Which insulin is best..old or new?

I looked at animal insulin but for me, its not very flexible.

You need to take the regular (short) acting insulin around 30 mins before eating. Correction doses wont work as quick. And actually I dont believe there is any evidence that supports the fact that its better than human.

Its all down to personal choice. Some people are allergic to human stuff so still use animal.

Theres also a lot of guff that suggests human might not have been tested very thoroughly!

Lets see the comparable testing for animal....

Its very subjective.

I remember when I was on animal (albeit in my teens) I had very violent hypos during the night without warning and frequently ended up in hospital. Might be fine for you though!

I have recently changed from Novorapid to Apidra - another fairly new human fast acting insulin. I seem to be getting on very well with it. I suffered from the wolley head and peaks and troughs on Novorapid. Tried Humalog but also had bad experience of that - stings on administering it and also had very fast hypos very soon after taking it/eating.

Apidra seems to suit me better. You just need to try a few out until you find the right one. Its a long slow process. Look at manufacturers profiles and see which might suit you (for your lifestyle) then speak to your specialist about it. Mines very supportive and could see i'd done lots of research so was happy to let me try a new one.
Paul

Hi Paul,
I'm sure your in a minority when you say you think it's "guff" that there's not been enough testing on analogue insulins. It's a fact. For many people the side effects can take 18 months to display-show me a study on lantus that lasted that long?? Newly diagnosed people can be too trusing of the medics treating them, and foolishly think that they know best. I had **** treatment from my hospital clinic and consultant despite telling them of the probs I was having with control and the side effects, which at the time I did not know were related to Lantus-I can assure you that I do now! My consultant told me it was fine for my blood sugar to rise to 15mm/l every day-it is obviously not. I think that many patients are being told the same guff, only because the consultants are reluctant to take these patients off the analogue insulins, even though it is clear they are not the best option for the patient. Patients can easily presume the problems and side effects are simply part of being a diabetic on insulin, it's doubtful they'll be told any different.
Patient choice is the key to control as I was told when I was diagnosed and initially treated at St Georges Hospital in Tooting. That patient choice does not seem to exist anymore-as soon as a patient is diagnosed type-1, they are put on analogue insulin-know any different??
These new "insulins" reduce hypo awareness, that is a fact, and how can that be good for any diabetic?
Animal insulins are tried and tested and safe, they have been used for quite a few years longer than synthetic ones!!
Animal insulins are definately not old-fashioned, and in my experience since changing to Hypurin Porcine Isophane after nearly 20 years on synthetic insulin, it gives the flattest profile I have ever experienced. My health is better than it has been since I was diagnosed, and I am now beginning to lose the weight that has troubled me since diagnosis.
Don't believe the hype :twisted:
Jus

And I'm very glad this change has worked out for you.

All I'm saying it does not affect everyone in the same way - animal insulin caused me a hellish time. Not something I've experienced to that extent on human stuff.

I dont think I'm the one thats been brainwashed! Yes they have been around longer. So have Austin Allegros but it doesnt mean thats a better car than a modern car - except Renaults!! All drugs have side effects with some users, some dont have any problem. Modern drugs are also often pushed through more quickly than older drugs too - although I have heard there have been some questions over the full extent of the testing of human insulin.....

If you think you have a serious problem on human or animal, I've found that by doing research and approaching your health care team armed, more often than not results in an option to change things. Of course this is dependent on the 'postcode lottery' and how approachable your dr is. If your Dr is saying its ok to have a bg of 15, thats a training/understanding issue, not a reluctance to provide animal insulin?!

"These new insulins reduce hypo awareness...." in a few users. I've had the reverse effect and have better awareness now. Again its very personal and just beware of the implication that human insulin is bad thing.

The best thing is to look at both, check out how either will best fit into your lifestyle and try them!

Paul

oh Rach, have you considered trying levimer twice a day instead of lantus?

gotta say if I wasnt pumping, that would be my choice now. Just a thought

Paul

Hi Paul,
I note that you are on a pump, can u explain what a pump does that is different to taking injections, I don't know anything about them.
thanks
Jus

Jus,
Pumps use a rapid acting such as Novorapid, Apidra, Humlog, or short/regular acting insulins from the bovine or or porcine range like your hypurin.

They have 2 profiles, one being a basal rate which (on my pump) drip feeds insulin every 3 mins which is supposed to best mimic the pancreas. Over a 24hr period I can change the amount of this I receive by the hour and this helps with things like afternoon lows (so I have much less) and early morning highs (so I have more).

The other is the bolus rate for mealtimes and paired with carb counting is pretty easy to manage. I just shoot up a relative amount to the food I am eating - luckily my ratio is 10 grams per 1 unit!

Of course it stay plugged in, which means I eat sleep and play with it on.

