had offered the Lantus to a veterinarian friend and she was interested, but we never made the transfer happen (she’s not super local to me), but the shelter idea is a great one. I will reach out to the animal rescue league, etc. And Tom, I managed to send a bunch of the Lantus to Ukraine when the war began, but haven’t found organizations that will accept insulin anymore – I think the transport is so challenging. If you have any ideas who I could contact, I would appreciate it! Love our community 
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People ask me about where to donate insulin ALL THE TIME. I never have an answer. If anyone knows, please post.
This is a reputable organization: INSULIN FOR LIFE | Saving Lives around the World
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While I am not a follower of TCOYD I am a firm believer of taking care of my own diabetic treatment. My pump history shows that my average TDD basal is 30 units. If I had to go back to MDI I would start out slightly less than that using Lantus in 2 doses.
When I was on MDI I actually split Lantus into 3 doses:
- Upon waking.
- Prior to lunch.
- Prior to dinner.
This may seem extreme but it gave me really flat and stable BG. I would not consul anyone to do the same. What works for me may not work for others.
Having a CGM makes it a lot easier to manipulate insulin dosage. Also, being T2DM means I am less prone to DKA. Our deadly condition is hyperosmolar hyperglycemic state HHS. Symptoms are extreme high BG, like 600mg/dl and dehydration without ketones.
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I have gone back and forth using MDI, pump, and both together. Right now I am using both but I am really thinking of going back to the pump for all my basal. Shots twice a day and remembering before you leave the house lol are a real hassle. I have timers set, but when I leave earlier it gets forgotten easily and the timer goes off when I am already somewhere else. And yes I could keep it in my purse but I am retired and I like the convenience of it being in the kitchen. Maybe I need a pen in the kitchen and my purse lol… But I am not getting the results I wanted from the combo.
But for me it wasn’t difficult, take the amount in the pump, divide it by two, then make the dose skewed lighter at night than the morning shot because of the peak of action. Now a combo of half and half pump/MDI was a little trickier, but the same basic principle. I use Lantus because I was familiar with it, which is also why I chose 2 shots a day because I know it didn’t work for a full 24 hours for me.
Now the switching itself is much trickier for that first 24 hours.
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Yes, be careful for the switch to MDI and for the switch back; the pump basal disappears from view in about 8 hours and a long acting basal takes maybe 8 hours to kick in full time. In my ideal world, where I still have the pump, I cancel the pump basal (set it to 0) but use the pump for correction boluses. IRL in an emergency that isn’t possible so there is going to be a gap.
Going back from MDI to a pump is easier; set the pump basal to zero and just do corrections for a few hours. Maybe increment the basal back to the original level but that might just be too sophisticated.
With an AIDS going back is trivial, though there may be a lot of alarums and excursions
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