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Lantus: Lethal or Saviour?

Discussion in 'Diabetes Discussions' started by helensaramay, Jul 8, 2019.

  1. helensaramay

    helensaramay Type 1 · Expert

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    I have seen this article (available on diatech) about Lantus quoted multiple times on the forum.
    As someone who took Lantus for 12 years with no problem and know of many many people with type 1 using Lantus with no issue, I wonder if this is scaremongery and fear it may add to anxiety of people newly diagnosed.

    However, there may be some truth in it ... and I may have been one of the lucky ones.

    Therefore, I would be interested to know the experience of forum members who have or do take Lantus?
    I know this is not a scientific study but personal experience may go some way to alleviate unnecessary anxiety or highlight cause for concern beyond one, repeatedly quoted, article.
     
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  2. Muneeb

    Muneeb Type 1 · Well-Known Member

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    I have used it since I was first diagnosed, almost 19 years ago. May have had issues when I was in my teenage years, but I wouldn't have necessarily known it was from Lantus. However last year I did have a very serious scare from Lantus. I always inkect Lantus into my buttocks, that day after injecting I noticed some blood had entered the cartridge which seemed quite strange. Within half an hour I was sweating and dripping like a tap. Checked my glucose levels and they were 1.8, I was in a hotel at the time, but luckily had glucose tablets on me.

    I had a complete pack of tablets and two small bags of skittles, waited 15 minutes and it rose to just above 4. 20 minutes later I was dripping with sweat again, checked my levels and they were below 2 again, at which point I really began to panic and ate another pack of glucotabs (at this point I wasn't bothered about any overshoot). Finally it began to rise, but wasn't until an hour where it reached good levels. It was a very scary situation, especially when I've been living on my own for many years. Researched online and found I wasn't the only one with a 'Lantus low'

    Overall control with Lantus has been good over the years though, and that swayed me to sticking with it, but I may try alternatives in the near future.
     
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  3. borderter

    borderter Type 2 · Well-Known Member

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    Sounds like you injected into venous system and that makes insulin work superfast so probably not the lantus itself .Isnt this disease exciting we never know what will happen next lol
     
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  4. Muneeb

    Muneeb Type 1 · Well-Known Member

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    It is, however this does not occur with other basal insulin's and is unique to how the Lantus works.

    "Lantus Insulin is designed to work by forming tiny crystals after hitting subcutaneous fat - these crystals then dissolve at a uniform rate to provide the 'basal' insulin release. If you don't hit that subcutaneous fat, then it may be that some or all of the Insulin is active immediately rather than crystalized and released slowly." As posted in an older thread.
     
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  5. Knikki

    Knikki Type 1 · Well-Known Member

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    I used Lantus for many years, the only reason I changed is because I wanted a Basel to last 24hours not less than 18hours as I was finding with Lantus.

    I do not find Lantus a problem in controlling BSL and as far as I know had no adverse events when using it, it was Novarapid that caused me the main problems, but that's another tale.

    What I do find interesting about the paper that is often quoted is the conclusion

    Now I’m not suggesting that Glargine is bad for everyone. Many people find it works well for them and there are plenty of anecdotal examples of the pharmacokinetics of Detemir not suiting people either, but my experience of it was terrible, and the two studies I can find looking at variability of absorption seem to reflect that experience.


    So the person writing the article had a bad experience but this is not uncommon as not all medicine suite all people plus as he mentions he has found people having difficulty with other insulin.

    As Lantus is a tried and testing long acting insulin that is most often the first one dispensed to those newly dx'ed and who are trying to find there way through quagmire of T1 this sort of thing dropped into a conversation with out any back up or explanation is scare mongering and uncalled for.

    Look around the forum and you will find that with all the various flavours of diabetese that some have quite bad reactions to the medicine or it simply does not do as they want but yet these are not called into question.
     
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  6. Muneeb

    Muneeb Type 1 · Well-Known Member

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    If my proven experience is scare mongering with no back up or explanation, then that's also your opinion, with no back up or explanation. With the level of technology available over the past 20 years, it is near on impossible for you to say categorically that Lantus was never the cause of erratic behavior or lows. Yes all medicines have side effects, but other basal insulin's do not have the same potential effect of the deadly lows. As I said, I'm still using Lantus now, but if the side effect kills one person, isn't that one too many when it could potentially have been avoided?

    Just like you I was reluctant to accept Lantus could cause these issues when I saw it a couple of years ago mentioned, but when it happens to you, you definitely know about it. Being a Type 1 with good and tight control, it was definitely the most scary moment in my diabetic journey. Just imagine what could have been if I didn't have sufficient hypo treatment.
     
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  7. Rokaab

    Rokaab Type 1 · Well-Known Member

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    I know I was on Lantus for a fair amount of time (maybe just under 20 years, not sure entirely), I never knew I had problems with it til i got my libre at which point I could see I was dropping into the red at about 2-3am in the morning (I took it somewhere between 10pm and 11pm normally), so whilst I may have had some issues with it, it most certainly did not kill me off :) (unless going to work everyday is part of some weird after life reality I'm living in without actually being alive)
     
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  8. kitedoc

    kitedoc Type 1 · Well-Known Member

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    And in the article quoted from diabettech.com, this rapid onset hypo due to likely accidental injection into a blood vessel was the very reason i believe for the use of the word 'lethal' in the title. I bow of course to the author's version iof events if I am mistaken.
    The other point raised in the article is that the other two comminly prescribed long acting insulins, Levemir and Tresiba are formulated in a way that does not cause the risk of severe hypo if accidental ( or intentional) intravascular injection should occur.

