lantus

[Batty]

so my moms taking me to the doctor and wants to talk about getting me on lantus because she heard its one shot a day...but i on the other hand don't think that's -all- you take, it can't be right? cuz how does it keep your levels normal unless you're on a fixed diet and never eat more than what your diet allows you to for each meal and everyday. someone explain to me excatly how this one shot a day is suppose to control my diabetes that for a while even 4shots of insulin a day could barely manage?

i've looked it up, but how they explain it doesn't really make any sense. its long acting..but it lasts 24hours? none of my long acting insulin ever lasted more than a 8hours...

and apparently "possible side effects may include blood sugar levels that are too low (hypoglycemia); injection site reactions, including changes in fat tissue at the injection site; itching and rash; and allergic reactions. Rare but serious side effects may occur." I don't see how that's really worth chancing it..i've 4 out of 5 of my friends who took a birth control have the side effects and they were less serious than any of these!

[camjen1]

You also take a fast acting with meals such as Humalog or Novolog (I think that is the name)?

[Batty]

right now i'm on humulin R and N, but i've been on Humalog and it did nothing to help control my levels, i actually have better results with R and N over Humalog. but my mom wants to get me on lantus cuz its one shot a day over three shots a day which i do now.

[KickStart101]

Hi Batty: :hello: Originally, Lantus was supposed to be used once a day
but as different as people are this treatment became variable to suit the person. Some people have to take half of their initial dose in the morning
and the other half in the evening. The units of their new treatment with Lantus may change also to suit the person.
Being that you are a Type 1, as far as I know, you would also have to use
a fast-acting Insulin, just before meals. You definitely have to get more info
on this from someone here and discuss it with your Endo.
You also still have to stay around the guidelines of eating as a Diabetic or
your BS's will go outta control.
I am not on Lantus so someone else please comment.

p.s. I'm listening to CNN right now and wolf Blitzer(I think) is going to talk about Diabetes as being an epidemic as it is. Just like that article I think Cinnabon posted.

[jen_slc]

You have to combine it with a faster-acting insulin like Humalog or Novolog (or even Regular might work I think) to cover your meals. You will end up taking 1 shot of Lantus (or 2 if you split your dose 12 hrs apart), but you will also still have to take multiple shots of faster-acting insulin according to how/when you eat. As for the side effects, the ones you've listed sound to me like potential effects of injecting any insulin. The only noticeable thing I find with Lantus is a bit more sting when injecting.

[JediSkipdogg]

Jen hit it dead on and beat me too it. Most users on Lantus take 3-5 shots a day minimum. My brother takes 4, one Lantus shot in the evening at 10 pm and then a shot of Humalog with each meal (breakfast, lunch, dinner) based on the number of carbs he eats. If you eat a carbless meal, then you don't need one of those shots.

The major disadvantage with Lantus is that it's unknown if it will last 24 hours for someone until they use it for at least a week. And if you are on the 24 hour one shot method, then you have to religiously give that Lantus shot at the same time every day. My brother must give his every night between 10 and 11 pm. If he misses that by any amount then it can throw his levels off that night or the next night.

My bro also has no side effects or any pain from it that I know of and he has better control on Humalog and Lantus than anything he's been on before.

You say you can't take Humalog, can you explain more of why it didn't work? Maybe you could try Novolog instead, as it's suppose to be very equal to Humalog and I'm actually switching over to it in about a month.

[Batty]

well all of this only shows my point of there being no good reason to take Lantus since you still have to take the other shots. my moms under the impression because everything they tell you about lantus is that its a one shot a day, 24hour fix..that i'd only take one shot a day over three shots.


The major disadvantage with Lantus is that it's unknown if it will last 24 hours for someone until they use it for at least a week. And if you are on the 24 hour one shot method, then you have to religiously give that Lantus shot at the same time every day. My brother must give his every night between 10 and 11 pm. If he misses that by any amount then it can throw his levels off that night or the next night.

