I see a lot of people on MDI slit their Lantus dose in half and take one shot in the morning and one at night. This has been suggested for those who experience dawn phenomenon as well as those who are having the dose wear off at the end of the 24 hour cycle. My question is this. How would taking half the dose at night prevent dawn phenomenon from occurring and prevent higher waking numbers? It seems having the full dose on board at night would do a better job at preventing the dawn phenomenon.
I had to split my Lantus not so much for DP but because the TOTAL amount I needed daily would just drop me TOO low over night. I just could not handle the total amount at one time, but if I cut back, I'd be running high throughout the day.
I agree that a full dose can knock down dp effectively and is the way to go if the dose provides 24 hour coverage. Splitting the dose doesn't work in my body as the smaller doses absorb inconsistently from dose to dose. I have seen peaks vary between 20 to 100 points.
I split, not in half, but in an amount in the a.m. that does not make me low in the afternoon and in an amount in the p.m. that does not make me low during the night. The total, if given at night, would have put me 6' under during the night. The total given in the a.m. would finish working about 9 p.m. at night. The overlap is just right. Dawn phenomenon had nothing to do with it.
I split my Lantus dose -- breakfast and supper. I split my NPH doses for many years, so I guess it made sense to maintain that on Lantus, even though they work quite differently. Even though Lantus is said to have no peak action, I think there are times when it works harder, so again splitting it makes sense depending on when one has his highs and lows. I had nighttime lows quite often, so my morning Lantus was increased and my evening Lantus decreased and it seemed to do the trick, although my overall number of units did not change.
That was the same for me, I had to take more during the AM dosage and less at night. It wasn't an even 50/50 split either, but it worked really well for me.
I started splitting my lantus dose in November I don't split it 50/50 though I take 20 units in the morning and 9 units at night. So it is closer to 70/30. Before when I took it all at night I would have some horrible morning lows in the 30's to 40's but before dinner I was never less than 200. The sanofi aventis people advertise that lantus lasts 24 hours with no spikes, but I don't know what they are smoking there. Insulins work differently in different people so there is no one size fits all. If lantus works smoothly for a full 24 hours you are very lucky. Most people find 16-20 hours is the max for duration and some people do have a spike from it. I guess for me I would rather have the majority of the insulin working during the day when I am conscious and alert and able to fix lows, not during the night when I am unconscious and unable to feel potential lows.
I took 16 units of Lantus at night, and 20 units in the AM, and that combination worked great for me, but if I attempted more than 20 units at night I was super low in the AM too. Although for my I think Lantus gave me better control than Levemir did, but no I dont think Lantus last a full 24 hours, and it certainly isn't peakless either.
The problem for some is that Lantus would peak after about 5 hours so if you dosed at 10 pm then at 3 am you would go low when your insulin requirements are at there lowest for the day and then this would be fallowed by a rebound if you where lucky about 6-7 am. The only way I could get Lantus to work and stay out of the hospital was to split the dose.
I was allergic to Lantus and soon after Levemir came on the market I switched and it did not spike but I still used a split dose. There was only 8 hours between the night dose and the morning dose so this stacked insulin in the morning when I needed it the most.
It never controlled my DP. Pumping and using a CGM has been the only option for controlling my DP...well most of the time.
yeah I have to split mine also. I had to split mine because I would either have to eat 50 uncovered carbs before bed (which would put well over 250 every night) or drop into the 40s. I'm lucky that my DP happens when I'm already awake so I can cover for it with my morning bolus.
I currently take 18 at night and 11 in the morning. I started by splitting my dose in half (12/12) and then I raised my night time lantus until I was stable over night. Then I adjusted for day time numbers... and here we are
Thanks guys for your info. I was just curious in that most mornings I am in range but if I eat too late I wake high. However, it could be that I drop low and rebound. I suppose I should do a basal test and then I will know for sure.
I think most people take the Lantus between 9 or 10 pm. Even if you split the dose, I think you might be taking it a bit too early. Try experimenting and see what works best for you.