I think the best thing about the pump is flexibility it gives. I can eat when I want to and dont worry so much when I have a big meal or something high in carbs like a pizza or chinese. You can also set extended boluses which deliver your dose over a time period that you set. Great for Pizza.

The difference with injections is the background insulin should give you a constant flatline. Of this in most cases this does not happen and will still end up with peaks and troughs exaggerated by your mealtime injections which may mena you are overloading or crashing. On MDI I fluctuated like a yoyo. Hence the pump.

Back on subject - I know there are even pump users on here that are happy using animal insulin. SarahQ will no doubt pop up soon with her experiences. I considered this very recently but I would be hopeless planning ahead for meals. I tend to eat as and when, and animal just would not work as it would be too slow responding. The other bonus for me on human insulin is that if my BMs are high, I have found that especially Apidra works very quickly at lowering the count. I have also realised that the meal spike does not occur and post meal hypo (at around 3-5 hrs) is very much bannished to the naughty step.

For Rachs info, just to add some people have been known to lose their hypo warning signs on human, so they might go onto animal to overcome this too.

Like I said, weigh up the pros and cons and decide how best to make it work for your lifestyle.

I understand the concerns that have been raised on human insulin through various forums but remember, the people you see on here have generally found the site because they've had problems. Its the same on car forums, people tend to use them when they have a problem. That doesnt reflect the many thousands of people that don't have problems.

Paul

This is OPINION only based on other's experiences.

The main problem insulin appears to be Lantus. For many people it is an order of magnitude better than NPH but for others it's the one most often associated with loss of hypo awareness. Some people do better on Levemir. Some people go back (or on) to Beef or Pork L and continue using the modern fast acting stuff in a successful combination, incidents or problems with Humalog Novolog or Apidra can usually be resolved by switching from one to t'other rather than going to R. Some people still pine for Ultralente.

Just because only a minority of users are affected doesn't mean these aren't real problems.

The best insulin is simply the one that gives you best control - that being a balance of HbA1c, hypo awareness/frequency/severity, weight and quality of life.

We're all individuals and the only way to find which works best for you is to try them. Be aware of the potential problems (otherwise more subtle side-effects might not immediately be recognised as such) but remember they're only potential and you may not get any of them. One man's meat is another's poison. If you have good control don't change your insulin just cos something newer and shinier comes along. If you decide to change, do so on the strict understanding that you can change back if it doesn't suit.

SarahQ said:

I and all other pumpers will tell you the same thing you just do not notice the pump is attached to you at all.

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....until you catch the line on a door knob :shock:

Sarah, you were a great help to me in making a decision to change to animal insulin, and life's been great since, so I'm very grateful for your advice. The main reason I remain active on this forum is because my experience on Lantus was so bad, that I want to keep telling my story to ensure no-one else suffers and thinks their life is over, as I did-I truly thought I was dying.
I have had someone contact me recently with similar problems to that which I suffered while on Lantus. I can't emphasise enough how awful my quality of life was for 4 years while on Lantus, and if me telling my experience helps just one person, then that's a result.
I'm not dead against synthetic insulins, despite what my recent rants may suggest. I do still take humalog, and I agree with you Paul, synthetic rapid-acting analogues are superior in their action & do "exactly what it says on the tin", but my long-term goal is to ween myself off it and on to Porcine Neutral. I take as little Humalog as possible, following a fairly low-carb diet a la Eddie! That's how I know my Pork Long-Acting is very effective.
I have no doubt that Lantus is a faulty product, and nothing anyone has said on this forum has changed my mind. In fact, everytime I do an internet search I find more people coming out of the woodwork with problem after problem with this product.
I'll shut up now before a huge pharmaceutical company send a hit-man for me!
Jus

Hi Rach,

I was on animal insulin when diagnosed in 1974 aged 4, then in 1982 ish changed onto synthetic insulin and suffered a few issues which consultants have told me are part of having diabetes and good control will resolve, which of course in my case seemed to be rubbish. After a sucession of HBA's of 7's up to 8 I changed 8 years ago to a Humalog 30 premix and since then my mood swings, tiredness and BS spikes have esculated. My HBA1c was 5.9% to 6.8% generally but I felt pants most of the time.

So I joined this website and then found that Animal insulin hadn't been discontinued and infact was very much alive. I read the IDDT report and could relate to a good percentage of those symptoms so I made an appointment with the DR. She was fantastic and last week I changed back to animal insulin.

