Lantus insulin

Sha-Sha RN · Dec 2, 2012

Lantus is a basal rate insulin and it last 24 hours. It's usually given once a day at bedtime. It is not like the shorter acting insulins like novolog or lispro that should be given before meals. I'm not sure why the md ordered 2 times/day. Lexi Comp of a drug reference book will help you with dosing guidelines.

ChristineN, BSN, RN · Dec 2, 2012

Lantus is a basal rate insulin and it last 24 hours. It's usually given once a day at bedtime. It is not like the shorter acting insulins like novolog or lispro that should be given before meals. I'm not sure why the md ordered 2 times/day. Lexi Comp of a drug reference book will help you with dosing guidelines.

When I worked on an inpatient endo unit, you would occasionally see pts that were having a difficult time with glycemic control that the docs would order Lantus for twice a day. Even though Lantus does not peaks and continues working for 24 hrs, some docs will split the dose in half and given morning and night. When I would have a BID Lantus pt, we typically gave one does in the AM with the breakfast insulin, and one dose at bedtime with any HS coverage. If this is the pt's home routine you could ask them how they typically do it, as taking it before or after meals should not matter.

Lundazi · Dec 2, 2012

Hi Sha-Sha RN

I did contact the MD about the twice per day order.He said his order is twice per day no change.Thank you for you reply.

Lundazi · Dec 2, 2012

Hi ChristineN

This will help. Thank you.The resident dose not have a fixed schedule for her breakfast.Sometime she likes to sleep in. Can i give it when she is having her breafast? Cause i understand that it has to be given at the same time everyday.Do you think this will affect her blood suger.Thank you

Mnartha

ChristineN, BSN, RN · Dec 2, 2012

Hi ChristineN
This will help. Thank you.The resident dose not have a fixed schedule for her breakfast.Sometime she likes to sleep in. Can i give it when she is having her breafast? Cause i understand that it has to be given at the same time everyday.Do you think this will affect her blood suger.Thank you
Mnartha

Giving it when she is getting breakfast should be fine. Sleeping in/minor variances in time should not be an issue, but if times are varying by several hours everyday I would be more concerned. It will effect her blood sugar, however since it will not start working until 4 hours after the does is given, you will not see it drop sugars much with breakfast. If you check a blood glucose prior to lunch you might see that it has been affected some.

adnrnstudent, ASN, RN · Dec 3, 2012

Lantus/Novolog user here. While I only use it once a day, a lot of very vigilant diabetics use it twice a day to ensure 24 hour coverage. While I think it works 24 hours for me, some feel it may begin to wear off, so twice a day dosing ensures some basal coverage at all times if it does wear off.

CDEWannaBe · Dec 3, 2012

Patient needs to work with the doctor to adjust the dose so she can sleep in a bit and take it later. Time of day is important. With Lantus it doesn't matter if it's before or after a meal.

For many Lantus coverage is closer to 14 - 18 hrs. coverage. Not 24. That's why the doctor has a split dose.

victorcr · Dec 4, 2012

Lantus is a Bsal rate insulin that does work on a 24 hr basis. However, it works better when givin twice a day. It's better that way because instead of having 1 peak time with the 24hr dose, having 2 peak times, ahving it givin twice per day the insulin is better used in a more steady basis like a insulin pump. Having it givin twice per day there is not as much time where the insulin starts to work, then is steady for a little while, then wears off. Twice a day the insulin stays at a more even pace like an insulin pump would be used.

classicdame, MSN, EdD · Dec 4, 2012

Lantus does not peak so it is not associated with meals. Give it about 12 hours apart. Period.

mammac5 · Dec 6, 2012

When I order it in split doses, I do ACBHS. I normally order it this way only for patients who require >50 units per dose. Our pharmacy gives us a notification that it is better absorbed in doses of 50 units or less, so we split it up. When pts go home and refuse to give themselves 5 injections daily (2 Lantus, 3 meal/correction) then I tell them to pull up their entire dose in one syringe (say, 90 units for example) and then prep 2 spots for injection...give some in one spot and some in another. Of course, we can't do it that way in the hospital, but it aids compliance after pts go home.

Lundazi · Dec 7, 2012

Thank all for the information all Lantus insulin.This is helping me alot.I have a good understanding of it.Happy Holidays.