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Lantus not working anymore?

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#1
jjames

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Okay, I'm on lantus (~57 units nightly) and for some reason it seems that it just won't work anymore. For the past couple of days, I've been waking up with a BG of 250+. Last night before I went to bed it was 170, this morning it was 276. Yesterday morning was 314, and the morning before was 300. Throughout the day I've been running high, and I can usually correct it at meal time with humalog, but lantus just seems to have stopped working all together.

Anyone ever dealt with this? Is it even possible for lantus to stop working all together? I'm not sure what the deal is, but it's very frustrating, and I'm starting to feel like butt!
Jay
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And don't let anybody make you think that God chose America as his divine, messianic force to be a sort of policeman of the whole world. God has a way of standing before the nations with judgment, and it seems that I can hear God saying to America, "You're too arrogant! And if you don't change your ways, I will rise up and break the backbone of your power, and I'll place it in the hands of a nation that doesn't even know my name." - Dr. Martin Luther King, Jr.

#2
xMenace

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Using a good site? Rotating?

Virginia Woolf: “Consider how common illness is, how tremendous the spiritual change that it brings, how astonishing, when the lights of health go down, the undiscovered countries that are then disclosed, what wastes and deserts of the soul a slight attack of influenza brings to view, what precipices and lawns sprinkled with bright flowers a little rise of temperature reveals, what ancient and obdurate oaks are uprooted in us by the act of sickness, how we go down in the pit of death and feel the waters of annihilation close above our heads and wake thinking to find ourselves in the presence of the angels and the harpers when we have a tooth out and come to the surface in the dentist's arm-chair and confuse his "Rinse the mouth-rinse the mouth" with the greeting of the Deity stooping from the floor of Heaven to welcome us - when we think of this, as we are so frequently forced to think of it, it becomes strange indeed that illness has not taken its place with love and battle and jealousy among the prime themes of literature”
Back on MDI and doing well. Trying Victoza and loving it. A1C 6.0, no major hypos; a few highs; lots of shots. Diagnosed Oct 19th, 1975.
HDL-101; LDL-64; TG-36; TOT-172


#3
grace girl

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How long has the vial been open? Do you keep it in the fridge or room temp? I've had lantus go bad on me before and both times it was more than 28 days old and I'd accidently left it out of the fridge. (I know they tell you that you can leave it at room temp, but it seems to have a longer life when refridgerated)
I would open a new vial and see if it solves the problem.
It's not a common problem, but it's not unheard of for it to go bad.
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#4
Gizmo

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Hi James :

What are you eattimg after supper ? How long have you been

on lanus ? Where are you takeing your shot at, ?

:T :T :T :T :T :T :T :T

BS seen any good movies ?????

#5
LancetChick

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Yes, that can happen, especially if you store the insulin at room temp, or expose it to direct sunlight or high temps. Open a new bottle to make sure. Also, if you rebound easily, you can end up taking way too much insulin, rebound from even minor lows, and go way high, making it look like the Lantus isn't working (57 units is a lot of Lantus per day). So if a new bottle gives you the same results, try lowering your Lantus dose, with your doctor's assistance if you are inexperienced, but I generally find that doctors give their patients more patently bad advice about diabetes than good advice.

#6
jjames

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LancetChick,
For the past year I've been having to increase my insulin intake dramatically (in my opinion.) About a year and a half ago I was at about 18 units of humalog for a meal, usually less. Now, I'm anywhere between 28-38 units of Humalog for my meals. (Also, in the same time period, I've gained nearly 60pounds.) Along with the Humalog increase, I was originally using 40 units of Lantus.

I haven't left it out, and I usually go through a bottle of Lantus somewhat quickly (around 2 weeks), so I rarely have it opened even close to 28 days. I don't do a scheduled "rotation", I just pretty much stick in where ever I feel like it. I've been on Lantus regularly for the past year and a half. I am a big eater, but . . . I just found it odd for my controls to just get out of hand suddenly. It was almost as if my body said, "Okay, I'm not going to use Lantus anymore" and just up and quit, because the previous day I ran fine.
Jay
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And don't let anybody make you think that God chose America as his divine, messianic force to be a sort of policeman of the whole world. God has a way of standing before the nations with judgment, and it seems that I can hear God saying to America, "You're too arrogant! And if you don't change your ways, I will rise up and break the backbone of your power, and I'll place it in the hands of a nation that doesn't even know my name." - Dr. Martin Luther King, Jr.

