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Dr. Andrew Rynne

Family Physician

Exp 50 years

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How can elevated blood sugar levels be managed after missing a dose of Lantus?

Answered by
Dr. Mirjeta Guni


Practicing since :2006

Answered : 2023 Questions

Posted on Fri, 25 May 2018 in Diabetes
Question: I take two doses of 21 units of lantus per day, one at 7 am and the other at 7 pm. I failed to inject the dose which was due at 7 pm last night, but did inject the doses which were due at 7 this morning and 7 this evening
Now, at ll pm this evening my blood sugar has risen from 187 at 7 pm to 200. It was 135 at 7 am this morning prior to first bolus feeding, 116 at 11 am feeding, 141 prior to 3 pm feeding, and 187 prior to 7 pm feeding, the final feeding of the day. Novolog was given prior to each feeding in accordance with a sliding scale provided by my Endocrinologist. What, if anything, should I do between now and 7 am if the blood sugar level continues to rise. which it appears likely to do.
Answered by Dr. Mirjeta Guni 2 hours later
Brief Answer:
Increase rapid dose:

Detailed Answer:
Hello and thank you for asking!
I can understand your concern.
As lantus effect is 16-24 hours, it is expected to have high blood sugar for some hours if a dose is missed.
What we suggest in these cases is to keep monitoring the blood sugar and do higher doses of rapid insulin during these hours ( probably 4 units more before each meal if the blood sugar before the meal is higher than 140 mg/ dl).
Do not worry because the values you reported are not worrisome if they are only for 24 hours.
Hope the information will help.
Kind regards,

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