Insulatard Effect

[azizdhl]

hi guys,

just want to ask something about insulatard, as I know it's an intermediate insulin which last approximately around 12 hours.

during its peak hours from 4-12 hours, does it lower the blood glucose like actrapid does or its effect it's just to maintain the blood glucose. please advice me how this insulin works, I've been many doctors and they all deal with it as a long acting insulin and gave me only once a day which lead to high number of blood sugar.

 

[Diakat]

Hi @azizdhl
Not used it myself, bumping up your thread.

 

[MrGrumpyD]

I do use it and have no idea on the info....good question

 

[tim2000s]

hi guys,

just want to ask something about insulatard, as I know it's an intermediate insulin which last approximately around 12 hours.

during its peak hours from 4-12 hours, does it lower the blood glucose like actrapid does or its effect it's just to maintain the blood glucose. please advice me how this insulin works, I've been many doctors and they all deal with it as a long acting insulin and gave me only once a day which lead to high number of blood sugar.

All insulin acts in the same way, in that once the insulin is absorbed, 1u of one insulin will lower your glucose level the same amount as any other.

The key point is how fast they are absorbed, so longer acting insulins are designed to be absorbed more slowly, while shorter acting ones are designed to be absorbed more quickly.

You also have to consider why they are designed that way. Insulatard (an NPH formulation) is designed to be absorbed over 12-18 hours while Actrapid is designed to act as rapidly as possible. That's because you dose with Insulatard to manage the glucose produced naturally over time, while your Actrapid is used to deal with more rapid carbohydrate climbs from your meals.

If you were to take enough Insulatard to manage your mealtime carbs, your glucose level would go very high then revert back to roughly where it started, but over a very long time period, due to the slow absorption of Insulatard.

 

[alphabeta]

I have used insulatard for years and I can tell you it is not the best insulin as its predictability is pain in the hand (you get it). Anyway, it used to drop me about 3.5 later like crazy then almost stable till the next day. Premixed insulin was better, but it went out of my body at about 4AM and it is neither the most flexible. Anyway, why are you still using insulatard?

 

[azizdhl]

Because it is the only option I have where the government in my country give it for free while others types like Lantau is very expensive over here ( 100 usd ), do you recommend lantus?

 

[azizdhl]

All insulin acts in the same way, in that once the insulin is absorbed, 1u of one insulin will lower your glucose level the same amount as any other.

The key point is how fast they are absorbed, so longer acting insulins are designed to be absorbed more slowly, while shorter acting ones are designed to be absorbed more quickly.

You also have to consider why they are designed that way. Insulatard (an NPH formulation) is designed to be absorbed over 12-18 hours while Actrapid is designed to act as rapidly as possible. That's because you dose with Insulatard to manage the glucose produced naturally over time, while your Actrapid is used to deal with more rapid carbohydrate climbs from your meals.

If you were to take enough Insulatard to manage your mealtime carbs, your glucose level would go very high then revert back to roughly where it started, but over a very long time period, due to the slow absorption of Insulatard.

Thank you sir for your response

Do you think using insulatard + actrapid for like 15 or 20 years will cause a problem where it lower the blood sugar after a long period which lead to unstable range everyday?

Do you recommend me to change to Lantus and novo where I read that lantus doesn't have a peak hours so it maintains the blood sugar during the 24 hours without any lower or upper the blood sugar, even in my sleep it maintains everything right unlike the insulatard

Thanks again

 

[scotteric]

Thank you sir for your response

Do you think using insulatard + actrapid for like 15 or 20 years will cause a problem where it lower the blood sugar after a long period which lead to unstable range everyday?

Do you recommend me to change to Lantus and novo where I read that lantus doesn't have a peak hours so it maintains the blood sugar during the 24 hours without any lower or upper the blood sugar, even in my sleep it maintains everything right unlike the insulatard

Thanks again

The standard treatment regimen before MDI became the norm was to take 2 doses of NPH/insultard per day at breakfast and before bed or at dinner, and use Actrapid to cover breakfast and dinner. The peak from the NPH would cover your lunch. The problem with this regimen is that you have to eat the same amount of carbs at the same time for lunch every day, and that the NPH peak can be unpredictable. Lantus, Levemir or Tresiba combined with NovoRapid, Fiasp, Humalog or Apidra is the standard treatment protocol in the western world now. Are there any assistance programs that could help you afford these insulins?

 

[azizdhl]

The standard treatment regimen before MDI became the norm was to take 2 doses of NPH/insultard per day at breakfast and before bed or at dinner, and use Actrapid to cover breakfast and dinner. The peak from the NPH would cover your lunch. The problem with this regimen is that you have to eat the same amount of carbs at the same time for lunch every day, and that the NPH peak can be unpredictable. Lantus, Levemir or Tresiba combined with NovoRapid, Fiasp, Humalog or Apidra is the standard treatment protocol in the western world now. Are there any assistance programs that could help you afford these insulins?

Unfortunately no, Lantus combined with novo rapid cost around 140usd monthly, but is there any case that Lantus not good for some people, I am afraid that if I change to it it will not work for me, and should I do any test before I change to lntus

 

[alphabeta]

Unfortunately no, Lantus combined with novo rapid cost around 140usd monthly, but is there any case that Lantus not good for some people, I am afraid that if I change to it it will not work for me, and should I do any test before I change to lntus

You have to be veeeeery patient with Lantus as if you increase your dose and see no immediate effect the next morning, this is very normal because the dose take around 3 days to settle down. I made this mistake when changing and I ended up being 3 to 5 units above my dose. Anyway, there is no test as far as I know, be prepared to test more than usual, and it can take about month or 2 to get stable again but for me it was definitely worth it.