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[IPk] Re: Lantus



Hi all,

I think the point about Lantus is it removes most of the problems associated
with unpredictable absorption. It is supposed to give you a relatively
constant background level of insulin, as opposed to something like
Insulatard which not only varies throughout a single day, but varies from
day to day too, causing difficulties in recognising BS patterns and thus in
achieving excellent control.

What Lantus cannot do that the pump can is provide different bakground (i.e.
basal) levels at different times of the day. It is extremely rare to find a
pumper who has only one basal rate throughout the day - apparently the
average is four. I imagine Lantus will work extremely well for someone whose
basal insulin needs vary little throughout the day - much like someone on a
pump they can then just take short acting to cover food eaten. However for
someone who has 7 or 8 basal rates a day (like me!) and especially where
these vary widely, I can't see that Lantus will offer the same degree of
improvement in control.

That said, I still think it will be better than most othermedium/long acting
insulins because it will remove the day to day unpredictability caused by
erratic absorption. Theoretically this should allow day to day patterns to
be worked out (assuming the elusive "vanilla day") and I guess times when a
top up ofextra short acting was needed to supplement the background level
could be worked out.

Caroline
IDDM 18+ yrs, MM507 3.5 months

> ------------------------------
>
> Date: Tue, 3 Sep 2002 09:06:51 -0700
> From: "Abigail King" <email @ redacted>
> Subject: [IPk] lantus
>
> I can't see that lantus would replace long and short acting insulin
> As far as I'm aware you would still give yourself humalog or whatever pre
> meal.
> What you might find is that you need to snack occasionally as well to
offset
> the "single basal rate", especially if you tend to need less insulin mid
day
> and early afternoon. I find that my morning basal rate varies from 0.5 to
0.8
> and afternoon is 0.5 to 0.6. Night times hardly ever vary, so if I was on
> lantus i would not be able to fine tune as with pumping- either needing to
> have between meal snacks during the day or give extra boluses when basal
> requirements were higher.
> But most people would find that insulatard and ultratard would leave them
too
> high at certain times and too low at others with the added variability in
> absorption and peaking at undesired times
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