You say you can't take Humalog, can you explain more of why it didn't work? Maybe you could try Novolog instead, as it's suppose to be very equal to Humalog and I'm actually switching over to it in about a month.

in regards to your brother having to take it between 10-11 every night..i don't have that kind of deal with my humulin N right now. i'm suppose to take 32units at 10pm..but i take it anywhere from 9pm-1 or 2am. depending on where i am, what i'm doing and whether i have the insulin on me at 10. it doesn't effect my levels very much if i take it at midnight rather than 10, i'm just a unit or two higher in the morning.

and i can't take humalog because it doesn't work at all. i took it for a few months, and there was an increase in my levels...my mom forgot once that i was taking humalog instead of R and ordered me R a few months later and suddenly my levels started to go normal..we told my doctor and he switched me back, telling me to take the R at breakfast(with my N) and dinner like i was doing with the humalog and then the N before bed..and now my levels are pretty much better than they have been.

[am1977]

I'm surprised you are using R and N too :confused:. What is your control like now- A1c?

I guess you have to do what works for you, but if your control isn't where it should be- it's worth injecting more frequently and using a Regimen of Lantus for your basal insulin and Humalog/Novalog for meals.

JMO :nerd:

[ang]

no, lantus will not mean that you no longer have to take any fast acting insulin for meals or for correction. the benefit to lantus is that it doesn't have a peak when it would work the hardest (unlike NPH or lente) and is supposed to last for 24 hours. so if everything works as it should, if you took one shot of lantus for the day and didn't eat anything your blood sugar should stay stable all day. if you only took your long acting insulin and didn't eat anything your sugar would go low when it hit its peak. if it lasts for you for 24 hours that means you will give one shot of lantus for the day instead of two shots (generally) of another type of long acting.

[JediSkipdogg]

I guess my question is are you only taking one shot of N every day? Someone tell me if I'm wrong, but I thought N only lasted 12 hours max, so what do you do the other 12 hours of your day as a general insulin?

Also, how often do you test your BG a day? What was your last A1C?

Generally N is not reccomended anymore for people because it has a controlling effect on what you have to do and with the peak halfway through it can cause many people to have extreme lows and force them to eat a meal religiously at the halfway point.

[Batty]

I guess my question is are you only taking one shot of N every day? Someone tell me if I'm wrong, but I thought N only lasted 12 hours max, so what do you do the other 12 hours of your day as a general insulin?

Also, how often do you test your BG a day? What was your last A1C?

Generally N is not reccomended anymore for people because it has a controlling effect on what you have to do and with the peak halfway through it can cause many people to have extreme lows and force them to eat a meal religiously at the halfway point.

I don't take it only once a day.

breakfast - R + N
dinner - R
bedtime/10pm - N

I test maybe once or twice a day now, although i'm suppose to at every shot. i can't be bothered when i am at work during dinner hour and have only enough time to do my insulin and eat. my levels are under control though, i had to do a log for my doctor after my A1C came back and except for christmas eve and christmas day my levels don't go higher than 15(testing four times a day).

my last a1c was 8.3 a single point up from what it was before, because i had moved out a few months before so my eating habits have changed and my doctor took that into account, but it's still better than any of the control i've had before. i used to have a1c results when i was little of 10 and 11. and after taking humalog but switching back and after my teenage hormone years got better, so did my control..using R and N instead of humalog.

i rarely have a problem with highs or lows as it is now.

[JediSkipdogg]

A level of 15 is still considered extremely high. A 10 should maybe be the max you ever hit, but unless you test more than once or twice a day you will never know what you are running and in the long run it can cause more complications than you are trying to solve by not taking 1 minute to test before each shot. That's all it takes is 1 minute, maybe 5 times a day. I guess I find it hard to believe that you don't have extra time in your day to test more often. I guess I don't see how you say you rarely have a problem with highs and lows when you really don't even know what you are running.

[Simon]

I'm on Luntus once a day plus Novorapid with meals. It works well for me. I take the Lantus in the evening and check the BG in the morning, averaging over a few days I'm able to get the optimum dose and stick to it. The hard part is getting the dose of Novorapid right for the meals. This is improving as I get a list of meals and what dose each one needs. Ultimately this regime will in theory at least most closely mimic the insulin levels in a non-diabetic.

