What Happens If You Miss Your Lantus Insulin Dose at Night?

Consequences and Precautions for Missing a Dose of Lantus Insulin at Night

Lantus is a long-acting insulin used to control high blood sugar in people with diabetes. It is often prescribed to be taken once daily at night to provide steady insulin coverage overnight and through the next day. But what if you forget to take your Lantus dose before bed? Missing a dose can disrupt your blood sugar control. This article will cover the potential impacts, what to do if you miss a dose, and tips to prevent forgotten doses.

How Lantus Long-Acting Insulin Works

Lantus contains the active insulin ingredient glargine. It is engineered to release small, steady amounts of insulin over 24 hours to keep blood sugars even. Taking Lantus at night helps control the rise in blood glucose that can happen overnight and prevents high morning blood sugar.

Lantus starts working within 1-2 hours of injection and keeps working with no peaks or dips in insulin action. It cannot be mixed with other insulins and is prescribed once daily based on a person's needs.

Consequences of Missing a Dose

Taking Lantus consistently at the same time each evening is important for maintaining its 24-hour coverage. If you forget to take your scheduled dose, you will have no long-acting insulin in your system until you take your next scheduled dose.

This lapse in insulin can allow blood sugars to rise out of the target range. Effects may include:

• Higher fasting and morning blood glucose levels
• Rebound high blood sugar throughout the day
• Increased thirst and urination
• Fatigue, headaches, blurry vision
• Potential diabetic ketoacidosis if untreated for longer periods

Over time, running consistently high blood sugar can increase risks for diabetes complications like nerve damage, kidney disease, vision issues and cardiovascular disease.

What to Do If You Miss a Dose

If you realize you forgot your scheduled dose of Lantus, take your normal prescribed dose as soon as you remember. Do not take an extra dose or double up to make up for the missed dose. Then, get back on your regular dosing schedule.

Be sure to closely monitor your blood sugar levels after a missed dose. You may need to check more often until levels stabilize - up to 4-6 times daily. Watch for high readings and treat accordingly with rapid-acting insulin or other medications as prescribed by your doctor.

Inform your healthcare provider about the missed dose at your next appointment. They may recommend adjusting your Lantus dosage or timing if forgotten doses become a pattern.

Preventing Missed Doses

To avoid forgotten Lantus doses, consider these tips:

• Take Lantus at the same time each evening to build a routine.
• Pair it with another part of your nightly wind-down for a cue.
• Use a pill box organizer or counting method to track doses.
• Set phone alarms or calendar reminders for your Lantus time.
• Keep your Lantus pen and supplies together in one spot.
• Ask a family member to help remind you if needed.
• Mark missed doses on your log so your provider is aware.

Alternative Insulins and Dosing Options

If you frequently forget your scheduled evening Lantus dose, talk to your doctor. They may recommend switching to an alternate long-acting insulin such as:

• Toujeo - Very similar to Lantus but lasts slightly longer, up to 36 hours.
• Tresiba - Lasts up to 42 hours so can be dosed less frequently.
• Basaglar - Essentially a generic form of Lantus, dosed once daily.

Your doctor may also suggest changing when you take your Lantus for better compliance. Some options include:

• Morning dose - Taking Lantus in the AM can also provide 24-hour coverage.
• Split doses - Dividing your total Lantus dose into twice daily injections can help if you miss evening doses.
• Flexible timing - Working with your doctor to shift the time +/- 1-2 hours can accommodate changes in routine.

Incorporating Other Diabetes Medications

If Lantus is proving difficult to take consistently, your provider may prescribe additional oral or injectable diabetes drugs to use alongside a reduced Lantus dose. Some options include:

• Metformin - An oral medication that lowers blood sugar levels.
• GLP-1 agonists - Injectable drugs like Ozempic that stimulate insulin production.
• SGLT2 inhibitors - Oral medicines such as Invokana that block kidney glucose reabsorption.

Adding one of these drugs can improve overall blood sugar control with less reliance on precisely-timed Lantus doses.

Using an Insulin Pump

For those who really struggle with Lantus injections, insulin pump therapy may be an alternative. An insulin pump continually delivers rapid-acting insulin under the skin via a catheter. Programmed basal rates mimic long-acting insulin. The pump can be disconnected temporarily if needed.

Pump basal rates adjust automatically to account for missed doses. However, pumps require careful monitoring and maintenance. Work closely with your healthcare team to see if pump therapy could be an option.

Risks of Frequently Forgotten Doses

While an occasional missed Lantus dose can be remedied, frequently forgetting or skipping doses is dangerous for your health. Consistently missing your Lantus can lead to:

• Loss of blood sugar control
• Increasing insulin resistance
• Higher A1C test results
• Increased risk for ketoacidosis
• Acceleration of diabetes complications
• Need for hospitalization

Make sure your provider is aware if you are regularly

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.