#7
Scratch

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It sounds like you're becoming increasingly insulin resistant.

You should seriously consider making an effort to drop some weight and becoming more physically active if possible.
MDI, Lantus and Novolog
A1c 2/12 -- 5.9%

#8
LancetChick

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LancetChick,
For the past year I've been having to increase my insulin intake dramatically (in my opinion.) About a year and a half ago I was at about 18 units of humalog for a meal, usually less. Now, I'm anywhere between 28-38 units of Humalog for my meals. (Also, in the same time period, I've gained nearly 60pounds.) Along with the Humalog increase, I was originally using 40 units of Lantus.


You sound like a classic easy-rebounder: more and more Lantus, highs that can't be controlled with more insulin, weight gain and seemingly high insulin resistance. If you're afraid to decrease the Lantus outright, try a daytime basal test. In the morning, take your Lantus as usual, if that's your routine, but don't eat and don't take any fast-acting insulin. Check your blood sugar every hour or two and wait until it reaches a plateau (it will continue to rise if you aren't taking enough Lantus, but I sincerely doubt that's the case). Once that happens, it will probably go down, and if that happens, see how dramatic the drop is. More than 30 points, and you know you are taking too much insulin, probably way too much.

#9
jjames

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Insulin resistence in T1? Didn't know that could happen.

Thanks for all the input and suggestions everyboyd. Much appreciated!
Jay
------------------
And don't let anybody make you think that God chose America as his divine, messianic force to be a sort of policeman of the whole world. God has a way of standing before the nations with judgment, and it seems that I can hear God saying to America, "You're too arrogant! And if you don't change your ways, I will rise up and break the backbone of your power, and I'll place it in the hands of a nation that doesn't even know my name." - Dr. Martin Luther King, Jr.

#10
Scratch

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Insulin resistence in T1? Didn't know that could happen.

Thanks for all the input and suggestions everyboyd. Much appreciated!

Yes, it is possible.

Type 1 diabetics can get ’double diabetes’ from insulin resistance, says University of Pittsburgh

Or even just consider my own experience. Last fall, my basal dose of Lantus was 24 units. I have been working on becoming more active, both aerobic exercise and strength training, and have seen my basal dose drop to 16 units as of present.

Insulin resistance, I suspect, exists along a spectrum. There is a genetic factor affecting how likely a person is to become more resistant, but there is much that people can do to keep from sliding deeper and deeper into insulin resistance.

1 -- Lower the percentage of body fat. Muscle is far more efficient.

2 -- Don't just be a skinny rail though either. Active muscle, muscle that is used, is more insulin sensitive than muscle which is little used.
MDI, Lantus and Novolog
A1c 2/12 -- 5.9%

#11
Deebeee

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I found that about a week before the end date of 28 days, my vial of Lantus was NOT working. My numbers went up so high it was as if I were not taking any insulin.

Does anyone know how or where a vial of Lantus could be tested for vitality?

I have heard this quite often and it's just not right.

#12
Psycho Penguin

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I found taking half in the morning helped, even if it meant an extra shot.
Type 1 diabetic since February 2008

Novalog: sliding scale as needed
Lantus 40u at night

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#13
grasshopper

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Hi, I concur with others regarding Lantus not working.

On several occasions, including currently, my Lantus seems to do nothing at all and I have to take increasingly large doses of short acting insulin to try to contain my blood sugars under control.

I have tried a few experiments that seem to confirm this. Recently I doubled my nightly dose of Lantus of approx 28 units by taking it twice. I did this several days running and nothing .... no reaction or difference to the blood sugar level problem I had been having. I also took an extra dose in the morning once while trialling this and again nothing happened.

When I changed the Lantus cartridge in my pen I saw some improved performance but still not what I would expect from my experience so I will try a new prescription next week.

I store my insulins (Lantus & Humalog) together in a plastic tub with a temperature guage inside that shows 5 degrees celsius at all times. My Lantus pens live in the fridge too.

Maybe my refridgerator is over-cooling at times and perhaps freezing and affecting my lantus supplies? Interestingly the Humalog insulin never has a problem.

I will say this from my experiences taking Lantus pens with me on travels. At even the slightest exposure to warm temperature (once in a bag on the back of my motorbike, once in a bag in my car), even below 30 degrees celsius, Lantus will just not work again afterwards.

