I have just changed my bg insulin from Lantus to Hypurine Porcine Isophane doctors seem to know little about it. I am injecting twice a day and have split the dose which is now 8 each time my Lantus was 15 I am still to high around 14 it is that you have to use a higher dose and if so how much. I know there are folk out there who are using the same and would like to talk with them. Good news is that although I am high I don't feel as bad as I did on the Lantus. I have been switched for 4 days now.
insulin change
- Thread starter latecomer
- Start Date
When I changed from Latus to levemir it took about two weeks to stabilise, kept upping the dose slowly. Please keep us updated on how you get on with the Hypurine Porcine because I want to change to this.
Glad you feel better off the Lantus.
Glad you feel better off the Lantus.
Hi Latecomer,
The way you describe the feeling of being poisoned while on Lantus in your posting in "Soapbox" will strike a chord with many people, including another forum member who pm-d me over the weekend. It's exactly how I felt, I accused my husband of poison me many times, poor soul
Kewgirl has also described the same feeling while on Lantus.
Many people are suffering horrendous problems on analogue insulins, and I have been reliably informed that the IDDT (insulin dependent diabetes trust) are soon to be involved in collating the experiences of patients. The outcome of this research will hopefully give us an idea as to why so many patients are suffering such a terrible experiences on synthetic analogue insulins. Although the probs associated with Lantus don't seem to affect Levemir users; eg exhaustion, feeling disconnected from world, severe exhaustion, general lethargy and malaise, cognitive disfunction,joint and muscle pains & erratic BG control. Not all patients on Lantus appear to suffer these side-effects either, although it is unclear why. Hopefully we will soon find out.
Glad you feel better Latecomer, welcome to the club!
Jus
The way you describe the feeling of being poisoned while on Lantus in your posting in "Soapbox" will strike a chord with many people, including another forum member who pm-d me over the weekend. It's exactly how I felt, I accused my husband of poison me many times, poor soul
Kewgirl has also described the same feeling while on Lantus.
Many people are suffering horrendous problems on analogue insulins, and I have been reliably informed that the IDDT (insulin dependent diabetes trust) are soon to be involved in collating the experiences of patients. The outcome of this research will hopefully give us an idea as to why so many patients are suffering such a terrible experiences on synthetic analogue insulins. Although the probs associated with Lantus don't seem to affect Levemir users; eg exhaustion, feeling disconnected from world, severe exhaustion, general lethargy and malaise, cognitive disfunction,joint and muscle pains & erratic BG control. Not all patients on Lantus appear to suffer these side-effects either, although it is unclear why. Hopefully we will soon find out.
Glad you feel better Latecomer, welcome to the club!
Jus
kewgirl
Well-Known Member
- Messages
- 678
- Type of diabetes
- Type 1
- Treatment type
- Insulin
Hi Latecomer
Glad to hear you are feeling better since coming off Lantus. Welcome to the club of animal insulin users which numbered approximately 50,000 in the UK at the last count.
If my experience is anything to go by you will feel better and better as time goes by.
I am not shocked to see you write that the doctors knew very little about animal insulin – I was at a GP’s surgery this morning and one of the GP's stated they had never heard of Hypurin Porcine (Pig) and Bovine (Cattle) animal insulin’s - they were only familiar with the Genetically Modified synthetic analogues! Scary :shock: :shock: :shock:.
Regarding the change to Porcine Isophane – 4 days in you are not going to get immediate control – it does take time as with any insulin change to get the doses to what you need/require.
Please don’t despair – I know it’s frustrating but you will get control back. It just will not happen overnight. It took me at least a month to get doses, times, fine tuning etc sorted.
One of the significant differences between Porcine Isophane & Lantus is the mode of action i.e. Lantus is quite aggressive whilst Porcine Isophane is more gentle in action. However Porcine & Bovine insulin's are considerably more reliable – the onset and peak actions are very consistent.
Regarding dosage this is going to be very individual.
