Which insulin is "best"?

[85percent]

Im in the UK and currently on Lantus. Im taking 4 units at the moment and its keeping my bg between 5-7 mostly (mostly just over 6 between meals) - combined with exercise and moderate diet management. I still need to be better & more consistent with diet/food and/or I might increase to 5 or 6 units.

However, I was watching Dr Bernstein monthly YouTube Q&A and he mentioned Lantus has 'potentially' some properties / receptors which align with cancer cells - im paraphrasing. Ive also read that this has not been proved... but tbh if there is even a remote possibility and there are alternatives available id rather avoid Lantus.

Im seeing my consultant very soon and before I watched this video (not finished yet) the insulin was something I was going to research further and discuss up at the appointment if appropriate. I was hoping to be extremely knowledgeable on all matters diabetes by the time the appointment came around but .... im not, yet.

Can anyone share their experience or research on this subject? What is the best?

Dr Bernstein mentioned Tresiba. Im going to research *everything* over the coming weeks (been meaning too for weeks but other things have come up) but in the meantime if anyone can expand on this topic that would be helpful.

 

[Muneeb]

Im in the UK and currently on Lantus. Im taking 4 units at the moment and its keeping my bg between 5-7 mostly (mostly just over 6 between meals) - combined with exercise and moderate diet management. I still need to be better & more consistent with diet/food and/or I might increase to 5 or 6 units.

However, I was watching Dr Bernstein monthly YouTube Q&A and he mentioned Lantus has 'potentially' some properties / receptors which align with cancer cells - im paraphrasing. Ive also read that this has not been proved... but tbh if there is even a remote possibility and there are alternatives available id rather avoid Lantus.

Im seeing my consultant very soon and before I watched this video (not finished yet) the insulin was something I was going to research further and discuss up at the appointment if appropriate. I was hoping to be extremely knowledgeable on all matters diabetes by the time the appointment came around but .... im not, yet.

Can anyone share their experience or research on this subject? What is the best?

Dr Bernstein mentioned Tresiba. Im going to research *everything* over the coming weeks (been meaning too for weeks but other things have come up) but in the meantime if anyone can expand on this topic that would be helpful.

I had been on lantus for nearly 20 years, and it was one of those because I knew no better I didn't know how well it was working. Similar to you I had heard of Lantus potentially having links to cancer, it was one of the first basal insulins and it worked well for the time it was developed.

Now there has been further developments such as Tresiba which have a much flatter profile and more consistent release. This also lasts longer than Lantus.

I found Lantus to be so unpredictive, some days I would be fine, others I would have hypos at night, the absorption just wasn't consistent. My BS levels have been better than ever since switching to Tresiba and my night time hypos have near enough been eradicated.

The thing that put the nail in the coffin for me was having a 'lantus low', this is unique to how lantus works and if it hits a blood stream it can act like fast acting insulin. Therefore within half an hour I was in severe hypo territory (1.2mmol/L) being in a hotel I had to have 2 tubes of glucose tablets before I got anywhere back to normal. Was probably the scariest moment of my diabetic life.

In summary, lantus served its purpose but there are many better insulins now. Better for effectiveness and less likely to have cancer links.

 

[slip]

Lantus needs to be injected into fat to work correctly - inject it just under the fat layer or into muscle it will act like a fast acting insulin - fortunately I've never used it, although I have sufficient fat. Never heard of it's cancerous tendencies but I've never looked in to it.

Tresiba is an ultra long acting insulin as muneeb says it has a very long and flat profile - great if your activity levels are pretty much the same everyday all day - if you exercise every other day for example it might be a problem for you. Also any basal changes take days to have any affect, something to bear in mind.

I use Levemir twice a day, it's not as 'peaky' as Lantus and doesn't rely on fat to delay it's onset, probably doesn't last quite as long but it offers some degree of flexibility.

The other option is no slow acting basal insulin but rather a pump?

Would be nice to see your investigative conclusion in a few weeks time!

 

[KK123]

I hadn't heard of this about Lantus and it sounds quite alarming. Can anyone provide any links?

 

[Antje77]

@85percent , which insulin is best is highly personal. Many of us like Tresiba a lot (including myself), but for others it doesn't work well at all, they may prefer Lantus or Levemir because those react much quicker to adjustments.
I know nothing about the cancer link.

I hadn't heard of this about Lantus and it sounds quite alarming. Can anyone provide any links?

https://www.diabettech.com/diabetes/lantus-lethal-or-lifesaver-doc-gbdoc/

 

[Muneeb]

I hadn't heard of this about Lantus and it sounds quite alarming. Can anyone provide any links?

In regards to the lantus lows or cancer links?

The problem with the cancer links is that you never really have sufficient information for many decades and even then there are so many other influences. Some studies have shown it MAY have increased risks, but its a balance of risks. Its kept me alive for 20 years, but now it was time I changed.

 

[KK123]

In regards to the lantus lows or cancer links?

The problem with the cancer links is that you never really have sufficient information for many decades and even then there are so many other influences. Some studies have shown it MAY have increased risks, but its a balance of risks. Its kept me alive for 20 years, but now it was time I changed.

Hi Muneeb, I meant the cancer association although the lows are interesting too. Thank you.

 

[85percent]

@KK123 This is the bit about insulin Lantus + cancer

At round 19 mins 38 seconds he starts talking about Lantus in response to a question someone asked. 2-3 mins total on Lantus.

He says "lantus has x165 more affinity for igf1 receptors than human insulin. igf1 receptors are prevalent in cancer tissue and you can make cancer cells replicate by simulatig igf1 rceptors. so lantus has an increased cancer risk..."

I like his viewer q & a's. Ive only listened to 2 but I plan to listen to all of them - 50 hours. Will learn alot in this format. Ill also read his book. This will be the foundational info after which I will seek other resources. You have to learn from someone who's had type 1 for 70+ years and is a practising doctor.

There was a book released recently called "Mastering Diabetes" - I haven't read it but I did listen to the authors on the Rich Roll podcast and they 'might' have more / new perspective to add to the diabetes management field. They advocate greater carbs to some extent, but I need to listen again to see if there is any value in the book.

Dr Bernstein also explains that the ph of Lantus is 4 and the body is 3.7. This is because they add acid to make the insulin more acidic so it dissolves into the blood at a slower rate - this is the time release aspect. Interesting (to me). The viewer asking the question said the Lantus gave a burning sensation for them.

I'll report back with anything interesting on my diabetes learning plan.