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Lantus Crystallization

alphabeta

alphabeta

Well-Known Member
Messages
615
Type of diabetes
Type 1
Treatment type
Insulin
I use Lantus before bedtime and I stay awake after taking Lantus for at least 1 hour because I don't want to rub the injection site. I have weird sleeping positions. Never had an issue before in fact but just curious, after how long till it becomes crystallized?
 
Thank you for the question @alphabeta. It lead me on a merry chase. At the site bd.com/resource.aspx?IDX=24410 are the New Injection Recommendations of the Journal Diabetes and Metabolism in French (and English, thank heavens) Oct 2010.
S7 - 3.2.3 - top second column - massage of injection site after injection of insulin is not recommended. and S8 - 3.7 second column for injections by insulin pen - count to 10 after completing injection to ensure no leakage of insulin. A longer time may be needed for large doses.
In 1989, a paper entitled ; Massage-induced insulin absorption: increased distribution or dissociation of insulin. ? Linde and Phillip Aug 1989 nbci.nlm.nih.gov/pubmed/2696618 suggested that increased size of the depot was only indirectly associated with increased effect of insulin absorption from massage.
I guess that one day's massaging of the injection spot may not have the same effect as the next day's of the next site of injection.
Or perhaps this is an approximation of 'If it ain't broke, don't try and fix it" !!
 
This says the crystallisation happens rapidly

"Following subcutaneous injection, insulin glargine is rapidly metabolized into its two main active metabolites: M1 (GlyA21) and M2 (GlyA21, des-ThrB30) [97], with little or no glargine molecule being detected in the systemic circulation. The M1 metabolite accounts for approximately 90 % of the available daily plasma insulin [97], and its release from the poorly soluble parent compound is the primary mechanism, resulting in the pharmacokinetic characteristics and consequent pharmacodynamic effect with the long-acting time–action profile observed with insulin glargine treatment [98–100]. Steady state is attained within a few days [101]. Importantly, adverse events, injection-site reactions, and antibody formation with insulin glargine were found to be comparable with NPH [75]."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045187/

Logically it would have to be a very rapid process, because otherwise other things would start to happen. I would assume it's pretty fast.
 
Why don't you move your Lantus injection to an earlier time?
I know, from a previous discussion, you are concerned about taking it with your bolus for your evening meal but you can move it to any time of the day: I remember you saying you don't notice the peak after 3 hours so you should not be concerned about it.

I know I used to take it at bed time because this was when I did habitual things like cleaning my teeth. However, as I am not habitual with my bed time, this meant I was taking it at a different time every day.
As a result, I just chose a time and stuck to it as much as possible rather than sticking to an event.
 
helensaramay said:
Why don't you move your Lantus injection to an earlier time?
I know, from a previous discussion, you are concerned about taking it with your bolus for your evening meal but you can move it to any time of the day: I remember you saying you don't notice the peak after 3 hours so you should not be concerned about it.

I know I used to take it at bed time because this was when I did habitual things like cleaning my teeth. However, as I am not habitual with my bed time, this meant I was taking it at a different time every day.
As a result, I just chose a time and stuck to it as much as possible rather than sticking to an event.
Click to expand...
Hmm well I am still on holidays, so if I take Lantus at 11-12 midnight, it is not a problem at all because I stay up pretty late till around 3 or 4 am. Anyway, when i am back on campus, i tend to eat dinner by 7 or 7:30pm so Lantus should be around 10 or so, bedtime by midnight definitely because I am not used to sleeping earlier than midnight.
 
Alison54321 said:
This says the crystallisation happens rapidly

"Following subcutaneous injection, insulin glargine is rapidly metabolized into its two main active metabolites: M1 (GlyA21) and M2 (GlyA21, des-ThrB30) [97], with little or no glargine molecule being detected in the systemic circulation. The M1 metabolite accounts for approximately 90 % of the available daily plasma insulin [97], and its release from the poorly soluble parent compound is the primary mechanism, resulting in the pharmacokinetic characteristics and consequent pharmacodynamic effect with the long-acting time–action profile observed with insulin glargine treatment [98–100]. Steady state is attained within a few days [101]. Importantly, adverse events, injection-site reactions, and antibody formation with insulin glargine were found to be comparable with NPH [75]."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045187/

Logically it would have to be a very rapid process, because otherwise other things would start to happen. I would assume it's pretty fast.
Click to expand...
Wait, Lantus dropped sugar by 50% its initial value? WHAT IN HEAVENS NAME?
 
alphabeta said:
Wait, Lantus dropped sugar by 50% its initial value? WHAT IN HEAVENS NAME?
Click to expand...

Oh no, I haven't given you more to worry about have I? Levemir works in a different way, it may give you a better night's sleep, even if it's not perfect.

I don't think worrying about your long acting insulin not behaving like a long acting insulin is a good thing.
 
Alison54321 said:
Oh no, I haven't given you more to worry about have I? Levemir works in a different way, it may give you a better night's sleep, even if it's not perfect.

I don't think worrying about your long acting insulin not behaving like a long acting insulin is a good thing.
Click to expand...
Wait no this might explain till some level the drops I get with Lantus and then I finally get to know that this is how it is supposed to be. At least I have an answer now! I can use that piece of information for my good.
 
alphabeta said:
Wait no this might explain till some level the drops I get with Lantus and then I finally get to know that this is how it is supposed to be. At least I have an answer now! I can use that piece of information for my good.
Click to expand...

That's ok then.
 
I've found recently with the heat, that if Lantus is kept in 37ish degree heat for around a week (I kept it in my room, whilst on holiday in the south of France; didn't put any spares in the fridge) it must lose its ability to crystallize.

When I injected it, it had the effect of short acting insulin; causing lots of hypos shortly after (I inject 16u Lantus, whereas I follow a low carb diet and don't usually inject more than 3 u of NovoRapid). I inject Lantus in the morning and overnight my BGs with going into the 20s (extremely unusual for me). As soon as I got home, I had some stuff from the fridge and I was back to good control again.

Lesson learned, keep out of heat and in the fridge.
 
SamJB said:
I've found recently with the heat, that if Lantus is kept in 37ish degree heat for around a week (I kept it in my room, whilst on holiday in the south of France; didn't put any spares in the fridge) it must lose its ability to crystallize.

When I injected it, it had the effect of short acting insulin; causing lots of hypos shortly after (I inject 16u Lantus, whereas I follow a low carb diet and don't usually inject more than 3 u of NovoRapid). I inject Lantus in the morning and overnight my BGs with going into the 20s (extremely unusual for me). As soon as I got home, I had some stuff from the fridge and I was back to good control again.

Lesson learned, keep out of heat and in the fridge.
Click to expand...
Oh wow I keep it outside the fridge as well. Interesting
 
alphabeta said:
You are making me feel bad
Click to expand...
Haha not my intention, just sayin there are other options. Lantus was the first basal analogue and I think the method it works is inferior to newer options. Absorption is variable depending on the injection site and it can drop someone dangerously low after injection. There was that cancer scare. I have no idea how real that is and understand all analogs may have a cancer risk, but Lantus has been specifically cited in a study. I think the company is pretty disgusting patenting a new basal, Toujeo, which is just 3x concentrated Lantus and trying to block another company from selling a generic version of Lantus. All pharma companies have disgusting practices though I admit.
 
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