I found I need considerably less Isophane to Lantus ratio but am aware that other users have needed more – we are all so different.
Increase doses by approximately 1-2 units every 2-3 days & keep checking blood glucose (BG) levels.
If you are using pen injectors the Humapen Luxura HD (which accommodates the Hypurin Porcine & Bovine Cartridges) is good as it gives ½ units – I’m aware that there is some school of thought that it does not matter with adult insulin dosages as to whether you give a 1 or 2 unit injection but actually the addition or subtraction of ½ a unit of insulin can make a significant difference.
By testing BG levels because you will also be able to discover how long the Isophane is lasting. The Porcine Isophane’s action profile is onset approximately 2 hours, peak 4 – 6 hours and duration 8 – 14 hours - you need to know how long its lasting in you.
I found that the Porcine Isophane was running out after about 6 hours so changed to Bovine Isophane twice a day, which for me is much better.
Depending on when you inject, as in the times of day may also influence the effectiveness & time action of the Isophane.
Depending on where you inject as in bodily may also influence how long the Isophane lasts.
The NICE Guidelines suggest injecting Isophane in the thighs can give longer duration of insulin with slower onset. Walsh’s book “Using Insulin” advises injecting in abdomen increases the speed of insulin but again we are all so different – so you might need/want to experiment with injection sites. Just don't chop & change injection sites too quickly as it is difficult to evaluate which is he most effective part of the body to use.
The type of short acting insulin / rapid acting analogue you are using can also contribute to gaining control – the bolus & basal insulin’s need to work in harmony which is another challenge.
I’m sure you already know to gently roll the Porcine Isophane before injecting as its cloudy but between use the particles separate (which is normal) – if you see clumps in the vial/cartridge its either not mixed correctly or it’s duff so ditch it.
If you shake the insulin too vigorously the insulin might lose some of its potency.
Once you have a feel for the insulin trust your gut instinct as well as analysing your BG results.
If the Porcine Isophane isn’t suitable there is always the Hypurin Bovine Lente - which is also a medium acting animal insulin and the Hypurin Bovine Protamine Zinc Insulin (PZI) - which is the animal long acting insulin. Both of these animal insulin’s have slightly different action profiles.
All of the above are available on prescription in the UK and also currently in my fridge!
The Insulin Dependent Diabetes Trust (IDDT) are also a very useful contact for additional help re using animal insulin. viewtopic.php?f=23&t=11071&p=106184#p106184
Its also worth considering that as we know Lantus causes many users very debilitating & “strange” side effects – in effect your body has to detoxify from the Lantus & get used to a new insulin.
Keep at it – control will come.
Best wishes
Txx
Glad to hear you are feeling better since coming off Lantus. Welcome to the club of animal insulin users which numbered approximately 50,000 in the UK at the last count.
If my experience is anything to go by you will feel better and better as time goes by.
I am not shocked to see you write that the doctors knew very little about animal insulin – I was at a GP’s surgery this morning and one of the GP's stated they had never heard of Hypurin Porcine (Pig) and Bovine (Cattle) animal insulin’s - they were only familiar with the Genetically Modified synthetic analogues! Scary :shock: :shock: :shock:.
Regarding the change to Porcine Isophane – 4 days in you are not going to get immediate control – it does take time as with any insulin change to get the doses to what you need/require.
Please don’t despair – I know it’s frustrating but you will get control back. It just will not happen overnight. It took me at least a month to get doses, times, fine tuning etc sorted.
One of the significant differences between Porcine Isophane & Lantus is the mode of action i.e. Lantus is quite aggressive whilst Porcine Isophane is more gentle in action. However Porcine & Bovine insulin's are considerably more reliable – the onset and peak actions are very consistent.
Regarding dosage this is going to be very individual.
I found I need considerably less Isophane to Lantus ratio but am aware that other users have needed more – we are all so different.
Increase doses by approximately 1-2 units every 2-3 days & keep checking blood glucose (BG) levels.