[Batty]

A level of 15 is still considered extremely high. A 10 should maybe be the max you ever hit, but unless you test more than once or twice a day you will never know what you are running and in the long run it can cause more complications than you are trying to solve by not taking 1 minute to test before each shot. That's all it takes is 1 minute, maybe 5 times a day. I guess I find it hard to believe that you don't have extra time in your day to test more often. I guess I don't see how you say you rarely have a problem with highs and lows when you really don't even know what you are running.

by highest being 15 i meant that if i was high, it was no higher than 15. and this is during the christmas and new year holidays, it's not very unusual to have a few highs during that time. i'm usually between 5-10(and yes, i know this for a fact because on my days off from work, i will test more..but i have school and work and there isn't always time to just pop into the staff room and do my bloodtest. unlike maybe yourself, i dont work a desk job. i am a bakery clerk, so i have to package all the product, help customers, clean, take phonecalls, take orders and such all day and sometimes i dont even take a break because theres so much work to be done, that if any of the clerks take a break, we'll get behind).

[Batty]

I'm on Luntus once a day plus Novorapid with meals. It works well for me. I take the Lantus in the evening and check the BG in the morning, averaging over a few days I'm able to get the optimum dose and stick to it. The hard part is getting the dose of Novorapid right for the meals. This is improving as I get a list of meals and what dose each one needs. Ultimately this regime will in theory at least most closely mimic the insulin levels in a non-diabetic.

what's novorapid? you have to have set meals so you can figure out your doses? so you can't sponatously change a meal in anywhere or it throws the count all off?

[JediSkipdogg]

what's novorapid? you have to have set meals so you can figure out your doses? so you can't sponatously change a meal in anywhere or it throws the count all off?

Novarapid is just like Humalog and Novolog but I think it's only in the UK or maybe it's Canada, not really sure. What I think he was saying by figuring out the doses is he knows if he has say Mac & Cheese that he needs to take 13 units of Novorapid. He uses that method instead of the true method of carb counting which would provide the best results and allow you to eat whatever you want whenever you want.

I don't have a desk job either, well, it kinda is, but I can't take a break when I want to, but I don't find it hard to find 1 minute to do a BG check to make sure everything is fine. And I use to work at McDonalds for 5 years and I found time in there too. I'm not trying to judge you or anything, just trying to help you get better control. And personally, you can't say you're in control without doing at least 5 checks a day at various times so you know what you are running then. Remember, an A1C only shows an average, so running 300, 40 and 40 in 3 checks shows the same as running 127 all 3 times. And the 127 will produce few if any complications, while the 300, 40 and 40 will produce MANY complications in time. And testing once or twice a day may only show the good times, not the inbetween meal times which is the most important times. Again, this is just my 2 cents.

[jen_slc]

Novorapid is the same as Novolog. Novolog and Humalog *technically* aren't exactly the same insulin protein, so they have very slightly different action profiles, but they are all classed as rapid-acting insulins.

With carb-counting, you can eat whenever you want/whatever you want on a Lantus/rapid-acting insulin regime. If you decide you need to skip lunch or push it back an hour or two, it's no biggie, you can do that with no problem. And you can decide on the spot what you want to eat, your meals are not set by any means! Your Lantus dose, assuming it's correct, will keep you stable until you want to eat. But just a warning, you'll need to test more, at least in the beginning, to determine how Lantus is working in you and to make sure you've got the right dose to keep you stable if you don't eat.

[Batty]

I don't have a desk job either, well, it kinda is, but I can't take a break when I want to, but I don't find it hard to find 1 minute to do a BG check to make sure everything is fine. And I use to work at McDonalds for 5 years and I found time in there too. I'm not trying to judge you or anything, just trying to help you get better control. And personally, you can't say you're in control without doing at least 5 checks a day at various times so you know what you are running then. Remember, an A1C only shows an average, so running 300, 40 and 40 in 3 checks shows the same as running 127 all 3 times. And the 127 will produce few if any complications, while the 300, 40 and 40 will produce MANY complications in time. And testing once or twice a day may only show the good times, not the inbetween meal times which is the most important times. Again, this is just my 2 cents.

well i've never let diabetes control my life, and i never will. i deal with it, but i don't go "oh i want a snack, better check" and whip out my meter everytime i wanna eat something. i might as well stay at home on disability saying i can't leave the house to work because i need to test everytime i wanna eat or drink something. sorry, but personally testing more than twice a day is just time wasting unless you're sick. when i was diagnosed i was told i only had to check three times a day..whenever i took a needle. now, my doctor says i can test once or twice if i can't find the time, and that he knows its harder when you're just getting out into the world to always test when you inject. i say i have good control because my blood sugars aren't like they were when i was little and when i was a teen..when other people decided what i should eat, when, and how much insulin to take.

