Anyone use Insulatard?

[LucySW]

Hi All. I'd like to ask those of you who take Insulatard what you use it for and whether it helps. I'm LADA and not insulin-dependent yet (diagnosed only three months ago). I take low doses of Insulatard at night (3-4 units) only, the point being to give my pancreas a bit of a rest. I usually take it about 11pm, and the effect is I wake up w fasting BS of 5.2 or so. These rise to 6.2 or so after breakfast, and then so long as I don't snack, my fasting levels go back to the high 5s till supper (they don't like supper). From what I can see on the graphs, Insulatard has mainly worn off after 11 hours, so it ought not to be affecting my daytime bloods much.

I find this quite useful because for a time my morning BS was high - dawn phenomenon I presume.

Anyone else find it useful? And anyone ever hypo'd with it?

Many thanks. Lucy

 

[Heathenlass]

I use Insulatard, and have never hypo'd on it yet, a great relief after years of hell with Lantus ! I was using Insulatard prior to the Lantus again, without problems.

My use is different to yours as I'm Type 1, and I split dose daily . It's been mentioned to me by others that they find it lasts longer than 12 hours, and in my experience it does. Because you are in the honeymoon phase it may be that it is in fact giving your pancreas a rest and working in tandem .

The action of Insulatard seems gentler to me, it does have a peak around five hours post dose, which may be why it has dealt with your dawn phenomena as it does mine I time the morning dose so it coincides with lunch, so usually don't need to bolus for it

Signy

 

[LucySW]

Can I ask what dose you take Signy? And this is your basal, and you bolus as well except for lunch?

Lucy

 

[borderter]

This is very interesting for me right now as in desparation went back on Lantus a week ago and now have so much neck pain that just have to leave it off
Heathenlass what did lantus do to you ?
I have insulatard in the fridge from a while back so will restart that in the morning but even that has side effects for me but nothing like this excruciating neck pain,I must lok in pain as hubby voluntarily washing up !!!

 

[Heathenlass]

Can I ask what dose you take Signy? And this is your basal, and you bolus as well except for lunch?

Lucy

Yes Lucy, it's the basal insulin. I bolus with Humulin S ( (Luddite ! ) My basal doses are low, I seem to be insulin sensitive and low carbing helps a lot . It's split at 8.5 u am and 5.5 pm so a total of 14 u per day, which seems to be spot on for me.No real highs, and very few lows .

@borderter , I remember you posting on the problems you have had with various insulins, I'm sorry you are still going through the mill Lantus didn't suit me at all, it was far from being a " flat" insulin and had peaks and troughs. I had hypos each and every night, despite splitting it and eventually using 2u overnight. Also, I felt physically **** on it, aches, pains, brain fog and memory problems It took years to get the HCP's to take me seriously and put me back on Insulatard , and earlier this year when I went to a new diabetes clinic and they took me off it , it was like someone had waved a magic wand- within two days I was back to what passes for normal with me At which point they said that a) many people didn't get on with Lantus b) it doesn't last 12 hours anyway, as the manufacturer had said it did, it is not a nice gentle curve with a lot of people, and also that some people were allergic to it . Finally rounding off this information with the fact that they don't prescribe it any more at that diabetes clinic

What side effects do you get from Insulatard , borderter ?

Signy

 

[LucySW]

Yes Lucy, it's the basal insulin. I bolus with Humulin S ( (Luddite ! ) My basal doses are low, I seem to be insulin sensitive and low carbing helps a lot . It's split at 8.5 u am and 5.5 pm so a total of 14 u per day, which seems to be spot on for me.No real highs, and very few lows .
Signy

That sounds good, Signy!

I didn't like that they only offered me Insulatard at first - it's old-fashioned and cheap, and Bernstein disapproves of it - but it seems to suit quite well, what with its very particular time curve. I just assumed that 4u at night was too low for hypo worries. The DSN and consultant said 6u would be fine. Anyway, I haven't had any trace of trouble, though I'm not sure when it can start ...

 

[Heathenlass]

If you are doing fine on it now, chances are you will continue to do so Yes, it's " old fashioned " in terms of fashions coming and going in medical land Often only because the pharmaceutical bods bring out something that is new, all singing and dancing, ( so they claim ) and better for everybody . The big move from porcine and bovine insulin didn't suit a helluva lot of people, and the reasoning behind it being mass prescribed was pretty bogus IMHO . The newer insulins DID suit a lot of people, but not all, and they still don't .