My view is that Lantus is incredibly temperature sensitive and susceptible to permanent damage very quickly when not refrigerated (unlike Humalog which can live in my car and be ok after an Australian summers day).

Perhaps my faulty Lantus supplies might come about through poor product handling by either the product distributor or the pharmacist in exposing it to higher temperatures than it can withstand?

Given that I have experienced both good and poor results with Lantus from different prescribed batches in the last 18 months I do not feel that I am experiencing Lantus insulin resistance issues.

Whatever the cause, I do believe there are issues with Lantus and temperature stability and susceptibility.

My next step will be to try a new pharmacist.

#14
hottmann4

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Hey, thanks for the info on lantus, I've been on it for about two years, and I often have ups and downs at different times of the month. I am also leaning towards it not working when I get near the end, but I was unaware about the radiant temperature problem.

#15
Kise1

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I'm Type 1 diabetic
Thanks a lot for everybody has posted here, it helped much answering my questions. although some where just suggestions, they seem to be rational and make sense to me.
I have been on Lantus (only) for 4 years. for the past 2 months, I started having problems with Lantus that I feel my body is not utilizing it at all. When I change the vial, the new one seems to work better but the same problem could happen again with the second half of the vial. I'm pretty sure that this is not an insulin resistance syndrome. Cause simply, if my body started having down regulation of the insulin receptors, then Humalog would have never worked with me with its full efficacy.
I can draw my conclusion as follow,

1-Lantus is super sensitive to temperature change.
2-Different batches of Lantus might give different actions.
3-Since the chemical formula is relatively new and no company other than Aventis is manufacturing it, the above possibilities could be true.
4-As long as Humalog (or any other insulin) works fine with you and me, No insulin resistance is to be expected.

Solutions,

1-Exercise more.
2-Enhance your food quality (you know what's the healthy food for diabetics)
3-Make very sure to store Lantus in the fridge without freezing it (2-8 degree Celsius)
4-expect lantus to stop working at any day, so keep a regular insulin bottle with you wherever you go.
5-Now, in very rare cases (Syndrome X), if your body develops resistance (receptors down regulations) to only lantus . Consider switching to Detemer (Levemir) or to any other long acting insulin for couple of months (3-6 months) to let your body synthesis new fresh lantus receptors. Then, you may try going back on lantus.

My plan,

1-exercise to lose my extra 20 pounds (to enhance my body sensitivity to insulin) and enhance food quality (more vegetarian food to avoid heart problems)
2-try another pharmacy.
3-if the problem persists, I will go ahead and try another long acting insulin for 6 months or so and go back on lantus.

#16
patricia52

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I need to borrow your thread. Is it all right to keep Lantus Pens in the fridge after opening? The package said not to put opened pens in the refrigerator.
Patricia


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#17
Bountyman

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Is it all right to keep Lantus Pens in the fridge after opening? The package said not to put opened pens in the refrigerator.


The wording on the package uses capitals when it says NOT, also. Don't get the word NOT confused with shouldn't. It's not that you can't store an opened pen in the refrigerator...it's that 36ºF - 46ºF Lantus won't last any longer than room temperature Lantus, and the cold pen/insulin causes the pen to work sluggishly and from what I've read here...cold Lantus kinda stings. If you'd like to keep it in the refrigerator after you've opened it because it's summertime in Alabama...go ahead. You can just take the pen out of the refrigerator about a half hour to an hour before you use it.

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#18
patricia52

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So there is no good reason to refrigerate Lantus after opening? I asked because I live in Alabama and this has been a super hot summer. I am new to insulin and still have a lot of questions that keep popping up. Thanks for your answer.
Patricia


Today is the first day of the rest of my life.


Lantus
Apidra
Diet & Exercise
Most recent A1C 5.6

#19
Bountyman

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So there is no good reason to refrigerate Lantus after opening?


The instructions on the back of the Lantus box also mention that you should not store your opened pen above 86ºF. Which basically means that if it's over 86ºF where you are...some colder storage is necessary. I'd be hard pressed to find a cooler place in ANY home other than the refrigerator. They need to make up their mind. :D

I asked because I live in Alabama and this has been a super hot summer.


I thought that might be the case.

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#20
shainesboostin

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I have never stored mine in the fridge...I leave it at room temp without issue.




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