Lantus results versus pump results

[Ailsa]

Hi All,
I would be interested in hearing from anyone who is happy to post their latest HBA1c result & whether they are using Lantus or a pump.

I have been using Lantus for a while & haven't had a recent test but the last one was 7.8 which was a bit disappointing considering I got better results using protophane/actrapid. Have been thinking about a pump depending on my next test.

Anyhow. I'm sure a lot of people other than my self, who are considering different therapies would be interesed to see if there is any difference.

Many thanks
Ailsa

[Simon]

5.8% using Lantus. That may have been helped by being in the honeymoon period though.

[JediSkipdogg]

Right now on my pump I'm bouncing in the 7s. However you can't really compare my results to say Simon's or Dewey's. We are totally different and the A1C really doesn't have much to do with a basal insulin. It's up to how accurate one counts thier carbs and gives a bolus accordingly.

If two items are on the shelf and only those two, a pump and a bottle of Lantus then one has to think of a few items. For my point we are going to put Bolus injections aside because multiple shots a day and such can make another huge different. But looking at just basal patterns, one may consider a pump if they need different amounts of insulin throughout the day. Like for me, Lantus alone wouldn't work. Here are my pump basal settings:

00:00-05:00-----0.875
05:00-09:00-----1.000
09:00-13:30-----1.525 (this and the number below was a doctor recommend change)
13:30-15:00-----1.550
15:00-00:00-----1.850

My main point with this is looking at what I require in the evening and at night. The difference is so great that Lantus alone can't do that.

[kgm0612]

I wasn't taking Lantus before switching to the pump in December, but I wanted to answer anyway just in case there are others on different insulins who are considering going on a pump.

I was on Novolin N and Novolog 70/30 before making the switch to the pump. I go for blood work next week and see my endo on the 16th. My last two A1c's were 6.3 and 6.0 before that. My endo forwarned me that my A1c probably would be higher than the 6.3 for awhile after starting the pump. I'll let you know as soon as I get my A1c results back.

Karen

[duck]

I test my A1c's monthly, the last one was 6.2 about a month ago (check my signature). I was not on Lantus before I began pumping, but when I was on NPH (which I believe is the same as Isophane), I had A1c's in the low 7's, but that was misleading. My blood sugars back when I was on NPH would bounce all over the place, as low as 40 as high as 350 some days, and if you average it all out, I guess it can look good. But I felt like ****. Nowadays I am more of a proponent of being consistent than I am a proponent of being low all the time, I think it makes us feel better.

[JediSkipdogg]

I forgot to mention that before I went on the pump I was on NPH and R. When I brought up the pump idea my doctor of 20 years was pretty much estatic. He then mentioned that he never brought up the idea of Lantus to me because my NPH shots were pretty much double one another therefore a steady dose of lantus wasn't a possibility. Just thought I'd throw that in.

[jen_slc]

My last one was 6.5 and I am on Lantus/Novolog. I'm an ex-pumper and my control has improved since coming off the pump - when I was on it, I'd hover between 7-8 and couldn't get it lower.

[rzrbks]

CDE used to push me towards pump,

However

on Lantus and NovoLog/NovoRapid, worst A1c has been 5.7.

Needless to say, CDE has quit talking about the pump. Although, she keeps saying,"Well, you'll probably want to consider going on a pump in several years when your control gets more difficult."


Personally, I consider my Induo (all the Regulars here are going, "Cripes, not again!!) as close to a pump as you can get without actually being hooked up

http://www.induo.at/quickguide.html


But the above statement is just my personal opinion.
Psychologically, the importance of getting away from syringes has been Very Important for me.

[duck]

CDE used to push me towards pump,

However

on Lantus and NovoLog/NovoRapid, worst A1c has been 5.7.

Needless to say, CDE has quit talking about the pump. Although, she keeps saying,"Well, you'll probably want to consider going on a pump in several years when your control gets more difficult."


Personally, I consider my Induo (all the Regulars here are going, "Cripes, not again!!) as close to a pump as you can get without actually being hooked up

http://www.induo.at/quickguide.html


But the above statement is just my personal opinion.
Psychologically, the importance of getting away from syringes has been Very Important for me.

I still think that is one of the neatest **** things I have seen in a while.

[Jak]

My last A1c before going onto the pump in November 2003 was 5.8. I was on Humalog and Humulin L.