a minute for you to test is like 5minutes for me. i work around food, so i'd have to walk all the way to the bathroom..wait in line because theres always a line to get into the female restroom since theres only one..do my test, and then wait for my finger to stop bleeding..or most likely have to call a first aid employee so i can get a bandaid since ANY open wound, no matter how small..even if its just a paper cut that isn't even bleeding just a little red..requires a blue bandaid on it at all times..and then of course a glove on it at all times. that 1minute to test..turns into about 20mins..considering its almost impossible to get a first aid attendant to show up right after you page them..and every bandaid they give out has to be writting up in the book with the person who requires the bandaid's information.

[Simon]

Novorapid is a rapid acting insulin taken with meals. It seems to peak at about 60 to 90 mins and is gone within 4 to 5 hours. It's not that I have to have set meals it's just that the dose is adjusted to the meal and if it's a meal I've never tried before it's harder to estimate the dose needed, especialy if it's a take-away or a resteraunt meal. Doses for meals I cook myself or take aways I have on a regular basis are easy. eg: for me:

Any small portion of meat, fish or poultry with 250g of potatoes + veg = 2 IU
Steak pie with 250g of potatoes + veg = 3 IU
2 prawn+mayonaise sandwiches = 3 IU
Small fish & chips = 4 IU
Chinese + rice = 5 IU

It works out at about 23g carbohydrate to 1 IU Novorapid but the relationship is not always that simple. I find it easier to have a list of meals to choose from than calculate the carbohydrate every time. I'm also so sensitive to insulin that one dose covers a wide range of carbohydrate so an acurate calculation doesn't always seem appropriate.

[am1977]

well i've never let diabetes control my life, and i never will. i deal with it, but i don't go "oh i want a snack, better check" and whip out my meter everytime i wanna eat something. i might as well stay at home on disability saying i can't leave the house to work because i need to test everytime i wanna eat or drink something. sorry, but personally testing more than twice a day is just time wasting unless you're sick. when i was diagnosed i was told i only had to check three times a day..whenever i took a needle. now, my doctor says i can test once or twice if i can't find the time, and that he knows its harder when you're just getting out into the world to always test when you inject. i say i have good control because my blood sugars aren't like they were when i was little and when i was a teen..when other people decided what i should eat, when, and how much insulin to take.

a minute for you to test is like 5minutes for me. i work around food, so i'd have to walk all the way to the bathroom..wait in line because theres always a line to get into the female restroom since theres only one..do my test, and then wait for my finger to stop bleeding..or most likely have to call a first aid employee so i can get a bandaid since ANY open wound, no matter how small..even if its just a paper cut that isn't even bleeding just a little red..requires a blue bandaid on it at all times..and then of course a glove on it at all times. that 1minute to test..turns into about 20mins..considering its almost impossible to get a first aid attendant to show up right after you page them..and every bandaid they give out has to be writting up in the book with the person who requires the bandaid's information.

Sorry, Batty, but I have to disagree with you :thumpdown. Diabetes does NOT control your life when you take the time to monitor frequently and take care of yourself- actually you are controlling it. Testing as a Type 1 is very important-it gives us the feedback as to if we are ok where we are or if we need to take some kind of action to correct. It's NOT a waste of time...it's worth every second it takes to test. By not taking the minute (or five, as you say) to test and monitor yourself, you are increasing your chances of ending up on Disability. I know you have said that you have improved your control over the years- and I think that's great :top: -but it would be in your best interest to try and get that A1c down under 7... and what can help you get there is taking that time to monitor your levels and possibly adjust your treatment plan.

Believe me, I know it's a pain to manage/monitor this disease 24/7, but isn't staying healthy and living a long, happy life worth the effort?

