 Hi, today we are going to talk about Lantas. Welcome to SugarMDs. I am Dr. Ergin, founder of SugarMDs.com. We are a virtual diabetes company. It's remote diabetes monitoring, telemedicine, 24-7 care, concierge care, you name it. So, basically, we help you from the comfort of your home, and we definitely are a great resource. Regardless of you being our patient or not, you will have to be our patient, of course, for us to give you specific advice. But for these type of videos, we try to help everyone who are on medications for diabetes or who have questions about diabetes, and I hope this video will be very helpful to you. Our goal is to keep your fasting blood sugars relatively controlled, because that's one of the important factors that you have to pay attention when you have diabetes. You have to control your fasting blood sugars, and you have to control your blood sugars after meals. Now, Lantas does not really help the blood sugar control after you eat. So, it helps to keep your blood sugar at bay, especially when you are sleeping or in between meals to prevent excessive blood sugar coming out from your liver. So, let's say you're on 20 units of Lantas, and you go to bed with 150 blood sugar. We expect you to wake up anywhere from 120 to 165 or so blood sugars when you're on Lantas. So, what happens when you're not on Lantas, and how do you know that you need Lantas, is based on a simple fact. If your blood sugars are rising overnight, even without eating anything, you probably will need basal insulin such as Lantas, Troceba, Tujao, or Levemere. And Lantas is most commonly prescribed medication still. It's not the best, definitely Troceba and Tujao work better. However, if your insurance covers Lantas, don't say no, because you will need it. Although there are better medications, the Lantas will still get the job done. So, let's say you're going to bed with 150, and you're waking up with 200 blood sugar, and that is repetitive. That's generally like you wake up and you're like, what happened? You know, I went to bed with relatively fair blood sugars, and my sugar is like super high in the morning. You would expect that your blood sugar would go down because you don't eat anything, right? But in diabetes due to relative insulin deficiency and excessive insulin resistance, your body, by mistake, make a lot of sugar. So, when you start taking Lantas, our goal is to keep your blood sugar at bedtime and the morning the same. Now, one misconception about Lantas or any other basal insulin is that people take so much insulin to try to bring their blood sugar in the morning, fasting, down to below 120 or 100. Now, why is it a mistake? So, the problem is, you know, you try to bring your blood sugar overnight from 300 down to 120. That is a risky behavior, because if your blood sugar is coming down like steep decline every night, what happens if you go to bed with a blood sugar of 150, you know, if your blood sugar is coming from 300 down to 150 one day, the next day, if you go to bed with 150, you may not even wake up because you are giving yourself too much insulin just to get the numbers right. But, again, you have to get the numbers right in a right way, in a correct way. So, if your blood sugar is 300 before you go to bed, you need to understand what is really causing the 300 blood sugar by the time you're in bed. So, if you're starting your day with 120, 130, 140 numbers, but you end up with 200, 250, 300 numbers, that means that the diet that you're on during the day or the medications you're on during the day is not right. So, we have to work on that. So, with sugar MDs, we basically monitor you with your blood sugars, with your medications, and we identify the problem immediately and then fix it immediately. So, we get you the right medications on the right time without waiting too long because early control of diabetes and timely control of your diabetes is the most important thing. Now, now you understand that the purpose of Lantus is to keep your blood sugar stable because if you're not on a medication that keeps your blood sugar stable overnight, Lantus is one of the medications that will help you do that. It's not the only medication that are a lot of other medications that are not insulin, such as Ozympic, Ribalcystrualicity, definitely can help you with these as well, but with the right choice of the medication on the right patient, you can get to your goal definitely a lot faster. Now, the side effects of Lantus, like any other insulin, it can cause low blood sugar. So, if you are taking excessively, like I said, if you're not taking it right, if you're not titrated correctly to keep your blood sugar stable, you may develop low blood sugars. Another thing that can cause low blood sugars is if you're doing something extraordinary or unusually different, such as excessive exercise or not eating well at all due to low appetite or due to sickness or anything like that, that can definitely increase your risk of low blood sugars with Lantus. So, these are the times that you can just text your coach at SugarMDs, tell them what is different and tell them how to adjust your medication and get an immediate answer. With that, I think we will move on to the next side effect, which is the weight gain and excessive swelling and water gain can happen with Lantus as well, especially if you are excessively or aggressively treated with any insulin agent. There are a lot of ways to avoid weight gain and excessive swelling due to Lantus, and there are a lot of things we have to consider before we put you on this medication. Finally, we are going to actually explain to you how to take Lantus correctly, and that's another important feature that you should be paying attention to. Again, I'm Dr. Ergin at SugarMDs.com, and we will move on to the practical aspect of the Lantus. All right, everyone, let's talk about the practical aspects of Lantus. So, again, this is a pen. There is 100 units per 1 milliliter, and there are 3 milliliters of insulin here, which means that you have 300 units in the insulin pen. So, you've got to take the cap off the pen, and you're going to remove this sealant, and you're going to put that on top of your pen, screw that on, and take the first cap, and then you will have another cap. Now, before you do that, you've got to clean your skin. You can do it after shower. It's okay. It doesn't have to be sterile. And the next thing is, you're going to consider this as your abdomen or your thigh, as you can see in this model. You can inject on your thigh right here, or in your abdomen, sparing your umbilicus area, and you can do it back up your buttocks, and it's a bit of a harm. So, having said that, you're going to consider this as your abdomen, and you're going to take the second cap off, and now we have to do priming. So, priming means that you are taking the air out of the pen needle, since you are using a pen needle, and you want every time, each time. So, you can do that one or two units, and then you see the little tiny insulin drop coming out. It means that you are primed now, and then you can go ahead and dial out to the insulin that you are prescribed. Let's say, in this case, it's 16 units, you dial that up, and now you're ready to inject. And then you go directly to the skin, especially for a 4 millimeter needle, just like this, very small, and you don't need anything longer. You can directly go into the skin just like this, and then push the plunger, and then give at least 5 to 10 seconds for a complete delivery of the medication. And then you can pull that back once you're done, and then you can remove the needle, and put that needle back into a safe container with a lid. And now you're back to zero, as you can see, and you're ready for the next reaction, next day. Again, this is a synthetic medication, long-acting insulin that you use only once a day. In very high doses, sometimes your physician may advise you to do it twice a day, but typically this pen is used only once a day. Thank you very much again for watching today.