My next-to-last A1c was 5.5. I have a doctor's appointment tomorrow, so I'll have to wait and see what the result for the latest one is.

Jak

[someone]

With Lantus, it is possible to achieve the same control as with a pump. The good thing about a pump is that basal rates for different time frames can be adjusted giving you much more consistant readings.

[jeggeman31]

Hi All,
I would be interested in hearing from anyone who is happy to post their latest HBA1c result & whether they are using Lantus or a pump.



Pre pump Lantus days HBA1c between 8 and 10. Went on the pump in Sept, and my last 2 HBA1c are listed below in my signature.

[Ailsa]

Thank you all.
WOW !
I'm amazed you are all getting such awesome results. I have to wonder if only the extremely well behaved are posting?

I hope as many as possible will post to give a clear picture.
'Have to say, I am about as diligent as possible for someone with a busy life & have never got below 7.2 except when I was pregnant. The measures I went to then however I do not consider realistic for a permanant situation.

Thanks again, & please keep posting if you haven't yet.

Ailsa

[Erin]

Well I've never been on a pump, but compared to NPH and R, Lantus has been amazing! Most recent HbA1c was 6.8. Since going on Lantus almost 6 years ago my A1c's have been consistently around 7 (if i had to guesstimate an average I'd put it around 7.3)

On NPH and R my A1c's were much higher. I was lucky to see an 8, and for a time (when I was a kid) they were around 10.

I am really really active and don't have the time to deal with diabetes control per say, so getting levels around 7 with little effort is so GREAT for me! I mean I try some, but i'm a very active young person, with too much on her plate already... does that make sense? I think Lantus is perfect for folks like me. Pumps seem like more mental work.

I've never wanted to go on a pump, honestly the idea of having something continuously attached to me really freaks me out (too many medical tubes too young, I value being disconnected far too much to ever go back to being tied to machines, unless I had NO other option), but that's my personal neurosis.

[mwalt2]

I was on MDI with lantus/humalog for the first 3.5 years I had diabetes. My average A1C on MDI was 5.4. I have been on the pump for about 3 months now and my last A1C was 5.7. While it is not very different, I think it is a little higher because I have less frequent low blood sugar now (which was one of the reasons why I wanted the pump). Lantus works pretty well, but at best it is a constant basal throughout the day (although in my case it seemed stronger at night). With my pump, I switch basal rates four times/day. To me, the accurate dosing (my humalog pen certainly could not do 0.05 U) and ability to change basal rates are the biggest advantages of the pump.

[jeggeman31]

I'm amazed you are all getting such awesome results. I have to wonder if only the extremely well behaved are posting?

What do you mean by this comment ? If you are talking about the way I eat to get such a low a1c ? If that is the case then no I am not extreamely well behaved at all. I got on the pump to me control my diabetes and not let diabetes control me. To me my pump is my pancreas. My wife will eat a candy bar and her pancreas does its thing, why can't I eat a candy bar and let my pump do its thing.


Now if you are talking about something else being extremely well behaved then I just waisted a post. :top:

[duck]

There are a few people here who have had issues with pumping, but in general I think the pump-population will respond with positive feedback about their pump experiences. ****, the convenience alone makes it a worthy device, but couple that with the ability to lower A1c's and match basal profiles to basal needs, it stands to reason that pumps would have a positive feedback rating.

[lelggren]

Before I got on my pump, my a1c's were always 9.0 or above. I just had my last one go down due to adding some oral meds along with my insulin. They work well together :) Oral meds are not just for the type 2's anymore! The pump is great though. I love mine :)

[rzrbks]

Ailsa

Thank you all.
WOW !
I'm amazed you are all getting such awesome results. I have to wonder if only the extremely well behaved are posting?

Oh, course. I Am the MOst well behaved person on the planet. Just ask anyone here.:hypocrite
I know that people actually point me out to other people.

[jenet]

With Lantus, it is possible to achieve the same control as with a pump. The good thing about a pump is that basal rates for different time frames can be adjusted giving you much more consistant readings.

For some people, it may be possible to achieve the "same control" with Lantus as with a pump. However, some people experience 25-30% variability with Lantus, some people do not receive 24 hour basal coverage, and some people have a very strong Dawn phenomenon. (Your mileage may vary.) So I would have to ask what definition are we using for "same control" - the 3 month A1C (with highs and lows averaged out) or the frequency and length of time spent high and low?

