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Insulin Kinds of insulin, action profiles, use in dogs, where to buy, etc.

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Old 11-04-2008, 03:13 PM
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Default Insulin Depot

I confess my position is based in complete technical ignorance... I just don't see much evidence of an insulin depot in the diabetic dogs I've encountered.

Kathy, is this something you happen to be an expert on?

Can you enlighten me?

We varied Chris' insulin dose often. Granted, he was on a faster-acting insulin, but with so many dogs getting barely 12 hours from NPH or Vetsulin, I just can't make sense of the concept of a depot... Maybe I expect more effect from it than I should?!?!?

Natalie
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Old 11-04-2008, 04:05 PM
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Default Re: We Hope - insulin depots

Natalie,

http://petdiabetes.wikia.com/wiki/Insulin_depot

"One's subcutaneous "spare tank" of insulin, which has yet to be used by the body.

"Because no insulin injection is immediately 100% absorbed by the body, the yet to be used insulin stays under the skin, the system drawing on this "reserve" as needed. Any such insulin effects that last after the insulin's expected action is over are also known as carryover in some literature.

"If you're using only intermediate-acting or long-acting insulin alone (without any short-acting insulin), about 24 hours worth of insulin requirements are in your depot.

"The larger your insulin dose, the larger the insulin depot in your subcutaneous fat tissue. Having a large vs smaller insulin depot means the effect of the insulin can be less consistent--more chance of it varying from day to day. This same insulin depot is the reason why it can take anywhere from 2-5 days to see any effect of insulin dosage changes.

"This handy "extra tank" is also there to give you a hand if you miss or are late with an injection.

"On the other hand, when you do miss an injection, your "spare tank" is very low by next injection time, and so the next injection may have less effect than expected!"

We need to realize also that most dogs' required number of insulin units is less than an adult human, because of size. Going on that, an adult would have a larger depot than most dogs. And we need to go back to our friend, Dr. Hanas:

http://www.childrenwithdiabetes.com/...as_insulin.pdf

Pages 10 & 11 are where she speaks about the insulin depot.

Re: some dogs using the insulin too quickly, we need to remember that U 40 insulin is absorbed faster--will go to work faster and have shorter duration than U 100 insulin does, and also that there's quicker absorption for an insulin which is identical to the one your pancreas used to create.

With pork being identical to canine insulin just as the r-DNA human insulin is identical to native human insulin, the absorption of that for people is faster than if the person uses either beef or pork insulin. So the absorption for pork insulin used in dogs would be faster than if they used human or beef insulin.

Chris' R insulin was made to be used quicker than the intermediate and long lasting insulins. There's no suspension or alterations to the insulin chains (analogs) to slow its being used by the body.

When we had the weak Lilly pork Lente, Lucky didn't immediately show signs of a problem--it took about a day or two for us to see something wasn't right. While we were trying to use either human or beef insulin with him, the depot was negated by his immune system deciding these insulin were "invading" his body like a bacteria, etc., and just literally destroying them within a few hours.

If there wasn't some type of depot, we wouldn't need to wait around 2-5 days to see the effects of an insulin increase--we'd see it faster than that when increasing the intermediate and long-acting insulins.

Also, when an insulin shot is missed, while we may see the dog's bg's higher than we'd like for a bit, getting back on track with the next shot as normal without any increasing, then keeping to schedule will get things back to where they should be.

A missed shot doesn't mean we start to regulate all over again; we'd need to start from scratch if there wasn't something in the insulin depot to help us get past the missed shot.

Basing it on this, I'd say there is an insulin depot--it's certainly not enough for you to miss a shot and not see some higher bg's from it, but I believe it's there because we need that waiting period for the insulin increase to "kick in" and that we don't need to re-regulate when a shot is missed.

Kathy
  #3  
Old 11-04-2008, 04:16 PM
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Default Re: We Hope - insulin depots

I understand the 12-hour (or so) depot from a single injection... that it is "released" from the additives used in intermediate acting insulins to slow down its absorption over time. That makes total sense to me.

So is it possible for a dog on two injections a day to have short enough duration if they metabolize the insulin quickly so that basically there is no depot left over by the next injection?

I know the 2-5 days concept is standard practice, I know some dogs who need that time to adjust, and I agree that it's a good practice especially in the beginning as you're working toward a long-term dose.

What I've often questioned is whether all dogs need that or whether some respond the way they're gonna respond on day 1. And whether fast metabolizers have any depot at all.
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Old 11-04-2008, 04:36 PM
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Default Re: We Hope - insulin depots

The more I think about it, the more I think it's how I've defined depot in my head that's mistaken... that I've been looking at the term as something it isn't necessarily.

If I look at it as just the last of the insulin from the preceding injection, then I can see that there would be a depot carrying through... since rising BG doesn't necessarily mean there's NO insulin left, just not enough to counter the rising blood sugar.

And that a dog whose complete duration on an injection might be 18 hours could start to accumulate a slowly growing depot as those injections overlap. Which would become evident when the blood sugar gets down into a normal range.

I think I've improperly defined/understood the term.

Does that make sense?
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Old 11-04-2008, 04:58 PM
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Default Re: We Hope - insulin depots

Perfectly! Because when you look at the Time Activity Profiles of any of them, those we know are intermediate-acting--NPH and Lente--are shown as "being around" 22-24 hours after the shot.

Not to say this isn't true because when they came up with these profiles, they measured whether there was still insulin left in the blood they could identify. It doesn't mean there's enough of it there to do a good job of controlling bg's, but it can be found and identified yet in the bloodstream.

We can look at it in the same way when we look at an insulin's onset.

http://petdiabetes.wikia.com/wiki/In...s_.26_dynamics

Kinetics refers to the time when an insulin can be measured in the bloodstream. It's important to understand that even though it's "officially" made its way there, the insulin has not yet done so in sufficient quantity to effectively begin to lower blood glucose.

Insulin Dynamics is the point where it has an effect on blood glucose levels.



The dotted line shows insulin entering the bloodstream (kinetics).
The bold line (dynamics) illustrates the insulin at the point where
blood glucose is lowered by it.

If we liken this to taking an aspirin for a headache, the aspirin doesn't relieve the headache the second you swallow it--the dynamic phase is when it relieves your headache. If you need to take more aspirin because the headache comes back, there's still some of it left in your system. Not enough to relieve the headache, but it's still there and that's why the aspirin bottles say X number of tablets every so many hours. So there's an "aspirin" depot too!

Kathy
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Old 11-04-2008, 11:29 PM
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Default Re: We Hope - insulin depots

Reading this seems like what the vet told me awhile back as to decreasing the evening dose, but her term was overlap, but I can understand what you guys are talking about, makes sense.
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