How do I manage my insulin regimen with Lantus (insulin glargine) and Lispro (insulin lispro)?

Managing Your Insulin Regimen: Instructions for Lantus and Lispro

Start with 10 units of Lantus at the same time every night and 3 units of Lispro before each meal, adjusting based on blood glucose readings and using a sensitive sliding scale for additional coverage when needed.

Basal Insulin (Lantus) Management

Daily Administration

• Administer 10 units of Lantus (insulin glargine) subcutaneously once daily at bedtime
• Use the same time every night for consistent coverage 1
• Inject into the abdomen, thigh, or deltoid area, rotating injection sites to reduce risk of lipodystrophy 1
• Do not mix Lantus with any other insulin due to its acidic pH 2, 3

Dose Adjustment

• Check fasting blood glucose (FBG) levels every morning
• Adjust Lantus dose based on pattern of fasting glucose readings over a week:
  • If 50% of FBG values are above target (90-150 mg/dL): Increase dose by 2 units 2
  • If more than 2 FBG readings per week are <80 mg/dL: Decrease dose by 2 units 2
• Make adjustments no more frequently than every 3-7 days 3

Mealtime Insulin (Lispro) Management

Regular Dosing

• Administer 3 units of Lispro immediately before each meal
• Inject subcutaneously into abdomen, thigh, or deltoid, rotating sites
• Take Lispro within 15 minutes before eating 2

Sensitive Sliding Scale for Additional Coverage

• Check blood glucose before each meal and add extra Lispro as needed:
  • If pre-meal glucose >150 mg/dL: Add 1 unit
  • If pre-meal glucose >200 mg/dL: Add 2 units
  • If pre-meal glucose >250 mg/dL: Add 3 units
  • If pre-meal glucose >350 mg/dL: Add 4 units 2

Blood Glucose Monitoring

• Check blood glucose at least 4 times daily:
  • First thing in the morning (fasting)
  • Before each meal
  • At bedtime
• Additional testing recommended:
  • When experiencing symptoms of hypoglycemia
  • 2 hours after meals to assess post-meal control
  • Before driving or operating machinery

Hypoglycemia Management

• Keep fast-acting carbohydrates readily available (glucose tablets, juice, or hard candy)
• For blood glucose <70 mg/dL or symptoms of hypoglycemia:
  • Consume 15 grams of fast-acting carbohydrate
  • Recheck blood glucose after 15 minutes
  • Repeat treatment if blood glucose remains <70 mg/dL
  • Once blood glucose is >70 mg/dL, eat a small snack if your next meal is more than 1 hour away

Important Safety Information

• Never share insulin pens, syringes, or needles with others 1
• Store unopened insulin in the refrigerator
• Once opened, insulin can be kept at room temperature for up to 28 days 3
• Do not use insulin that appears cloudy, discolored, or contains particles 1
• Do not use Lispro at bedtime due to increased risk of nocturnal hypoglycemia 2

When to Contact Your Healthcare Provider

• If you experience frequent hypoglycemia (blood glucose <70 mg/dL)
• If fasting blood glucose remains consistently above 150 mg/dL despite dose adjustments
• If you require frequent use of the sliding scale (more than once daily)
• Before making any significant changes to your diet or exercise routine
• If you become ill, as insulin requirements may change during illness

Special Considerations

• The timing of Lantus can be changed from bedtime to morning if needed, but maintain consistency once you choose a time 2, 4
• If you miss a dose of Lantus, take it as soon as you remember but never double a dose
• Insulin requirements may change with physical activity, illness, stress, or changes in diet

Remember that this insulin regimen provides basal insulin coverage with Lantus and mealtime coverage with Lispro to mimic normal insulin patterns. Regular monitoring and appropriate adjustments will help achieve optimal blood glucose control.