[Batty]

Sorry, Batty, but I have to disagree with you :thumpdown. Diabetes does NOT control your life when you take the time to monitor frequently and take care of yourself- actually you are controlling it. Testing as a Type 1 is very important-it gives us the feedback as to if we are ok where we are or if we need to take some kind of action to correct. It's NOT a waste of time...it's worth every second it takes to test. By not taking the minute (or five, as you say) to test and monitor yourself, you are increasing your chances of ending up on Disability. I know you have said that you have improved your control over the years- and I think that's great :top: -but it would be in your best interest to try and get that A1c down under 7... and what can help you get there is taking that time to monitor your levels and possibly adjust your treatment plan.

Believe me, I know it's a pain to manage/monitor this disease 24/7, but isn't staying healthy and living a long, happy life worth the effort?

i've been testing at breakfast and dinner the last few weeks because i've been working til 830 which means i get an hour break..and its been slow. my doctor told me to only test at breakfast and dinner. are you gonna correct him? anyways, everytime i've tested..i havent been above 10. what does that say?

[am1977]

I'm not trying to argue or be difficult...this is my opinion.

I am surprised that your doctor told you to test ONLY @ breakfast and dinner...that seems like an antiquated way of doing things :confused: and I'd suggest finding a new doctor. It's in your best interest to take care of yourself, even if it is an inconvenience in some way. If your doctor thinks testing so little is okay, then I'd have to question his thought process.

That's great that you haven't been over 10, but you only test 2 times a day. Aside from those two small moments during the day, how do you know what your blood sugar is doing the rest of the time? Obviously, it's bouncing around somewhat since your A1c was over 8.

It's your life and it's really your decision... If you are satisfied with things, then so be it, but I guess I think you should consider your future health. I'd hate to see that you are kicking yourself later on in life.

Good luck and Take care.

[Batty]

I am surprised that your doctor told you to test ONLY @ breakfast and dinner...that seems like an antiquated way of doing things :confused: and I'd suggest finding a new doctor. It's in your best interest to take care of yourself, even if it is an inconvenience in some way. If your doctor thinks testing so little is okay, then I'd have to question his thought process.


well not only does he have a few diabetic clients..as well as when i first started going to him he was in the -same- office as my specialist so for the first year of be being his client i would have appointments with them -both- at the same time...and they agreed on everything. plus my specialist told me to keep going to him after he moved offices..because i can't go and see my specialist more than once a year(and hes one of two on the whole island) and recommended my doctor to deal with my diabetes the rest of the time. he knows i only test twice a day if i can't do it before bed. i was started on 3-4times a day shortly after my honeymoon period was over by the diabetic team at the hospital..and when i started going to my specialist when i was 13 he said i could go down to 2-3times a day, and the diabetic team said that was alright as well..so its not like its my regular doctor is the only one saying its okay, and when we talk about my diabetes and theres something that will effect me greatly, he always calls my specialist and they discuss it before any huge change is made.

[Xonelith]

Well, I would have to agree with almost everyone here. Your specialist seems like he doesn't know a whole lot about diabetes. I suspect you may have misinterpreted his comment. As for your other doctor agreeing with him, I would ignore that other doctor, as my experiences have proven that 95% of non diabetic specialists know nothing about the proper treatment of diabetes (in particular emergency staff at hospitals). I have switched specialists 8 times since I started looking after my own treatments, and I would suggest you do the same.

As for the amount of times you test, I used to feel the same way as you. I've had T1 since I was 3 and assumed I 'knew' how I felt. I think my A1C's were 9 or 10, and in my opinion was good enough. You test more than I did!!(I didn't test at all)

Once I found an appropriate endo, I realized that what I was doing, was not in my best interests, as the possible 'side effects' kind of suck (ie impotence, missing limbs etc).

I started to test my blood and found that the 'good' levels I thought I had were incorrect. I was bouncing from 4 to 22!!!! Kind of explained the drowsy times of day I was having...LOL

Anyway, I suggest getting a good meter that reads the results quickly and using small lancets to minimize the healing time. If your employer has an issue with that, than I'd be really surprised (maybe wear some gloves if it is a really big deal).

[someone]

Yes, Lantus does require more than one shot. You actually end up taking more shots than you would with something like NPH. The advantage is that you only take a shot when you have carbs. There are no set times for meals or carbohydrate restraints. When I was on Lantus, I was taking 7-8 shots a day (I know it sounds terrible, but it is not that bad.).

