Lantus v Levemir v anything else?

[Deb Arkle]

Hi - our daughter was diagnosed as type 1 DM just 3 weeks ago, and has been put on Lantus & Novorapid insulin. The novorapid seems to be fine, but for the last couple of days she's been in tears at the Lantus injection as it's painful for her. Having read a few threads on here, it seems that Lantus, as well as being painful, is also associated with hypos (she's having 1 or 2 hypos a day ATM, although her BG in the morning is fine). Would she be better off with Levemir, or is there another alternative? We're new to diabetes so haven't a lot of background info yet.

We're seeing the diabetic nurse on Monday, and I was going to request a change to Levemir in the hope that it would:
a - be less painful
b - cause less hypos.

Am I thinking along the right lines?

 

[copepod]

There are older long acting insulins, such as Humalin I, which is cheaper too, so I can't understand why they're not suggested more often). Best to explain the problematic aspects of Lantus to your diabetes team. Not all hypos are result of long acting dose, particularly if morning fasting blood glucose levels are OK. It's also worth asking about carbohydrate counting, to match short acting doses with food, activity and so much else. Some areas run courses, although these are rarer for parents and children than for adults with type 1 diabetes; even if no course is available, sittingdown with a dietician, if possible, would be useful.

 

[janabelle]

Hi Deb
There are loads of alternatives to the 2 Ls! Like Copepod, I'm amazed that everyone seems to be put on analogues at diagnosis these days. The reason for it is pressure/financial incentives from pharmaceutical companies, and partly ignorance of medical professionals. Here's a page from this website that lists alternative insulins. http://www.diabetes.co.uk/insulin-in-the-uk.html
You could print it and take it to your daughter's diabetes team, but I'm doubtful they will have any knowledge of other insulins, and might even suggest they are old-fashioned, not as effective, or have been discontinued. While many synthetic "human" insulins have been discontinued, the older insulins and animal insulins work better for many people, especially those who've suffered problems on the newer analogues.
The reason Lantus is causing your daughter so much pain is because it is very acidic on injection, it then neutralises which is how it releases itself slowly. Lantus is the only medication that works in this way, she's unlikely to experience this with other insulin treatments. For some people Lantus can cause unexpected and unexplained hypos, I experienced this, but as Copepod stated it is more likely the mismatch of her rapid-acting and carbohydrate. It's very early days yet, and hypos are unfortunately likely at this point, learning to carb-count will be very beneficial.
Everyone is different, it will take time to find the best insulin and regime for your daughter. If you have any concerns you should expect your daughter's team to address them and work with you.

Jus

 

[Deb Arkle]

Thanks for the replies! We're going to the diabetic clinic on Monday, so I'll try to get the Lantus changed...as you said, it may be the Novorapid causing the hypos (although she's only on 1u:20g!) but we want to make her injections as trauma free as possible, which is why I wanted to change to a different long-acting insulin.

 

[jopar]

Levimer does have a different PH balance so if lantus is stinging you might find swapping over to levimer will do the trick..

Are you injecting the lantus straight from the frdige?

Once the cartridge is in the pen it can be left at room tempreture for a month without harm, just keep it out of direct sunlight..

The Animal insulin debate, you will hear a lot of scaremongering stories concerning this..

You need to remember that Insulin is like any other medication, so will get on with a paticular type/make others will not! Just like antibiotics how many people do you know who's has a reaction to some or all of these????

Animal Insulin has as many added ingredients as human insulin, any one of these can give an individual an reaction...

I've been using human insulin now since the mid 90's without any problems with it. For my husband husband human insulin has been a godsend, he produced anit-bodies to animal insulin to rendered it useless! Since going onto human insulin in late 90's he's had one insulin change, is quick as always been Novorapid, they changed his background insulin to Levimer in 04/05 when he went onto MDI...

Another thought about animal insulin is the actual regime of having to inject 30 minutes before eating which does limit flexability big-time... This is something that a lot of people don't tell you about..

And there are many reasons while individuals get control problems, I've seen it here where members have been persuaded that there issues are all based on the human insulin, so they battled with there HCP to get Animal insulin only to find out that there issues had nothing whats so ever to do with human insulin!!

 

[Deb Arkle]

I'll see what the clinic suggest as an alternative - we're not keeping any of the current meds in the fridge, just the unopened packs. It does seem that Levemir would be better - the Lantus seems to be fine other than the stinging, the hypos could well just be due to the honeymoon period....I just want her to be able to cope with the injections without having to dread one of them!

 

[noblehead]

I'll see what the clinic suggest as an alternative - we're not keeping any of the current meds in the fridge, just the unopened packs. It does seem that Levemir would be better - the Lantus seems to be fine other than the stinging, the hypos could well just be due to the honeymoon period....I just want her to be able to cope with the injections without having to dread one of them!

The lantus and levemir insulin's work in pretty much the same way, but do keep in mind that levemir insulin does not tend to last 24 hours and may need to be split into two doses, one in the morning and again at night.

Nigel

 

[Lisa21]

I've just switched from once a day Lantus to twice daily Levemir and I'd like to add that I experienced painful stinging on injecting the Lantus. Since I've changed to Levemir, this hasn't happened. 8)

 

[Deb Arkle]

Thanks for that, Nigel & Lisa - she doesn't seem to mind the quantity of injections, it's the stinging which is upsetting her so I reckon she'll be OK with it....I'll explain it all to her, and then it can be her decision.

 

[Hazza]

Hi Debs, Lily was put on levermir and novorapid from day one, and the levermir did sting more than the novo rapid, but we now use something out of the freezer to apply before we give the injection. This certainly seems to help. Also, do you use a penmate with the pens? if not ask your diabetes nurse about them. We are convinced that they help. They are a bit bulkier but are kinder to young skin.
Hope this helps.
We only keep unopened insulin in the fridge too. Once it's in the pen it stays in her bag.

Harry

 

[Deb Arkle]

Thanks for that, I'll ask them about it.