If you are using pen injectors the Humapen Luxura HD (which accommodates the Hypurin Porcine & Bovine Cartridges) is good as it gives ½ units – I’m aware that there is some school of thought that it does not matter with adult insulin dosages as to whether you give a 1 or 2 unit injection but actually the addition or subtraction of ½ a unit of insulin can make a significant difference.
By testing BG levels because you will also be able to discover how long the Isophane is lasting. The Porcine Isophane’s action profile is onset approximately 2 hours, peak 4 – 6 hours and duration 8 – 14 hours - you need to know how long its lasting in you.
I found that the Porcine Isophane was running out after about 6 hours so changed to Bovine Isophane twice a day, which for me is much better.
Depending on when you inject, as in the times of day may also influence the effectiveness & time action of the Isophane.
Depending on where you inject as in bodily may also influence how long the Isophane lasts.
The NICE Guidelines suggest injecting Isophane in the thighs can give longer duration of insulin with slower onset. Walsh’s book “Using Insulin” advises injecting in abdomen increases the speed of insulin but again we are all so different – so you might need/want to experiment with injection sites. Just don't chop & change injection sites too quickly as it is difficult to evaluate which is he most effective part of the body to use.
The type of short acting insulin / rapid acting analogue you are using can also contribute to gaining control – the bolus & basal insulin’s need to work in harmony which is another challenge.
I’m sure you already know to gently roll the Porcine Isophane before injecting as its cloudy but between use the particles separate (which is normal) – if you see clumps in the vial/cartridge its either not mixed correctly or it’s duff so ditch it.
If you shake the insulin too vigorously the insulin might lose some of its potency.
Once you have a feel for the insulin trust your gut instinct as well as analysing your BG results.
If the Porcine Isophane isn’t suitable there is always the Hypurin Bovine Lente - which is also a medium acting animal insulin and the Hypurin Bovine Protamine Zinc Insulin (PZI) - which is the animal long acting insulin. Both of these animal insulin’s have slightly different action profiles.
All of the above are available on prescription in the UK and also currently in my fridge!
The Insulin Dependent Diabetes Trust (IDDT) are also a very useful contact for additional help re using animal insulin. viewtopic.php?f=23&t=11071&p=106184#p106184
Its also worth considering that as we know Lantus causes many users very debilitating & “strange” side effects – in effect your body has to detoxify from the Lantus & get used to a new insulin.
Keep at it – control will come.
Best wishes
Txx
what a loy of information thank you so much for taking the time.
Today is not so good I keep forgetting to take my second dose and to check and shake the insulin, so I am feeling tired again but I know that it is in my control, I am not sure which time to take the second dose so I have split them to 7 at 10 evening and 8 at 10 morning That is the one I forget hence at 4 in the afternoon I am giving myself half the dose. Is that okay?
Today is not so good I keep forgetting to take my second dose and to check and shake the insulin, so I am feeling tired again but I know that it is in my control, I am not sure which time to take the second dose so I have split them to 7 at 10 evening and 8 at 10 morning That is the one I forget hence at 4 in the afternoon I am giving myself half the dose. Is that okay?
kewgirl
Well-Known Member
- Messages
- 678
- Type of diabetes
- Type 1
- Treatment type
- Insulin
Hi Latecomer
Forgetting to gently shake the cartridge or phial – whichever you use - was on of the many reasons that the long acting synthetic analogues like Lantus & Levemir were hailed as great because they required less “preparation” as such i.e. no gentle rolling to mix the insulin.
I guess it’s a habit you need to get into & like with anything the more you do it the more adept you become and less likely you are to forget to roll!
You are still in the early days of an insulin change – if however you keep forgetting to roll then it might be worth considering some aide memoirs :idea: to assist you even a reminder post it note stuck to the cartridge/phial or pen injector – whatever you use.