[Batty]

Yes, Lantus does require more than one shot. You actually end up taking more shots than you would with something like NPH. The advantage is that you only take a shot when you have carbs. There are no set times for meals or carbohydrate restraints. When I was on Lantus, I was taking 7-8 shots a day (I know it sounds terrible, but it is not that bad.).

but i dont carb count and i never will, so i guess it wouldnt work for me

[someone]

How can you not carb count?

[Batty]

easy, when i was diganosed, we weren't told to carb count. i'd never heard of carb counting besides in those diets(that fail and seem like way to much work) that people use to lose weight..until i came to this forum though. i've never been told too, or taught too and i don't.

[someone]

Wow, that is amazing. It is hard to imagine that it would be possible to have even somewhat decent levels without carb counting. So do you just eat the same meal all of the time?

[Batty]

Wow, that is amazing. It is hard to imagine that it would be possible to have even somewhat decent levels without carb counting. So do you just eat the same meal all of the time?

**** no. i eat what i want when i want for my meals. saying its hard to imagine it, is only proving that people diganosed now are being taught to be ignorant. i dont agree with testing all the time, but i know for some people thats how they do it and how they were taught..and they can do what they want as long as they don't push it on me. people are taught different things and what might work for one person, might not for another. i dont agree with carb counting, i don't know a lot about it though but its not something i'm interested in doing..but if it works for some people and they do it, then thats their business as long as they don't push it on me.

[MarkMunday]

....... my last a1c was 8.3 a single point up from what it was before .....
Batty,

I am feeling the urge to climb on my soap-box. So here comes a lecture ....

You are obviously comfortable with the way you are managing your diabetes. And the sensible thing is to do what works for you. But the harsh reality is that your control, as measured by your HBA1c, simply isn't good enough. It should be telling you that your control is not good enough and you need to find a way to improve it. Your method of control obviously isn't working very well for you.

It really doesn't matter what your doctor says. An HBA1c of 8.3 is way too high and will eventually lead to complications, like kidney disease, eye problems and nerve damage. Complications that could compromise your quality of life in a big way. You can avoid these complications if you act now. But you need to stop looking for problems and start looking for solutions.

The only way to avoid these potential problems is to reduce your HBA1c to below 7.0, or better still, below 6.5. And the only way to improve your control is to more closely match your insulin requirements with the insulin you inject. Finally, the only way to achieve this outcome is to learn how the system works and to manage it actively. As all the others have said, you do this by using modern insulins, counting carbs, testing regularly and tweaking your insulin dosages. Testing really is the key. Without the information that regular testing provides, you are on a hiding to nothing ...

I guess the bottom line is that dealing with diabetes has to become a way of life. You are in it for the long haul. You need to be constantly looking for ways to improve your control. And you need to open your mind to modern methods of treatment that have been shown to produce better results.

Eating what you like and injecting arbitrary amounts of insulin will result in steadiuly deteriorating control. This is probably already happening to you. And you definitely need to question your doctor's advice if you want to stay healthy long term. Don't be tempted to delay or postpone achieving good control. Because, before you know it, the damage will have been done and it will be too late.

....... lecture over.

Cheers,

Mark

[JediSkipdogg]

Thank you Mark and I couldn't have said it better myself. I second everything he said.

[Sparkle]

I have to agree with Batty a bit :shakehand and say that in the UK we don't carb count either. It's a bit trial and error whether you do or don't I would think as it depends on your body at the time, exercise or what you are doing in the day etc as to how much insulin you take at mealtimes.

Anyway, Batty may have left the forum now (read the last post!) but...I take lantus at night between 10 and 12 and just take novarapid during or just after a meal. If I don't have much to eat I don;t have any insulin with that meal - if I think it's only going to go up a few notches. The I have lunch for example and inject with that. I like the regime as if I want dinner late I can :eating: . Just have an apple or something if I need it about 4ish.

I test alot though whether it's good or bad thing - drive a bit with work etc.

[Dobson]

I just have one thing to add about carb counting. A non-diabetic's body carb counts, no? I mean, it analyzes what the person eats, and the pancreas releases the correct amount of insulin to digest the carbohydrates. It's my opinion that we should be doing the same thing. Since our pancreas is basically non-existant, we must take over the role of it in our bodies. That includes testing, carbohydrate counting, and all of that. Just my opinion :)