I have a bunch of old Lantus, Apidra, and Tresiba sitting in my fridge that I would like to use up. (Levemir would be my preferred insulin if I were doing MDI.)
A year or two ago I tried the “untethered” regimen of taking 50% of my basal as an injection of Lantus and 50% from the pump. I didn’t notice any huge benefit so gave up after a few weeks.
But since I have Lantus to use up, I decided to give it another try. Especially now that I’m using Fiasp, which has the downside that I can’t disconnect my pump for even half an hour without a very noticeable impact on my BG. And if a pump site “wears out” after two days and I don’t change it right away, I end up fighting highs for hours. I’ve been having more instability in my BG lately, and I felt like maybe small interruptions in insulin delivery (from disconnecting, site issues, absorption issues) combined with the faster onset and tail of Fiasp might be contributing to this issue.
This time instead of taking 50%, I just took five units of Lantus. I didn’t even really change my basal rates, just injected the five units on top of the basal I was already taking. I think maybe I may have lowered basal by 0.2 units an hour, but I didn’t keep records and I was also making other basal tweaks for overnight, so I can’t remember. Okay, so not very scientific of me, but I wasn’t planning on posting about this, I was just doing it for personal curiosity but have been surprised at the impact.
My BG has been near perfect for the past four days. I thought I might have problems with lows, but I haven’t. I’m still able to suspend my pump for half an hour to get a small bump up in BG, but the bump up is considerably less than what it used to be (which is good). Disconnecting for showers with creates a flatline rather than a spike (even when I don’t bolus to cover the disconnect period). It seems to me that the difference between having five units of insulin in my system at all times and having zero insulin in my system at times is surprisingly large. (I do still often have to do follow-up boluses about two hours after eating because Fiasp wears off too soon. Experimenting with combo boluses will be next.)
I have wondered if maybe the Lantus I’ve injected has gone bad (since it’s sat at room temperature for several months) and maybe that’s why I haven’t really had an issue with lows despite not changing my basal rates. But I don’t know… At five units a day this cartridge will last me about two months, so I guess I’ll see when I inject with a new cartridge of Lantus out of the fridge if I continue this for that long. (Or I guess I could just inject with a refrigerated cartridge right now to see if there’s any difference…).
I think some others on FUD have experimented with the untethered regimen, so I’d be curious of others’ experiences.