Can someone tell me how lantus works?

[IrishJoe]

Can someone tell me how lantus works?

im on lantus (12 units bedtime 11pm +/- 1hour) and novorapid (3 injections dialy 6/5/12) i know how novorapid works but how does the lantus work ?

Also why does it feel tingly/stingy or 'cold' going in even though its actually room temp ?

Also how does it work ? is it slower releasing or a larger molecule that breaks into insulin more slowly or what ? :confused:

[Lloyd]

Can someone tell me how lantus works?

im on lantus (12 units bedtime 11pm +/- 1hour) and novorapid (3 injections dialy 6/5/12) i know how novorapid works but how does the lantus work ?

Also why does it feel tingly/stingy or 'cold' going in even though its actually room temp ?

Also how does it work ? is it slower releasing or a larger molecule that breaks into insulin more slowly or what ? :confused:

It is more acetic than your skin, so it tends to "burn". The larger the dose, the more you experience this.

Lantus crystalizes after you inject it, and the crystal dissolves slowly, releasing insulin as it does so.

-Lloyd

[Scratch]

Lantus has a ph of about 4, so it's acidic and that's why many people feeling a burning or stinging sensation. Being acidic in the way it is causes it to release a fairly slow and steady rate over time, in some people for a period of 24 hours, others experience more rapid uptake.

[LancetChick]

Well, THEORETICALLY, at least, Lantus is a liquid only when the pH is very acidic, but turns to a gel when the pH is raised, causing it to be absorbed much more slowly (hence the variable rates of absorption among different individuals, and why it works well for some and not for others). Apparently, the pH is raised the instant it comes into contact with the body once it is injected, or if it is mixed with another insulin, which is why Sanofi-Aventis advises you never to mix Lantus with any other insulin.

On the other hand, there's experience, and I can tell you that I have mixed Lantus in the same syringe with both Humalog and Regular with good success (didn't turn into a gel in the syringe, and each insulin did its job as expected). I've used a single syringe over and over for both Lantus and Humalog, however (without mixing them), and I did notice a gel residue forming after a while. Lantus always worked very well for me, for some reason, but I know that some have real problems with absorption, so it doesn't stand to reason that my little mixing experiments would automatically be duplicated in others.

[KCP]

OK so does this mean that if I have been injecting it around the same area then i may need to move my injection site around? IM starting to feel lumpy spots!!

[Scratch]

OK so does this mean that if I have been injecting it around the same area then i may need to move my injection site around? IM starting to feel lumpy spots!!
It's always a good idea to rotate over as much flesh real estate as you can, because repeated trauma, with insulin, in the same area over and over can cause lipotrophy -- increased fat formation -- and it can also cause absorption issues.

[KCP]

yea, i think i have a fear amount of that! ive been injecting around the lower abdomen for a vey long time now lol
How is lantus absorbtion when injected in the upper thigh??

[BlueSky]

Injecting into any fatty tissue is fine. The butt is the best place, if you can turn around far enough ;) .

[The_QUIET_one]

Welcome to lantus IrishJoe. Actually I have to say till I read this thread I had no idea how lantus worked at all, thanks everyone.

Injection sites are supposed to be rotated quite often. When I was on injections I rotated a cycle throughout. The back of both arms, my belly, my behind, and my legs. that just worked for me.

[KCP]

yea i also recommend rotating alot...
believe me after 17 years, its something you pick up! <sorry grumpy day>
I had difficulty injecting my novo rapid into my legs cos of the absorbtion rate, but didnt wonder about changing lantus to legs only... will give it a go..

[IrishJoe]

yeah I rotate a lot too. Thanks. I was wondering how it was slow releasing. as you can see I thought maybe it was a longer molecule (or mixed with a some polymer) so that it would take longer to break down. But the gel/acid stuff makes sense. Thanks :D

[Eddy]

I was wondering how it was slow releasing. as you can see I thought maybe it was a longer molecule


Not a bad thought. That's how Levemir works: It has a long "tail" that binds it to albumin, which then slowly releases the insulin detemir.

Also, FWIW:

http://www.diabetesforums.com/forum/diabetes/29395-basal-lantus-vs-levemir.html

Note well table 1: Although Lantus is easier to predict than NPH, it's nowhere near as predictable as some people say. I prefer the slightly-peakier-but-more-consistent Levemir.

[BlueSky]

Levimer certainly seems to be a lot less variable than Lantus. But I found the action profile graph even more interesting. The Lantus graph has a much bigger peak than the manufacturers suggest. And there is not a lot of difference between the action profiles of Levemir and NPH. I would like to try Levemir, but it is not funded here ... :(


http://i288.photobucket.com/albums/ll181/stratplan/basalinsulincomparisonandvariabilit.jpg

[jennyz]

It's always a good idea to rotate over as much flesh real estate as you can, because repeated trauma, with insulin, in the same area over and over can cause lipotrophy -- increased fat formation -- and it can also cause absorption issues.
Does anyone know of a way to get rid of lipotrophy? I have it in my lower abdomen as well.

[Alene]

Does lantus start to work as soon as you start taking it? Or does it take an hour or two to kick in?

[Lizzie G]

this is a really interesting thread (or am i just becoming a diabetes bore!)....i definitely think there is a lot to be said for the 'everyone is different' line of thought on absortion rates.

i can say with some certainty that lantus lasts out a good 26 to 28 hours in me. yet NPH is definitely done with after 8 hours. i was quite surprised by the graph BlueSky posted as I thought NPH was supposed to be done pretty quickly. Also, i know a lot of people speak of splitting lantus and that duration of action can be dose dependent hence letting it cover 2 distinct phases of basal requirement; i tried splitting and it seemed to make no difference. perhaps i am very alkaline (like any good battery...) and hence the absortion is slower of lantus.

my other spurious contribution to this thread regards injection site. i used to almost exclusively inject in what i fondly call 'cuddles' ie my lower abdomen. however, as time has gone on i use my thighs and arms far more. i do a lot of swimming so my arms are quite active and moreover i spend a lot of time outside absorbing sunlight (is that vitamin A or D i dont remember). anyhow, i think the combination of the active tissue and sunlight makes a huge difference to healing; you cant even see marks on my arms whereas my tummy you can, so to anyone that hasnt tried it id say give it a go!!!

[Eddy]

perhaps i am very alkaline


Oooh. Lizzie admits to being caustic!

:vroam:

[Eddy]

Apologies for the thread bump. It seems that enough basal questions exist that I'm trying to aggregate various bookmarked threads into one easy location. Hope this helps.

http://www.diabetesforums.com/forum/diabetes/36850-ramblings-about-basal-regimen.html