Strange insulin combo

[NinaB73]

A weird one I guess as I've searched the forum! I am on Humalin S and I and am about to have a play about with Lantus and Humalin S!! I have tried analogue insulin in the past and not been too successful as I find Novo rapid and humalog hits me like a spade and causes me to crash hence Humalin S, (which I like for its slower pace) and in the past Lantus and Levimir have not reached their 24 hours and despite splitting has not made a huge difference. I am now going to try Lantus as my Humalin I is just causing too many peaks and unwanted hypos. I know some people take unusual combinations of insulin and am just wondering if anyone has this one? I just thought I'd give it a try, nothing to lose and my old insulin to hand....

 

[catherinecherub]

Bump

 

[catherinecherub]

Can anyone help @NinaB73?
@himtoo, @azure, @noblehead

 

[himtoo]

Hi there @NinaB73
as with any change of insulins care and caution are to be exercised
definitely dropping dose amounts to start with and loads of testing , and titrate doses up over a few weeks

have you spoken to your DSN or Endo to discuss.

lantus can take 2-3 days for any dose changes to show up in BG results

 

[azure]

A weird one I guess as I've searched the forum! I am on Humalin S and I and am about to have a play about with Lantus and Humalin S!! I have tried analogue insulin in the past and not been too successful as I find Novo rapid and humalog hits me like a spade and causes me to crash hence Humalin S, (which I like for its slower pace) and in the past Lantus and Levimir have not reached their 24 hours and despite splitting has not made a huge difference. I am now going to try Lantus as my Humalin I is just causing too many peaks and unwanted hypos. I know some people take unusual combinations of insulin and am just wondering if anyone has this one? I just thought I'd give it a try, nothing to lose and my old insulin to hand....

I've not taken that combination of insulins as I moved onto a pump years ago after I couldn't find a basal that worked for me.

However, I have used a variety of insulins - regular human, analogue and porcine. I would second the advice above to watch your dosage. It would be wise to err on the side of caution to start with.

If you're having particular problems with your basal insulin needs eg Dawn Phenomenon, then you might want to take a look at pumps. Only a pump can precisely match your individual basal needs, especially if they're not 'flat'. Just another thing to think about

 

[NinaB73]

Hi there @NinaB73
as with any change of insulins care and caution are to be exercised
definitely dropping dose amounts to start with and loads of testing , and titrate doses up over a few weeks

have you spoken to your DSN or Endo to discuss.

lantus can take 2-3 days for any dose changes to show up in BG results

Thank @himtoo for your reply I didn't think I was going to get one! Yes, I agree and am cautious! I was hoping to do my lantus as a single dose but past experience and a 'gut' feeling says I will probably end up splitting it as I do now. I am worried about loading the whole lot in one dose so yes I was planning on cutting a bit off, my nurse says 10% but I think I may go just a little lower as I'm planning on taking it all at once, and at night (so worried about the night hypos, but I have those anyway) and if it doesn't last 24 hours I can up the Humalin S with tea to cover the deficit if that makes sense? And yes that is worth remembering that it may take a few days, Its easy to get impatient when you see higher readings! So thanks for that little hint!

 

[NinaB73]

I've not taken that combination of insulins as I moved onto a pump years ago after I couldn't find a basal that worked for me.

However, I have used a variety of insulins - regular human, analogue and porcine. I would second the advice above to watch your dosage. It would be wise to err on the side of caution to start with.

If you're having particular problems with your basal insulin needs eg Dawn Phenomenon, then you might want to take a look at pumps. Only a pump can precisely match your individual basal needs, especially if they're not 'flat'. Just another thing to think about

Thanks for your reply too @azure! Yes I have pretty much been through the lot over the years too! Your pump suggestion is the obvious answer but alas I tried a pump a couple of years ago and when it worked I did have excellent control overnight but I had cannula problems and it was so hit and miss with insulin doses that after six months I gave it up! I was really fed up about this as I had really geared myself up to the pump sorting my problems with basal insulin.
If I am honest I don't have the greatest diabetes team in recent years after a really great one for most of my diabetic life and I wonder if I could of persevered with using a pump with the right support! My saving grace is my nurse at my G.P clinic and we have discussed me moving to a different health authority to access better support. As I said to @himtoo I DO need to remember to go carefully and I can be a tad impatient so thanks for you messages, less is more...

 

[noblehead]

@NinaB73, there's a newish basal insulin called Tresiba which is said to be much flatter than lantus/levemir and lasts up to 42 hours, it's still injected once a day but might be worth enquiring about if lantus is causing you issues.

 

[himtoo]

hey @NinaB73
the forum usually works given time -- there is usually so much activity on the forum that sometimes important questions like yours ,they get lost in the mountain of people commenting on the weather .
ultimately we "own" our own diabetes and we learn the things that work for us and the things that don't.

you hopefully have lots of test strips and an alarm ( on your phone) so it just means lots of testing as you titrate to doses that work for you.

do keep us posted on your progress

 

[NinaB73]

@NinaB73, there's a newish basal insulin called Tresiba which is said to be much flatter than lantus/levemir and lasts up to 42 hours, it's still injected once a day but might be worth enquiring about if lantus is causing you issues.

Thank you @noblehead I have heard of Tresiba through this forum and have read with interest. My nurse did suggest it as a future option if I can't make the lantus work but it would require me to be referred to the hospital as she does not have the experience with it. It is certainly an option to consider and I may well be quizzing other forum users if I go down that route!

 

[noblehead]

it would require me to be referred to the hospital as she does not have the experience with it.

Perhaps if you get referred to another hospital you could discuss returning to a pump or changing to Tresiba, there's a member on here who has used Tresiba for the last 2 years with great success, I'll tag @robert72 in the hope that he replies to your thread.

 

[robert72]

Hi @NinaB73 - I would definitely recommend Tresiba as lasting way past 24 hours if you are having no success with Levemir or Lantus.

 

[NinaB73]

Hi @NinaB73 - I would definitely recommend Tresiba as lasting way past 24 hours if you are having no success with Levemir or Lantus.

Yes it is certainly a consideration and I have read some past posts of yours @robert72 and am glad you are having success with it. It seems these new insulin's are not always made aware to us so the information from others on here is invaluable!

 

[davidhcarlisle]

A single late evening dose of Tresiba keeps me flat 24/7 even during dawn phenomenon. Dr. Bernstein online is also encouraging of Tresiba. He recommends against Lantus for its potential for cancer as cited in studies.

Similarly to you, I had bad experiences with the pump, and having used it for 10 years, I don't recommend going back to it. Two split doses of Levemir was fine enough, but DP was an issue.

With low carb, I do Tresiba with Regular insulin (in the USA), bolused 45 min before eating. This combination of insulins and diet works great for me. Hope this helps.