Bovine insulin

[Beaver Lee]

Hi!
We live in the Midlands.
During the last six months our 17 year old son has found problems such as:
When out walking in the Peak District last week he felt that his blood sugars were high.
On testing he found that they were under 2mmol/l.
He has had diabetes for 5 years and uses Lantus - glargine and NovoRapid.
He wants to change to bovine insulin.
However ...
Our Consultant cannot prescribe short and intermediate bovine insulins for him due to the fact that she has not had any experience with animal insulin during her medical career.
She has suggested that we find a consultant who has experience with animal insulin.
Obviously we would need to give the name of a consultant who has had experience with caring for patients using animal insulin to our GP to ask for a referral.
Does anyone have any knowledge that would help us to locate such a consultant?
Thanks so much.
Beaver Lee

 

[tim2000s]

Can I ask a couple of quick questions? Why have you decided that bovine insulin is the answer? Have you looked at alternatives like CGMs with low blood sugar alarming? Who has driven the decision that bovine insulin is the way to go? Who came up with the idea?

As a 17 year old, your son is undergoing hormonal changes that will change his warning signs. From what you have said, he is still getting them. Why change insulin when they are still there and just need recognition?

I went through being a 17 year old with diabetes and a lot changed. The amount of insulin I needed, how hypos showed them selves and a sudden growth spurt to name a few. I'd strongly suggest looking again at alternatives before making a change like this.

 

[Beaver Lee]

Can I ask a couple of quick questions? Why have you decided that bovine insulin is the answer? Have you looked at alternatives like CGMs with low blood sugar alarming? Who has driven the decision that bovine insulin is the way to go? Who came up with the idea?

As a 17 year old, your son is undergoing hormonal changes that will change his warning signs. From what you have said, he is still getting them. Why change insulin when they are still there and just need recognition?

I went through being a 17 year old with diabetes and a lot changed. The amount of insulin I needed, how hypos showed them selves and a sudden growth spurt to name a few. I'd strongly suggest looking again at alternatives before making a change like this.

Hi Tim,
Thanks for taking the time to reply.
Yes, he is well aware of the possibility of CGMs.
He would like any help that any one may have with this rather unusual request for help.
Many thanks
Beaver Lee

 

[donnellysdogs]

How long has your son been diagnosed? Was your son feeling like he needed to eat when he thought he was high?

When walking such places your son is far more likely to go low than high..

Bovine insulin is rarely used. Has your consultant discussed a cgm and / or a pump instead?

Is walking a regular exercise?

 

[Beaver Lee]

How long has your son been diagnosed? Was your son feeling like he needed to eat when he thought he was high?

When walking such places your son is far more likely to go low than high..

Bovine insulin is rarely used. Has your consultant discussed a cgm and / or a pump instead?

Is walking a regular exercise?

Thanks for your reply.
He is used to exercising for extended periods.
Do you know of a consultant who cares for patients using animal insulin?
Thanks a lot,
Beaver Lee

 

[tim2000s]

Many of us on the forum are long term t1. I personally, like many others, have always used human insulin. Amongst the endurance sports have included half marathons, long cycle rides, tae kaon do tournaments and bowling 30 overs in a cricket match.

I have to admit to being a little surprised by your initial request being information on bovine insulin. Would you be able to share with us your reasons for taking this approach, because, like others ,I'm sure, I don't understand why?

 

[noblehead]

Bovine insulin isn't the answer, all your son has to do when out exercising is reduce his insulin accordingly and take some carbs on board, I had far more hypo's when I was on animal insulin than I do now on basal/bolus.

Take a look at the following two sites, the first is a carb counting course similar to what is taught on the DAFNE programme and the other is a site for people with type 1 diabetes and enjoy sport, both should be extremely useful to your lad:

http://www.bdec-e-learning.com/

http://www.runsweet.com/

 

[CarbsRok]

Hi!
We live in the Midlands.
During the last six months our 17 year old son has found problems such as:
When out walking in the Peak District last week he felt that his blood sugars were high.
On testing he found that they were under 2mmol/l.
He has had diabetes for 5 years and uses Lantus - glargine and NovoRapid.
He wants to change to bovine insulin.
However ...
Our Consultant cannot prescribe short and intermediate bovine insulins for him due to the fact that she has not had any experience with animal insulin during her medical career.
She has suggested that we find a consultant who has experience with animal insulin.
Obviously we would need to give the name of a consultant who has had experience with caring for patients using animal insulin to our GP to ask for a referral.
Does anyone have any knowledge that would help us to locate such a consultant?
Thanks so much.
Beaver Lee

Hi, I use bovine insulin it's quite widely used and your son's consultant is being a bit naughty in not prescribing it. Any GP can prescribe it. Just because the consultant doesn't know anything about it doesn't mean they can't go and find out about it either.
It's no different in action than the humalin and insultard in duration.
Perhaps try http://iddt.org/ they might be able to help.
I saw an Endo about 6 years ago who hadn't had any dealings with animal insulin's and he asked me details of it who made it and went and did his research. I use bovine neutral in an insulin pump.