Forgetting the dose at 10am is also easy to do especially if you are busy or occupied – one of the considerations with giving at dose at 4pm even if its half of the usual dose is the action profile of the insulin thus – the onset of the Porcine Isophane will be approximately 6pm with a peaking effect between 8 – 10pm – that’s the theory.
However it depends how different your body is & how long the Porcine Isophane lasts in you - some users only get 6 hours so technically the overlap time with your 10pm dose would be minimal however if you get duration of the Porcine Isophane up to 14 hours then you might & I stress might have a little too much insulin circulating.
Checking blood glucose BG levels when you have forgotten the 10 am dose is going to be the main way of assessing what to do with a missed dose.
The effect of giving an insulin dose late will also also depend on many other factors such as what time you eat in the evening and what rapid acting / short acting insulin you use, exercise, hormonal influences, previous food, previous days BG levels etc etc.
Its not ideal to forget to take a basal insulin dose but we are all human and sometimes we do forget things so please do not beat yourself up about it.
Have you considered setting an alarm :idea: – I have in the past set my mobile phone alarm (if I am working out in the community) & on the days when I am hospital office based have a small travel alarm clock on my desk.
Strangely if I am in transit I am less likely to forget the 10am dose & give the dose wherever I am but on the 2 occasions I have forgotten :roll: it was when I was very busy and occupied with work things. I remembered at midday so gave my full dose. I do permit myself an 1 hours window each way for my Isophane doses in order to give some flexibility. :lol:
However we are all different so its another case of experimentation as to what works best for you.
Best wishes
Txx
Forgetting to gently shake the cartridge or phial – whichever you use - was on of the many reasons that the long acting synthetic analogues like Lantus & Levemir were hailed as great because they required less “preparation” as such i.e. no gentle rolling to mix the insulin.
I guess it’s a habit you need to get into & like with anything the more you do it the more adept you become and less likely you are to forget to roll!
You are still in the early days of an insulin change – if however you keep forgetting to roll then it might be worth considering some aide memoirs :idea: to assist you even a reminder post it note stuck to the cartridge/phial or pen injector – whatever you use.
Forgetting the dose at 10am is also easy to do especially if you are busy or occupied – one of the considerations with giving at dose at 4pm even if its half of the usual dose is the action profile of the insulin thus – the onset of the Porcine Isophane will be approximately 6pm with a peaking effect between 8 – 10pm – that’s the theory.
However it depends how different your body is & how long the Porcine Isophane lasts in you - some users only get 6 hours so technically the overlap time with your 10pm dose would be minimal however if you get duration of the Porcine Isophane up to 14 hours then you might & I stress might have a little too much insulin circulating.
Checking blood glucose BG levels when you have forgotten the 10 am dose is going to be the main way of assessing what to do with a missed dose.
The effect of giving an insulin dose late will also also depend on many other factors such as what time you eat in the evening and what rapid acting / short acting insulin you use, exercise, hormonal influences, previous food, previous days BG levels etc etc.
Its not ideal to forget to take a basal insulin dose but we are all human and sometimes we do forget things so please do not beat yourself up about it.
Have you considered setting an alarm :idea: – I have in the past set my mobile phone alarm (if I am working out in the community) & on the days when I am hospital office based have a small travel alarm clock on my desk.
Strangely if I am in transit I am less likely to forget the 10am dose & give the dose wherever I am but on the 2 occasions I have forgotten :roll: it was when I was very busy and occupied with work things. I remembered at midday so gave my full dose. I do permit myself an 1 hours window each way for my Isophane doses in order to give some flexibility. :lol:
However we are all different so its another case of experimentation as to what works best for you.
Best wishes
Txx
well it is now the 4th Nov and I am still not there yet in fact I seem to be loosing the plot This morning work up with sugars at 25 ( This is becoming common) even though I had reduced the dose last night and also keytones of 1.3 my sugars are refusing to respond to insulin and I have gone to the DAFNE limit with my short term and increased my morning long term by one unit. This happened when I was on Lantus. I just want to go back to hospital and start again I feel so confused now.
