Juicebox Podcast: Type 1 Diabetes

Episode #1755 – Defining Diabetes: Lantus Lows

Date: January 31, 2026
Host: Scott Benner
Guest: Jenny
Theme: Understanding the term “Lantus Low” and how long-acting basal insulin (specifically Lantus) can sometimes cause low blood sugar.

Episode Overview

This episode of the ongoing "Defining Diabetes" series tackles the community-submitted term “Lantus Low.” Host Scott Benner and diabetes educator Jenny examine what people mean when they use this phrase, dig into the mechanics of how Lantus (a long-acting basal insulin) can sometimes cause hypoglycemia, and discuss strategies for avoiding these lows. The conversation includes real-world anecdotes, physiological explanations, and practical tips for identifying and handling potential Lantus-related lows.

Key Discussion Points & Insights

1. What Does "Lantus Low" Mean?

• [01:37] Scott: “This is one of the things people want defined. So what do they mean? Are they talking about like their blood sugars just keep getting dragged down by basal?”
• [01:46] Jenny: Suggests that a "Lantus low" happens when Lantus (basal insulin) brings blood sugar down lower than intended, especially in the absence of bolus insulin or recent food intake.

Key Points:

• Lantus is a 24-hour, long-acting insulin, dosed usually once daily.
• Unlike intermediate insulins, Lantus has a flatter effect, reducing extreme peaks and drops.
• However, some users report blood sugar “lows” seemingly due solely to Lantus, particularly overnight.

2. Evaluation of Basal Insulin and Lantus-Related Lows

• [02:16] Jenny: “Usually we would do basal evaluation to note whether the dose is right or not by looking at overnight... If it's pulling your blood sugar down… the dose would need to be adjusted because the basal's job isn’t to pull you down.”

Key Points:

• Basal evaluation typically occurs overnight, as other variables (food, activity, rapid-acting insulin) are minimal.
• If blood sugar falls overnight, this points to a possible “Lantus low”—i.e., an excessive basal dose.
• Basal insulin should hold blood sugar steady, not lower it beyond necessity.

3. Individual Variability of Lantus Effect

• [03:33] Jenny: “For me, Lantus was my transition to a long acting basal coming off of that cloudy intermediate. And for me, I can say that had I not adjusted it and also always had a nighttime snack, I would have been consistently low during the overnight time.”

Key Points:

• The “plateau” of Lantus can differ by person.
• Some experience a stronger Lantus effect at certain times, or find that the insulin does not last the full 24 hours, running out sooner (about 20 hours for some).
• Individual factors like activity, food, and hormonal cycles (for women) affect Lantus’s impact.

[03:33] Jenny: “Is there a peaking time? Not like the intermediate insulins, but there could be a time period where it seems to really work heavier.”

4. Contextual Factors That Can Lead to Lantus Lows

• [04:42] Scott: Offers a scenario: a person with a sedentary weekday job but high weekend activity, using the same Lantus dose every day, may encounter lows on their more active days.
• [05:01] Jenny: Notes menstrual cycle influences basal needs: “I had a dose for the time period after my period started and up until kind of mid cycle... Then I had a dose for that week before that was three units higher.”

Key Points:

• Activity and hormonal changes can lead to increased sensitivity and greater risk of basal-induced lows.
• Adjusting the dose for different life situations (e.g., exercise, menstrual cycle) is a practical strategy.

5. Advice on Identifying and Avoiding Basal Lows

• [05:34] Scott: Encourages listeners, when encountering overnight lows, not to immediately blame Lantus but to “zoom out a little more and see the other things that are affecting them.”
• [05:57] Jenny: Agrees, highlighting that many variables beyond just basal insulin could contribute to lows.

Notable Quotes & Memorable Moments

• [01:46] Jenny: “You can’t… Lantus being a long acting insulin, it’s dosed typically once a day. It’s supposed to be a 24-hour acting insulin.”
• [02:16] Jenny: “The basal’s job isn’t to pull you down.”
• [03:33] Jenny: “I would have been consistently low during the overnight time.”
• [04:42] Scott: “It would be easy for somebody to say my basal insulin is pulling me down, instead of thinking my activity is making me lower.”
• [05:34] Scott: “I would probably try to ask those people to maybe zoom out a little more and see the other things that are affecting them.”
• [05:57] Jenny: “You might find the variables that are creating [the low] are at hand.”

Timeline of Important Segments

| Timestamp | Topic/Content | |-----------|--------------| | 01:37 | Initial definition and question: What is a "Lantus low"? | | 02:16 | Basal evaluation and how to diagnose a Lantus-induced low | | 03:14 | Variability in Lantus effects and anecdotal experiences | | 04:42 | Impact of activity and routines on basal insulin needs | | 05:01 | Hormonal impacts, especially for women (cycle-related dose adjustments) | | 05:34 | Encouragement to broaden perspective beyond just blaming basal insulin |

Tone and Takeaways

The episode is conversational, supportive, and practical—reassuring listeners that “Lantus lows” can be nuanced and are rarely attributable to just one factor. Both Scott and Jenny advocate for individualized management, ongoing self-evaluation, and an open-minded approach to troubleshooting.

Final message: Understanding the real causes of overnight or unexplained lows with Lantus is less about blaming the insulin and more about seeing the bigger picture—including dose timing, lifestyle, hormonal shifts, and activity patterns. Awareness and small adjustments can go a long way in staying safe and achieving steady blood sugars.

For more definitions: Check out the full "Defining Diabetes" series at juiceboxpodcast.com.