[BriOnH]

I imagine everyone has run into this problem at somepoint:
You bolus up for a meal, and for some reason or another you can't get enough carbs in, or you just don't feel like eating anymore. I would like an insulin that I can give after I eat, not before. Could u400 insulin do this? I shouldn't be complaining, huma/novolog are great compared to the regular days, but I'd like just a little bit more, know what I mean?

[JediSkipdogg]

U-400 would help SOME. The problem is you are still giving it into fat and not straight into the bloodstream. If you inject U-100 into the blood stream the insulin will work at 50% in about 30 minutes. Then fully be out of the body in an hour max, usually within 60 minutes. That's why injecting into blood is very dangerous. Basically when people do it accidentally they will go low first, then pick back up to where they were and never have a peak during that meal

U-400 insulin and injecting under the skin works and is fully used in about 30 minutes, with a peak of 10 minutes and an instant punch start. And unfortunate to say, the fatter one is, the less pain they will have injecting, but the slower the insulin acts. Fat has an extremely low amount of nerve endings, but also a low amount of blood circulation.

So while the U-400 insulin that is used in trials and in some hospitals (I believe some places use it for your IV drips), it's not perfected yet for giving after a meal. The only way one will be able to give insulin after they eat is going on a pump and getting use to that then going to the implantable pump when that becomes available in about 5 years (my estimate since Europe already has it, not sure if that is in trials or to the general public though.)

[BriOnH]

Originally Posted by JediSkipdogg

U-400 insulin and injecting under the skin works and is fully used in about 30 minutes, with a peak of 10 minutes and an instant punch start.

I would LOVE insulin like this! How did you get so much info on this, if I may ask jedi? I've been googling it and couldn't find any pharmakenitcs on it.

[JediSkipdogg]

Originally Posted by BriOnH

I would LOVE insulin like this! How did you get so much info on this, if I may ask jedi? I've been googling it and couldn't find any pharmakenitcs on it.

Clinical trials and knowing where to search my pal. LOL, actually, I hope the above is accurate, I can't remember where I saw it at and it's been a while, so I'm going off the top of my head.

[BriOnH]

You tha man Jedi.

[DeusXM]

Another option might be to split your bolus for every meal - say, take 30% just before you eat, and then take the rest when you've finished, according to how much you've eaten. That way you're limiting how high your blood sugar goes whilst actually eating without having to play catch-up with your food.

[Lynne1]

Originally Posted by DeusXM

Another option might be to split your bolus for every meal - say, take 30% just before you eat, and then take the rest when you've finished, according to how much you've eaten. That way you're limiting how high your blood sugar goes whilst actually eating without having to play catch-up with your food.

That's a great idea!!! I think I'm going to try that.

[jen_slc]

Originally Posted by DeusXM

Another option might be to split your bolus for every meal - say, take 30% just before you eat, and then take the rest when you've finished, according to how much you've eaten. That way you're limiting how high your blood sugar goes whilst actually eating without having to play catch-up with your food.

Yup, that's what I do when I get that "hmm, are my eyes are bigger than my belly" feeling.

[BriOnH]

I do the same thing often. Sometimes I'll inject up to three times just for one meal (that's usually when I am running high before I eat). Once and a while I get caught off gaurd though. The other day I injected before eating and after I took my first bite I thought to myself "Uhg, I really dont feel like eating this now", granted it was very poor planning, but there was no option of going back, had to ingest 45 grams of carb or go low. It just kinda sucks to have to inject before eating instead of after, but such is diabetes. I really haven't thought through the consequences of eating first, if any.

[JasonSmithMT]

Originally Posted by JediSkipdogg

U-400 insulin and injecting under the skin works and is fully used in about 30 minutes, with a peak of 10 minutes and an instant punch start.

Jedi - I would love to see any pharmacokinteic information you know about pertaining to this. Everything I have heard is that the U-400 given subcutaneouly is only slightly, if any, faster than U-100 because of the decrease in volume.

Thanks - Jason

[JediSkipdogg]

Originally Posted by BriOnH

It just kinda sucks to have to inject before eating instead of after, but such is diabetes. I really haven't thought through the consequences of eating first, if any.

Until I got the pump I use to always inject after I ate. That was even during NPH and R days. My doctor actually told my mom to do that for me and then when I took over my injections I still did it afterwards. My reason was for exactly as you mentioned. I was a terrible kid and even a pickier eater. Therefore my mom was never sure what I would eat. Rather than risking going low, my doctor said to inject afterwards to make sure I ate.

Your A1C will run slightly higher doing that since your food will peak higher before the insulin brings it down, but there really shouldn't be too many problems from it.

[JediSkipdogg]

Originally Posted by JasonSmithMT

Jedi - I would love to see any pharmacokinteic information you know about pertaining to this. Everything I have heard is that the U-400 given subcutaneouly is only slightly, if any, faster than U-100 because of the decrease in volume.

Thanks - Jason

The main problem with finding info on it is that much of it is in German since Hoechst, a german company, is currently the only one I believe that makes U-400. I don't think Lilly makes it yet, or if they do, it's not widely known. I'll research into it more if I can find it.

[BriOnH]

I've also seen that there is u500 insulin, from what I read on it, it's for people that are very resistant to insulin (in the study which I am trying to refind by googling, this was classified as >200 units of insulin per day).

[JasonSmithMT]

Originally Posted by JediSkipdogg

The main problem with finding info on it is that much of it is in German since Hoechst, a german company, is currently the only one I believe that makes U-400. I don't think Lilly makes it yet, or if they do, it's not widely known. I'll research into it more if I can find it.

Wow ... time warp ...

Hoechst and Rhône-Poulenc merged to become Aventis in 1999 (or 1998 some where in there). In 2004 Aventis and Sanofi merged to become Sanofi-Aventis. Sanofi-Aventis does still make U-400 insulin for implantable pumps. Lilly makes a U-500 insulin.

Let me know if you find any pharmacokinteic info.

Jason

[JediSkipdogg]

Originally Posted by JasonSmithMT

Wow ... time warp ...

Hoechst and Rhône-Poulenc merged to become Aventis in 1999 (or 1998 some where in there). In 2004 Aventis and Sanofi merged to become Sanofi-Aventis. Sanofi-Aventis does still make U-400 insulin for implantable pumps. Lilly makes a U-500 insulin.

Let me know if you find any pharmacokinteic info.

Jason

LOL on the time warp. I kept on wondering how those two were related. When I first search I found Hoechst as the only one that made U-400. Then I search more and found Aventis as the only one that made it, and they were in the same city. I never put together that a merge took place.

I'll keep looking for info on the drugs. Maybe I'll search the FDA for a U-500 insulin now and see what I find.