 

[Beaver Lee]

Hi, I use bovine insulin it's quite widely used and your son's consultant is being a bit naughty in not prescribing it. Any GP can prescribe it. Just because the consultant doesn't know anything about it doesn't mean they can't go and find out about it either.
It's no different in action than the humalin and insultard in duration.
Perhaps try http://iddt.org/ they might be able to help.
I saw an Endo about 6 years ago who hadn't had any dealings with animal insulin's and he asked me details of it who made it and went and did his research. I use bovine neutral in an insulin pump.

Thank you so much for this post.
It is both helpful and encouraging.
Thank you so very much
Beaver Lee

 

[Beaver Lee]

Bovine insulin isn't the answer, all your son has to do when out exercising is reduce his insulin accordingly and take some carbs on board, I had far more hypo's when I was on animal insulin than I do now on basal/bolus.

Take a look at the following two sites, the first is a carb counting course similar to what is taught on the DAFNE programme and the other is a site for people with type 1 diabetes and enjoy sport, both should be extremely useful to your lad:

http://www.bdec-e-learning.com/

http://www.runsweet.com/

Thank you for the links
We hadn't been aware of the latter one.
Beaver Lee

 

[donnellysdogs]

I must admit, I can't quite fathom out why you are seemingly persistent at using bovine insulins for the occurence of one walking hypo?

How does your son feel about changing to bovine insulin?

 

[czj]

In my experience I found I regained my hypo awareness by changing from Lantus to Insulatard (not bovine, obviously) . That wasn't the reason I stopped the Lantus so it was just a bonus.

Good luck in finding the help you are looking for.

 

[Beaver Lee]

Hi CarbsRok,
Thanks for your posting above regarding your experience with Bovine Neutral Insulin / insulin pump / your visit to the Endo 6 years ago.
We found a very interesting article coauthored by Dr Phil Coates regarding using animal insulin in an insulin pump. Really encouraging all round. Did you take part in the survey for it?
Even though our son does not want a pump the article still has a lot of encouraging information regarding animal insulin. Especially regarding hypo awareness.
http://www.iddt.org/wp-content/uploads/2011/05/JDN15-1pg32-6.pdf
Thanks again for all your help and encouragement
Beaver Lee

 

[LizLola]

Hello! I suspect your son has had other problems and has read about the effects of 'human' and analogue insulins on some people. Which include loss of warning signs, this is what I presume you mean when you say he did not know he was low.

I switched back to animal insulin with the help of IDDT, as mentioned above - Jenny who runs this organisation can help you with any of your questions about animal insulin and can I suspect give you some names of consultants who are able to advise your son.

I use an insulin pump.

Your son may not like the thought of a pump, but it can return hypo awareness. It is also the case in those who have many hypos that they may not need a background insulin at a flat rate. I need a high doses of basal in the morning for example but none in the afternoon and during the night. If your son is one of those people, it is possible that no basal insulin can replicate what he needs and he will have hypos regardless. With a pump you can change the basal rate hourly, which is useful for some people who have hyos which are unexplained.

 

[jack412]

your son is 17, I think you need to respect his opinion.
if he gets the schites on, a teen that throws his blood meter away and all that involves is going to be far worse.

 

[Beaver Lee]

Hello! I suspect your son has had other problems and has read about the effects of 'human' and analogue insulins on some people. Which include loss of warning signs, this is what I presume you mean when you say he did not know he was low.

I switched back to animal insulin with the help of IDDT, as mentioned above - Jenny who runs this organisation can help you with any of your questions about animal insulin and can I suspect give you some names of consultants who are able to advise your son.

I use an insulin pump.

Your son may not like the thought of a pump, but it can return hypo awareness. It is also the case in those who have many hypos that they may not need a background insulin at a flat rate. I need a high doses of basal in the morning for example but none in the afternoon and during the night. If your son is one of those people, it is possible that no basal insulin can replicate what he needs and he will have hypos regardless. With a pump you can change the basal rate hourly, which is useful for some people who have hyos which are unexplained.