I believe that if it ain't broke, don't fix it

It was interesting to have that chat early this year, that they don't prescribe Lantus, and do prescribe a lot of the older insulins along with Levemir. Tresiba is rarely prescribed because of a) the cost, and b) people still have problems with it along the lines of Lantus. Levemir was discounted for me as it was considered likely that I would react to it in the same way as I did for Lantus, whereas Insulatard has a good track record with me.

Why does Bernstein not recommend it ? Is this because it has been " superseded " by the newer ones with a "flat profile " ?

Signy

 

[LucySW]

No, it's because it contains protamine. Which a) is the thing that makes the timing of NPH a bit unpredictable ( wh he doesn't like), and b) can cause problems if people have a coronary angiography. Protamine is injected for that, and if you've used NPH you may have antibodies to it and hence a bad allergic reaction.

But apart from that and in small doses, I don't see the problem.

Dr B's favourite insulin was a really old-fashioned one called ultralente. It was very very gradual and gentle. But the money now is with super-fast.

 

[Heathenlass]

Ah, I see Thanks for that . I must re read his book sometime I had a lot of difficulty with the US measurements and because I'm vegetarian , so I kinda switched off .

Signy

 

[borderter]

Heathenlass the insulatard makes my heart jumpy and think its the protomine for long action which causes it .Lantus does it a wee bit but levemir was fine but just had no effect on glucose for me. I have had heart surgery a few months ago so wondering if Lucy has given me a clue as to why it (long acting) affects my heart so

 

[LucySW]

I don't know, @borderter. Just checked (hurray for Kindles!), and in the Dr B book it is described as a possible allergy which may arise if you've used NPH and produced antibodies to protamine. It comes up if protamine, aka isophane, is injected after a medical procedure to switch off an anti-clotting substance called heparin.

Ask your doctor about it?

Lucy

 

[Heathenlass]

Heathenlass the insulatard makes my heart jumpy and think its the protomine for long action which causes it .Lantus does it a wee bit but levemir was fine but just had no effect on glucose for me. I have had heart surgery a few months ago so wondering if Lucy has given me a clue as to why it (long acting) affects my heart so

What have they tried so far, @borderter ? You did say , but I can't find the original thread It sounds like Lucy has hit the nail on the head as to why your heart was racing .what do your HCP's say ? Have they mentioned trying Tresiba ?

Signy

 

[borderter]

Lucy I had an angiogram prior to heart surgery and so may have antibodies
Heathenlass I have tried Levemir Lantus insulatard and novo 50/50 and to be honest diabetes consult does not seem bothered saying my figures are not too bad and as for tresiba my area wont finance it so drawing a blank now ,can up the novorapid but then overnight rises happen
Sadly Lantus does the job but side effects spoil that
I have asked a DNS i know to find out if i can try tresiba on a private script so awaiting the result but think tresiba also has protamine in

 

[LucySW]

You poor thing Borderter :-(

 

[Heathenlass]

@borderter - does your cardio know about the problems you have had ? Given how common angiograms are, I'd be surprised if they weren't aware of the protamine issues. It sounds like there needs to be communication between the two consultants

A point to make to the diabetes team is that if you are having problems with basals, you should be considered to trial Tresiba because of your other health issues.

Signy

 

[LucySW]

Seems like another case of Dr B knowing his stuff.

Lucy

 

[smidge]

Hi Lucy,

I used to use Insuman Basal at your stage of LADA. It's another NPH and is very similar to Insulatard. I really liked it and am going to try to persuade my consultant to prescribe me some when I see him next month.

I really struggle with Levemir. It seems a bit weak. I actually want to take Levemir in the morning as it doesn't clash with my morning Apidra, but use Insuman at night to deal with Dawn Phenomenon. My consultant won't hear of taking three insulin so I might have a tough job persuading him.

In your position Lucy, I'd consider a small dose evening to stop your DP, and a small dose morning to cover your lunch - it would just help out a bit as the peak is at about 6 hours.

Smidge

 

[LucySW]

I might try that, Smidge, or taking it a bit earlier at night to cover supper, which is my weakest time of day.

Thank you so much for that.

 

[jack412]

if you take it earlier, I think it might just shift the time of the weakness to tea. it might be time for a consultant?

 

[LucySW]

Ah, I see Thanks for that . I must re read his book sometime I had a lot of difficulty with the US measurements and because I'm vegetarian , so I kinda switched off .

Signy

Yes. Actually I think his book is well worth rereading, in fact I seem to have read it lots of times already. I th his basic method absolutely shines. In a way it doesn't matter what level carbs people choose, but his basic method I th is absolutely on.

Thanx for swapping notes.