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