Yes, absolutely, it was the danger of hypo unawareness that triggered all the research.
Yes, Jenny has been really helpful.
She said that we would need to be clear about why he wanted to change.
His reasons can be summed up by the acronym PASSED: this puts them in reverse order as his top priority is being safe on the roads.

P - Pure
A - Available
S - Sustainable
S - Safer
E - Existing Regimen
D - Driving License

Regarding your encouragement regarding the pump. At the moment he is quite at home with how he uses insulin; regarding animal insulin in a pump we have been really encouraged by:
http://www.iddt.org/wp-content/uploads/2011/05/JDN15-1pg32-6.pdf
Did you take part in this survey?
Thanks so much for your help,
Beaver Lee

 

[LizLola]

Yes, absolutely, it was the danger of hypo unawareness that triggered all the research.
Yes, Jenny has been really helpful.
She said that we would need to be clear about why he wanted to change.
His reasons can be summed up by the acronym PASSED: this puts them in reverse order as his top priority is being safe on the roads.

P - Pure
A - Available
S - Sustainable
S - Safer
E - Existing Regimen
D - Driving License

Regarding your encouragement regarding the pump. At the moment he is quite at home with how he uses insulin; regarding animal insulin in a pump we have been really encouraged by:
http://www.iddt.org/wp-content/uploads/2011/05/JDN15-1pg32-6.pdf
Did you take part in this survey?
Thanks so much for your help,
Beaver Lee

I'm so sorry - I can't remember! I've taken part in so many...

 

[wildfire]

Yes, absolutely, it was the danger of hypo unawareness that triggered all the research.
Yes, Jenny has been really helpful.
She said that we would need to be clear about why he wanted to change.
His reasons can be summed up by the acronym PASSED: this puts them in reverse order as his top priority is being safe on the roads.

P - Pure
A - Available
S - Sustainable
S - Safer
E - Existing Regimen
D - Driving License

Regarding your encouragement regarding the pump. At the moment he is quite at home with how he uses insulin; regarding animal insulin in a pump we have been really encouraged by:
http://www.iddt.org/wp-content/uploads/2011/05/JDN15-1pg32-6.pdf
Did you take part in this survey?
Thanks so much for your help,
Beaver Lee

Being clear about reasons for wanting to change to animal insulin is a good question and the one that has been troubling before Thursdays GP appointment. Thanks for your thoughts on this.
wildfire

 

[Beaver Lee]

Being clear about reasons for wanting to change to animal insulin is a good question and the one that has been troubling before Thursdays GP appointment. Thanks for your thoughts on this.
wildfire

Hi,
I am going to attempt to explain each of the reasons.

P - Pure
Bovine insulin has 48 of the amino acids that are the same as insulin produced by humans. Only three amino acids differ: A8, A10 and B30. Bovine Lente and Bovine Neutral are the least modified two preparations:
Insulin preparations and analogues: structure and properties Pages 150 - 154 of Journal of Diabetes Nursing Vol 2 No 5 1998
http://www.thejournalofdiabetesnursing.co.uk/media/content/_master/2994/files/pdf/ jdn2-5-150-4.pdf
Bovine, rather than Porcine, insulin is our son's personal choice. A personal decision that he feels strongly about

 

[Beaver Lee]

Being clear about reasons for wanting to change to animal insulin is a good question and the one that has been troubling before Thursdays GP appointment. Thanks for your thoughts on this.
wildfire

A - Available
Availability has been checked with the suppliers:
Drug Safety and Information
Wockhardt UK Limited
Ash Road North
Wrexham Industrial Estate
Wrexham
LL13 9UF
United Kingdom
Email: [email protected]
Hypurin Bovine Lente is available in 10ml vials. This is not available in cartridges.
Hypurin Bovine neutral is available in 3ml cartridges which can be used with the AN3810 Autopen Classic from Owen Mumford.
Also, this was sent to me by email from Wockhardt's Drug Safety and Information Department:
‘Hypurin Bovine Neutral and Hypurin Porcine Neutral are soluble (clear), short-acting insulins which contain a phosphate buffer. In the United Kingdom, it is generally considered that the presence of a phosphate buffer in a short acting insulin product should render the product suitable for use in a continuous, subcutaneous infusion pump. The manufacturer of the pump may be able to provide advice on the requirements relating to the insulin. Patients must seek advice from their doctor or Diabetes Specialist Nurse.'