Now it's early days and I have not got and am struggling to get my BS's correct and I am trying to follow a lowish carb diet of around 90-100g a day but I do feel better, infact and I don't want to put a damper on it in case things change but I feel much much better. I haven't snapped or got grumpy since day 1, which for me is amazing as it seemed like more than a daily occurence. I am conscious that perhaps I am trying harder not too snap or be grumpy which I have tried before on the human insulin but always failed, now though I just don't actually feel grumpy. People are commenting how relaxed I am. The tiredness is much better I have the energy to play with my 2 year old son as long as he wants and not as long as i can manage. Long may it continue but at this point I have to say I think it's working.

Different things work for different people Rachel, so there is no harm trying different insulins until you find the one that works well for you. Thats what I intend on doing if this doesn't continue or I have to change to slow acting daily and fast acting during the day regime.

Hi all,

I have been using Lantus for a number of years now and it seems not too bad for me. What have other people experienced on Lantus? Im obviously keen to see if there is anything similar to what I may or may not have experienced myself?

Many thanks
Paul

Im on Mixtard 30 and feel absolutely awful still though Bg appear fine and at clinic appt Doc was in raptures re how things have settled over past weeks so diabetes in and of itself is not being blamed for feelings of general malaise ie fogginess, viral type feelings, blah blah blah (though if they mention stress one more time.................)
Dx only in Sept and HBA1c of 7.9 - not great obv but not as bad as I thought, and only way is down. Well, in HBA1c terms, i hope LOL.

Most pre meal sugars between 4.5 - 7 and most fasting am sugars around 5.6 - 6.5 so due to fact that they arent 'blaming' diabetes GP has taken blood tests (nowt so far) and Consultant is going to test for more (Addisons, electrolyte probs etc). As they rule more and more out I am fast coming to conclusion that it is my insulin that is contributing to this - its the only constant thing since diagnosis. Anyclaims of stress (that cause such problems) would surely show up in bg, bp, resting heart rate - both which are deemed normal. IDDT makes reference to it but nothing concrete anywhere else that I can see and even IDDT site does not have any great deal of empirical proof as such.

Dont know if anyone else has experience of this with the mixes? Am pushing to change to b/b - not least just to change insulin and see. However, am bit worried about Lantus now?. If they suggest it and I insist on Levemir then I'm sure my cards will be marked :wink:

L

Hi Rach,
My Aunt has been T1 diabetic for 33 yrs and has always been on animal insulin twice a day and injecting 30 mins before each meal, (my 10 yr old son is also T1) My Aunt is now a healthy 72 yr old, and in a recent conversation said her DN had told her that her animal insulin was being removed from the market in the near future, but not to worry they'd give her 6months warning!! She's thinks she's too old to change regimes now, she tried synthetic insulin once before and had such a bad experience with hypos which she had no warning of, she'll be very reluctant to have to change.
Of course everyone reacts differently and what works for her may not work for you. My son is heading for another change in his insulin, this will be his 4th, and injects 3 times a day, but think we'll be heading for 4 shortly. One day we'll hit the jackpot and find a regime that works for him, till then we'll just keep trying. At present he's on insuman comb 15, humalog and lantus.
Take care
Suzi x

Hi Rach,
I'll let my Aunt know by phone ,she lives in Harlow Essex and i'm in Ballymoney N. ireland. She also told me her clinic were asking her to attend annually as they have so many diabetics in the area! This only after recovering 2yrs ago from liver damage after being prescribed drugs for blood pressure which did not agree with her insulin and therefore caused 40% damage to her liver, Thank God our liver repairs itself!
But honestly i'd have thought T1's would be entitled to at least two visits a year regardless of how many were in the area, is this a sign of cutbacks/over worked and under staffed clinics!
I won't rant any longer it just makes me sooo cross.
Take care
Suzi x

SarahQ said:

Hi Suzi, will you ask your dsn to back her statement regarding the withdrawall of animal insulin's. Her statement is totally incorrect. It is the normal blurb that is spouted each time someone asks to change to it and all it does is worry people like you Aunt. Please tell your Aunt not to worry. There is plenty of info here to put your Aunt's mind at rest http://www.iddtinternational.org/index.htm Please give Jenny Hirst a ring

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It's not unlikely that it has been withdrawn from her PCT's formulary in which case you will have to jump through hoops to continue to get it prescribed. They try to limit the number of drugs that are permitted to be prescribed, and stocked by pharmacists, within their own area. You CAN get non-formulary drugs whatever they try to tell you.

Yes I'm not disagreeing, it's just something I came up against when we moved, they don't prescribe famotidine here only ranitidine and when I was changed over saying it didn't work wasn't enough to get changed back, I had to claim that it gave me side effects.

Similarly my losartan was changed for olmesartan (which actually proved to be better as well as cheaper) and I'd have been changed to simvastatin if I wasn't already on it.

There's local financial control as well as general issues, and I suspect this is at least part of the reason behind lying about the availability of animal insulins.

Just out of interest how does it compare cost-wise?