    And the fact that along with shortacting insulins, Lantus and its relations might be a great risk to life if administered into a blood vessel for any reason remains a pertinent fact, though accidental injection into a blood vessel is said by many to be rare.

    The other problem is that with use of pens for MDI the old time practice of drawing back on the syringe plunger to check for possible entry of the needle into a blood vessel is not possible. The best one might see,with pen use, as described by one person posting here, is a flash back of blood into the insulin in the ampoule.

    Of a total of 52 years on insulin, about 29 years of them with traditional needle and syringe, 16 years using pens and the remainder on an insulin pump, i can only recall 3 blood 'hits' with traditional use, 2 blood flashbacks on pens and one flashback with use of a pump cannula.. As the adverts say, experience of problems may vary between users.
     
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  9. Mel dCP

    Mel dCP Type 1 · Well-Known Member

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    I used Lantus for 10-12 years and never had an issue with it.
     
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  10. Circuspony

    Circuspony Type 1 · Well-Known Member

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    I had it for 6 months after being diagnosed and felt dreadful on it. Aches all over. The DN agreed to change me to Tresiba because it was more stable and within a week the aching that would keep me awake at night he'd gone.
     
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  11. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    I have never used Lantus, but like you, I have noticed negative posts about it.
     
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  12. kitedoc

    kitedoc Type 1 · Well-Known Member

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    I do not doubt for one minute that your experience was absolutely ghastly @Muneeb. Who knows if your original prescriber even knew about this problem with Lantus when he\she first prescribed iti? There is certainly no mention of this particular problem in the official drug information or updates or post marketing reports.
    I believe people here have been reporting their own experience of Lantus and that is not done to downplay your experience at all, just making a statement of their own.
    One particular issue is that the doses of a long-acting insulin are likely to be higher that a shortacting insulin so that the 'hypo whammy' of an intravascular injection is more pronounced. The apparent rareness of insulin being accidentally injected Intravascularly may well have covered up someone dying of a heart attepack due to the resultant hypo.
    There is a thing about duty of care of doctors to provide all information about side-effects of a drug to patients before prescribing it for them, no matter how rare the side- effect. There was a famoue Aussie medico-legal case yonks ago. which led to an increased emphasis on this duty of care and issuing from Oz of all places, which is why I remember it.
    It would be interesting to know if doctors have ever received warnings about this problem with Lantus, either from the manufacturer or the authorities.
    In that regard i would encourage you to report your experience with Lantus to whatever Adverse drug reaction authority exists in your country, for all users of Lantus sake.
    Of course, whether continuing on Lantus or not is your decision to make.
    Best Wishes.
     
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  13. Antje77

    Antje77 LADA · Moderator
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    I've been on Lantus and have had one of those Lantus lows. Very, very scary, and I remember the last thing I thougt before passing out for some 2 hours (reconstructed through the gap in Libre scanning and finger pricks) was 'I really shouldn't close my eyes now if I want to live'. The passing out happened after already having had enough carbs, both quick and slow, for at least 3 normal days, plus a rather carby, fatty meal some 2 hours earlier.

    I'd like to see statistics on the insulins used by people who died from 'dead in bed syndrome' but I'm quite afraid of what they would show.

    I think I got lucky that I wasn't asleep yet and noticed the bizarre fall in bg in time to notice something was very wrong and to drink all that undiluted lemonade before passing out. I should have called emergency and unlock the door but I didn't.
    Took me 2 days of googling to find information about Lantus being able to do this, and when I did I called my HCP that I wouldn't take my Lantus anymore and could she prescribe either Levemir or Tresiba.

    I'm quite happy to be alive.
     
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  14. kitedoc

    kitedoc Type 1 · Well-Known Member

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    I hope you or your HCP reported this trouble to whatever adverse drug reaction authority exists in your country @Antje77 .
    The more reports the better to prevent what yiu experienced and worse. You raise an interesting point about Dead in the Bed Syndrome!!
     
  15. Antje77

    Antje77 LADA · Moderator
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    Of course I did!
     
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  16. mike@work

    mike@work Type 1 · Well-Known Member

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    Hello all!

    Tried Lantus about 10 years ago, and I'm sorry to say it was NOT suitable for me. After about 1½ to 2 weeks usage, I started to get very tired, but worst of all, was the feeling of going around in a dense fog.
    Kept my BGLs steady though, so from that point of view not all with it was bad...
    Symptoms gone after change of Insulin.

    Mike
     
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  17. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Great! I
    Do they allow you or your doctor to know how many such reports have been received and whether there have been alerts sent to prescribers and the manufacturere about it?
     
  18. Antje77

    Antje77 LADA · Moderator
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    I just had a look on the website (Lareb) and statistics of reports are open to view. Sadly, this means it's only noted as hypoglycemia, which of course is the main side effect from insulin anyway.
     
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  19. Muneeb

    Muneeb Type 1 · Well-Known Member

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    Out of interest which basal did you switch to and why?
     
  20. Antje77

    Antje77 LADA · Moderator
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    Tresiba, which was my first choice because of the flexibility in timing, and it turned out to be the first choice of my HCP as well. I would have accepted Levemir as well, although that's more of a hassle with the injecting twice a day.
     
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