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[IPk] re: long-acting insulin discussion

Ingrid wrote:

I am now on split doses of ultratard (I know people say that ultratard is
also unpredictable) and with a bit of fiddling most of my morning levels

I had used ultralente, the Eli Lilly product similar to ultratard, and I
was quite happy with it as a background insulin.  I had also tried lente
early on because I thought it would sort a few problems, but it was
disastrous!  I discovered my problems weren't with dose (the dose changed
very little), but with the split of the dose and the timing of the dose. I
was on two shots of ultra as well (large dose at 3pm, booster dose at
8.30pm), and that worked very well. I don't believe there is such a thing
as a 24-hour acting insulin. Ultalente was supposed to last in the body up
to 36hours, and I found it ran out after 18!

the thing that I really hated about Ultralente was that, when my hormone
pattern changed unexpectedly, I had to wait an entire day before changes in
my background insulin dose could take effect. That was really starting to
annoy me. Additionally, I walked home from work, and whatever happened, the
last few months before the pump (possibly it was the onset of spring?), if
I left work after 5.30pm, I would need upwards of 60g of carb before I left
in order to prevent a hypo during my walk. When it first started happening,
I would sometimes eat two packs of glucose tabs walking home! The pump is
much better that way.

I think that different long-acting insulins will suit different people, and
one of the great faults of the medical profession is the
one-long-acting-insulin-for-all approach.


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