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torontodiabeticguy 03-04-2014 13:42

LANTUS Usage differences
 
My insatiable curiosity and a desire to battle this insidious disease prompt me to wonder what differences in results (if any) we are achieving using different regimens with LANTUS usage.

For example: I am a 61 year old male, 5'10", 265 pounds. I suffered a battle with Influenza A/H1N1 in summer 2009, despite flu shots, that put me in a coma on life support for three weeks and as of today I continue to battle Type II Diabetes, Atrial Fibrillation, Obstructive Sleep Apne, Hypertension, and a host of other afflictions that were either undiagnosed or non-existent prior to my battle with H1N1 in summer 2009, which resulted in two code blues and a request to unplug me from the equipment that was keeping me alive. Yet, although it took a year to have the energy and strength to roll over in bed by myself, here I am.

I have been battling diabetes II since being in hospital. I was never in hospital before that day. Please keep in mind that I am using a wonder drug called TIKOSYN that is so seriously unflexible and caustic that I speak to the hospital's cardiac arrhythmia clinic if I should even want to take a laxative, for fear of messing with the TIKOSYN and a brush with the grim reaper. It is a seriously dangerous medication. I also take RAMIPRIL for hypertension and THYROXIN for thyroid inactivity (for a loooooong time).

So here are my questions (but please do not limit your answers to the specific questions by any means!

1. Does one generally split LANTUS and take it twice daily? Split the daily dose or take the full daily amount twice a day?
(I find that splitting the dose exactly 12 hours apart works well and that taking the full dose every 12 hours is fine and works well.

2. Does one injection site work any better than another? Or provide a different rate of release than other sites?

3. Does a difference in needle length make any difference in efficacy of the dose injected? I have both 6mm and 12mm needle lengths, have been using 6mm and have just started using 12mm to see if there is a noticeable difference. The LANTUS info sheet(s) say little to nothing in regards to this.

4. How many of we LANTUS users are using another diabetic mediation in our BG control program? For instance, I ran into two other LANTUS users last night at a meeting of our fraternity. One is obese, as am I, and splits her LANTUS into tow full doses 12 hours apart, also taking Metformin just prior to meals to a total of 2500mg. daily. Her BG is under control - well under control. The second LANTUS user I bumped into takes simply her LANTUS once per day at awakening and uses nothing else. Her BG is also well under control. I forgot to ask about needle lengths, sites, etc.

Funny enough, our DOG had major surgery a month ago and is now diabetic. Blood results just prior to surgery to remove a mass from her shoulder were pretty normal; post surgery, NOT very normal. LANTUS does not work for her at all although we are told that there are OTHER types of insulin that work well with canines! She actually looks forward to getting her injection and will come and beg for it because she knows that she is going to get a treat with the injection (denta stick).

If those of us who are using LANTUS or have knowledge of LANTUS as above would be so kind as to share that knowledge, I would be very VERY grateful.

Thanks again.

TorontoDiabeticGuy
Murray in Richmond Hill, Ontario, just north of Toronto.

Tinss_C 03-04-2014 15:22

Hello Torontodiabeticguy...I'm also from Canada, Hamilton actually, that makes us practically neighbours.
Sorry to hear about your health problems specially with that bout of H1N1. I know of a coworker and her whole family who got it and still, up to today, can't shake some of the side-effects off. She gets sick so easily and so does her kids and husband.
I'll try and help you with the Lantus questions as my son uses it.
If you have to administer larger doses, it is best to split the dose as this lessens the chance of pooling. Use 2 different sites, like opposite sides of your abdomen. My son never injects in his arms or legs because he 'burns' through the Lantus and leaves him with a hypo. Some people find that for them, it doesn't last the 24 hours it suppose to, if that's your case, then inject morning and evening, 12 hours apart. A good site also is the the top of the buttocks. Remember, it has to be a subcutaneous injection as an intramuscular injection uses up the insulin much faster also. When you inject Lantus, it forms micro precipitates under your skin and does a gradual release into your system. It is also coated with zinc that causes stinging with some users. My son is one of them.
The length of the needle is also important. My son is fairly thin, so he uses the 4 mm, 32 gauge. If you are a bigger person, you should use the longer needle as the 4 mm might be too short and it could mess up the dose. I don't think the gauge size would matter to much. Your doctor should be able to help you determine the size needle you should use. When you inject, if you see a drop at the injection site, that means that you didn't leave the needle in long enough or perhaps the needle isn't long enough too. Do you use a pen or syringes? With pen usage, it's best you count up to 10 after injecting, then pull it out. The pen delivers much slower than the syringe.
Lantus is also very susceptible to hot and cold temps. Store in fridge until you have to open it then leave at room temperature. Another thing, avoid hot saunas and hot tubs as this can cause the Lantus to be used up quickly by your body.
So far, that's all that I can think of concerning Lantus. If I come across more info., I'll send you a message.
A good book to read is Using Insulin by John Walsh. I learned loads off his book. ; )
Good luck with your health and controlling your bg's. Take care

torontodiabeticguy 03-04-2014 17:11

Tinns: Thanks for that information. Confirms some of the things that have been on my mind like how deep the injected mass needs to be. And where it needs to be. I think I am going to inject in my stomache area ongoing (moving around). I need to find out how deep subcutaneous is without going into other stuff. I imagine the 6mm. will cover it and that 12mm may be even more efficient; will stick (pardon the pun) with the 6mm needles on the pen until I get to chat with the doc next week.


Quote:

Originally Posted by Tinss_C (Post 473921)
Hello Torontodiabeticguy...I'm also from Canada, Hamilton actually, that makes us practically neighbours.
Sorry to hear about your health problems specially with that bout of H1N1. I know of a coworker and her whole family who got it and still, up to today, can't shake some of the side-effects off. She gets sick so easily and so does her kids and husband.
I'll try and help you with the Lantus questions as my son uses it.
If you have to administer larger doses, it is best to split the dose as this lessens the chance of pooling. Use 2 different sites, like opposite sides of your abdomen. My son never injects in his arms or legs because he 'burns' through the Lantus and leaves him with a hypo. Some people find that for them, it doesn't last the 24 hours it suppose to, if that's your case, then inject morning and evening, 12 hours apart. A good site also is the the top of the buttocks. Remember, it has to be a subcutaneous injection as an intramuscular injection uses up the insulin much faster also. When you inject Lantus, it forms micro precipitates under your skin and does a gradual release into your system. It is also coated with zinc that causes stinging with some users. My son is one of them.
The length of the needle is also important. My son is fairly thin, so he uses the 4 mm, 32 gauge. If you are a bigger person, you should use the longer needle as the 4 mm might be too short and it could mess up the dose. I don't think the gauge size would matter to much. Your doctor should be able to help you determine the size needle you should use. When you inject, if you see a drop at the injection site, that means that you didn't leave the needle in long enough or perhaps the needle isn't long enough too. Do you use a pen or syringes? With pen usage, it's best you count up to 10 after injecting, then pull it out. The pen delivers much slower than the syringe.
Lantus is also very susceptible to hot and cold temps. Store in fridge until you have to open it then leave at room temperature. Another thing, avoid hot saunas and hot tubs as this can cause the Lantus to be used up quickly by your body.
So far, that's all that I can think of concerning Lantus. If I come across more info., I'll send you a message.
A good book to read is Using Insulin by John Walsh. I learned loads off his book. ; )
Good luck with your health and controlling your bg's. Take care



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