Lantus

[rolvue]

Hello,

I have a questions about Lantus. Do I give Lantus insulin without meal? Lantus was schedule BID 0800 and 2200. Patient was order not to have breakfast only clear liquid before renal ultrasound. Right after ultrasound, patient goes to get MRI done. And not only that patient prefer to take Lantus with meal. This is her normal routine at home. I charted against the short acting insulin but I left the Lantus stay active until she comes back. I reported off to the next RN at 10:00 and told her I left the Lantus active because she prefer taking it with her meal. My thinking was that she may need this lantus insulin to help her control her blood sugar once she starts eating. Was it a good judgement or should I had charted against the Lantus? I'm just confused about Lantus. Her BS was 214.

[blondy2061h, MSN, RN]

Ideally Lantus is a basal insulin, used to maintain blood sugars in a fasting state. When used correctly, the sign of a well dosed Lantus dose is that if nothing is eaten after it's taken, blood sugar doesn't go up or down. So, given that information- the correct thing to do would be to give it.

Now, that's the ideal situation, and assumes a basal/bolus insulin regimen. More realistically, some people take only Lantus and their blood sugar will drop if they don't eat with it. If she has been taking it for awhile, she probably knows if she needs to eat or not. But, with a blood sugar in the 200's you had wiggle room. Also- she wasn't NPO. She was on clear liquids, which are usually full of sugar.

[rolvue]

OK. Thank you. I will keep this in mind.

[TheCommuter, BSN, RN]

Since Lantus is a basal insulin that lowers the blood sugar by only 1mg/dL to 2mg/dL per hour, it does not need to be administered with meals in most cases. For the vast majority of patients, it can be administered without regard to meals.