I have been using Tresiba for a long time now, and it it the best basal for me since it lasts for the 24 hours each day. There is shortage in Tresiba where I live, and unfortunately i am down to my last pen. My doctor told me to switch to Lantus for the time being, but my problem is that basal insulin tends to stay active in my system much less than advertised. What do you recommend me to do? Should I inject lantus twice a day to avoid highs? FYI I am taking 42 units of tresiba everyday.
Lantus twice-a-day can work, but there will probably be some overlap since it would probably last more than 12 hours.
If you time it so that the overlap is during a meal time, that would probably not be too big of a problem.
Here is just an example. Your situation would just depend on how long it lasts for you and when you take it:
Suppose it lasts 16 hours for you, and you take it twice-a-day. And suppose you take it at 7am and 7pm, 12 hours apart.
You would have some overlap from 7pm until 11pm, and again from 7am until 11am.
In that case, maybe the overlap coincides with breakfast, lunch, and dinner. In that case, it’s not too big of a problem.
You can adjust when you take it, and split the doses however you want. So it gives you some versatility, if your basal requirements are not always the same.
Before MDI and pumping I split Lantus into 2 doses 2/3 at bedtime and 1/3 12 hours later. When I started MDI I found splitting into 3 gave me better results.
My initial issue was night time hypos 6 hours after injection.
When I was on MDI my basal was lantus, and I used 2 equal doses.
@MMansouri I used to use Lantus before going on a pump and had issues with a single injection of Lantus lasting, seemed to go about 20 hours at most. I read here on FUD about splitting my dose and decided to try it (advised my Endo, got no objection). I was on 11 units/day, splitting it 6 on waking up, 5 at night before bed; gave it a few days to “even” out based on the FUD recommendation and it needed a couple to do so. Found I needed to increase the total dose to 14 and split evenly, morning and night, to get good control. One lesson, if you don’t do it already, ensure you put your slow and fast acting insulins in different locations; I was a newbie congratulating myself on decent control and kept my pens in the same drawer next to the bed for convenience; one night I injected 11 units of fast acting, vice slow, and spent the next couple of hours eating out of the low I caused myself.
Note: I’m not a doc, comments are my experience offered for your consideration and decision; good luck with whatever you decide to do and let the rest of know what worked best for you!
I have started taking Lantus split into 2 doses every 12 hours. Seems ok for now, but I think that to get better contol I have to increase my first dose by a couple of units. Thank you everyone for your advice.