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

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  #11  
Old 06-11-2009, 12:46 PM
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Default Re: Hello! Rolo and I are new here.

Grace,

What's said when you talk about Lantus vs Levemir is that Levemir has more consistency in both the same patient and from patient to patient than Lantus does.

There's also the way each one does its job. Lantus forms crystals under the skin and after that, they absorb very similarly to the way the rest of the suspended insulins do--by the crystals being absorbed gradually. Levemir's action is to bind to the albumin in the blood to produce its effect, so there's nothing to "break down", if you will, as in Lantus and the suspended insulins.

With Levemir, there's no waiting for any crystals, whether they're in the vial and injected or are formed under it after injection by the reaction between Lantus and the pH of the skin. Levemir's "suspension" takes place in the bloodstream, with the binding to the albumin in the blood.

Some people put the knock on Levemir because it's approved for being used once or twice a day, depending on the patient's needs. Lantus is approved for once daily use. But when you talk with people who use Lantus, it becomes clear that many of them didn't work out with once daily dosing; they're on twice daily split dosing, which would be considered "off label" (nothing wrong about using a drug off label). Have a friend who has been using it twice a day for a long time--once daily didn't work for her.

The big "sell" on Lantus from Sanofi-Aventis has always been once daily dosing. The big "sell" on Ultralente insulin was always that it was once daily dosing. That more often than not didn't work out for the people using it, and they needed to use it twice daily. Both Novo and Lily discontinued their Ultralente insulins in the period between 2003-2005 because neither of them were selling enough of it to keep up production.

I'd believe the Levemir onset is because of its action.

Kathy
  #12  
Old 06-14-2009, 08:41 PM
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grace.device grace.device is offline
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Default Re: Hello! Rolo and I are new here.

Good news and bad news from our curve yesterday. I tried thought the green beans had no effect based on the urine test but I was wrong. I left out the evening snack all together yesterday and today and still got a massive spike

Saturday:
0745 - 220 (+ breakfast, 1.0U Levemir, 0.2U NR)
0945 - 157
1145 - 146
1545 - 212
1945 - 398 ( + dinner, 1.0U Levemir, 0.3U NR)
2145 - 306

Sunday
0745 - 184 ( + breakfast, 1.0U Levemir, 0.15U NR- the drop yesterday was a little much)
0945 - 169
1145 - 121
1745 - 185
1945 - 375 ( + dinner, 1.0U Levemir, 0.3U NR)

Today's numbers were great, and if it weren't for that spike I wouldn't change a thing! Rolo has never had such consistency or such good numbers. Tomorrow I will start giving her dinner at 1745 with her NR, and leaving the Levemir until 1945, so the NR will cover the gap in duration (thank you "Using Insulin" for that trick). Luckily her night dose seems to be giving her adequate duration, judging from her morning fastings.

For now I am just going to keep the doses the same (0.15U NR and 1.0U Levemir), but I am sure I will have to adjust them now that they're not being given at the same time. Since I am going to be giving her evening Levemir at the peak of the NR, I want to make sure she does not get a drop from the NR so the Levemir doens't send her too low. I think the Levemir is what is causing the lowest number at 4-hrs post injection (146 yesterday, 121 today), so she may need a little snack before bed, but we'll see tomorrow.

I'll report back tomorrow with our results!

Grace
  #13  
Old 06-15-2009, 09:57 AM
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Default Re: Hello! Rolo and I are new here.

I know it will be a bit of a battle getting the NR to cover the gap - it needs to cover her food, and stop a 200 point rise. I will start conservatively tonight with 1/4U NR with dinner at 5:45pm and see where we end up at 7:45 for the Levemir. I don't think I'm going to increse the Levemir dose at all - she's pretty much below 180 most of the time. Plus, 1.0U Levemir keeps her steady all day even starting at 350-400 at 7:30pm, so it may bring her a bit lower when she dose not have that giant spike to contend with.

Grace

Last edited by We Hope; 06-19-2009 at 10:30 PM. Reason: removing non-Levemir-related information
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