I have all of the above, even splitting Lantus morning and evening to try and provide full coverage. I have lots of overnight lows (and rebound highs). My BG will rise 100-160 points from 4:30 wake-up to 6:00 before breakfast unless I take 2-4 units of Humalog (depending on each morning's starting point), and that's on top of the rise from 3:30 - 4:30 am that happens before I wake up. This was verified by wearing a CGMS for three days - I went below 40 all three nights, and didn't wake up for any of them - completely surprised my endo and CDE. Now I check every two or three days, and usually see I am still relatively low at 2:00 (90-110) but high at 4:30 (230-450), and six out of seven days wake up with a really, really bad headache - the aftermath of a low.

Sorry for rambling on, but I have been struggling with this for what seems like forever, and needed to voice a different perspective.

cheers,
j

[duck]

Oh, course. I Am the MOst well behaved person on the planet. Just ask anyone here.:hypocrite
I know that people actually point me out to other people.

If it makes you feel any better, I run around wishing I could use as little insulin as you use for boluses, etc. You make me green with envy, actually.

[Ailsa]

I'm amazed you are all getting such awesome results. I have to wonder if only the extremely well behaved are posting?

Perhaps I should rephrase that!
Just that I suspect some people with higher results might be a bit shy about posting them, with you all looking so fantastic!

Have to say I have never got results that low despite best efforts.

From what everyones posted so far, I'd say overall there's not too much difference between Lantus & the pump.
I have been considering a pump which is why I am interested.

Lantus works quite well for me. I take it in the morning & it lasts through to breakfast the next day with great control at night. there's a bit of a gap after breakfast till the next shot kicks in, but I can cover that with novorapid.
I am still not getting the results I want though. It is the Novorapid that seems to be the problem. If I never ate the Lantus would give me almost perfect control. however even though I've always carb counted ( maybe a bit loosely) I can never get the carb/ novo mix to come up with the right result.
It's either hypo or high & once that happens it's a seesaw all day!

I've also noticed that if I'm aroud 4-5 (90-100 I think) I can stay there quite happily, but if I get up to 7-8(180-200?) it tends to creep up regardless, so somethings not working efficiently with the Lantus then.

If I could make it work I'd stick with the Lantus, as like Erin I'm not too keen on being connected, but also don't want to switch to a pump & have the same issues, especially since where I live they are not covered by insurance or govt funding!

Ailsa

[Mark C]

Lantus/Novolog user. Last A1c was 6.6. I am always high at dawn and would probably be lower if I could do something about it.

[Mick]

Alisa--

Hiya! I've been T1 since 1965, and so, like you, have "been thru the wars" so to speak. I switched from NPH/R to Lantus/Novolog (Pen) almost 6 years ago, before Lantus was actually available--I was in the final phase of clinical trials. Prior to my switch, my a1c was not usually a problem--they would bounce between 6.2 and 7.2--it was the roller-coaster of my daily glucose and my dangerous hypos which came up without warning. Since the switch I have not had one single low which I could not handle by myself. I have managed to keep my a1c at a virtually rock-steady 6.5 the entire time without the lows. I mean, 6.4, 6.6, 6.4, 6.7, 6.3, 6.5, like that, year after year. Yeah, okay, I am pretty "well-behaved"--if I wasn't, I'd be long dead, as my doctors all predicted for me 40+ years ago. However, this lantus/Novolog Pen routine has actually allowed me to be a lot LESS well-behaved than before while maintaining the same degree of control. If I am not hungry, I do not eat. If I'm humgery and the opportunity presents itself, I'll eat whatever I wish--tonight, in fact, my son brought home some mini-eclairs, and I counted up the carbs, multiplied by my bolus ratio, and ate up--yummy!! So life is good.

By the way--welcome aboard!
Michael

[gettingby]

I have to go on my NPH rant for a bit. Sorry.
When I was on NPH and Reg, I was like Duck. BG's bouncing from Earth to the Moon and back. I always felt like I had been run over by a semi. LOL
Within the last year, with the help of friends (thanks again gang), my A1C's have been better (last one not so great but at least I know why). Next A1C will hopefully be below 7. I'm not being unrealistic, I'm really really trying !! Right now Lantus/Humalog is working for me.

[Ailsa]

Thank you both.
I'm trying to count my carbs very meticulously for a while & see if that helps.

Ailsa