12/20/2011 Marilyn AMPS:466 +2:424 +3:334 +4:301 PMPS:498

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Re: 12/20/2011 Marilyn AMPS:466 +2:424 +3:334 +4:301 PMPS:49

hopefully that little bit of dose increase is going to bring marilyn's numbers down as she settles into it.

in regards to your question yesterday about the shed, i thought that i'd read that the lantus shed is a physical deposit. here's what i found on http://www.diabetesnet.com/about-diabetes/insulin/basal-insulins

How Lantus Works
This insulin analog was designed to have low solubility in water at a neutral pH, such as that found in body fluids and other insulins. Lantus becomes completely soluble only at an acid pH of 4. Once this is injected under the skin, the acidic solution is neutralized leading to the formation of microprecipitates. The microprecipitates allow small amounts of insulin to be released slowly, resulting in a relatively constant concentration/time profile over 22 hours +/- 4 hours with no pronounced peak in activity.
Lantus was modified to allow this precise action. Normal insulin has two protein chains called A and B that have two zinc crosslinks between them. Lantus differs from other insulins in that one asparagine at position A21 of the A chain is replaced by glycine, and two arginines have been added added to one end of the B-chain.
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also http://www.drugs.com/uk/lantus-100-...injection-in-opticlik-cartridge-spc-7557.html
5.1 Pharmacodynamic Properties

Pharmacotherapeutic group: Drugs used in diabetes. Insulins and analogues for injection, long-acting. ATC Code: A10A E04.

Insulin glargine is a human insulin analogue designed to have a low solubility at neutral pH. It is completely soluble at the acidic pH of the Lantus injection solution (pH 4). After injection into the subcutaneous tissue, the acidic solution is neutralised leading to formation of micro-precipitates from which small amounts of insulin glargine are continuously released, providing a smooth, peakless, predictable concentration/time profile with a prolonged duration of action.
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not sure if it makes a difference if you rotate the area you inject into. there was a discussion on the think tank where people said the lantus action seems faster from non-scruff injections. so that might make a difference if you were trying to speed up or slow down a nadir. i'm not sure i'd bounce around though - most of what i've seen says to stay with an area for a while, just try not to inject in exactly the same spot repeatedly.
 
Re: 12/20/2011 Marilyn AMPS:466 +2:424 +3:334 +4:301 PMPS:49

Hi Julie,

Wow, thanks for these links. It's interesting stuff...although, I'm still finding the actual "filling of the shed" an elusive topic. I'll read everything a few more times and see if anything "clicks". Right now, my right wrist is out of commission...so I'm having difficulty using the computer and typing. I will say though, it looks like you're correct about staying within an area for awhile. I've heard people say they alternate left, and right, sides of the cat with each injection. Although, maybe that's okay too, since Lantus was formulated for SID dosing in humans? Hmmm, now I've confused myself again.

Thanks again,

Deb
 
Re: 12/20/2011 Marilyn AMPS:466 +2:424 +3:334 +4:301 PMPS:49

Just because if forms a precipitate, it doesn't mean that it all stays in one place. Remember, even though you're not shooting into the circulatory system, there are still fluids in the subcutanious space that move insulin throughout the body. Remember, you are lowering blood glucose -- the insulin makes it's way into the blood stream. Those micoprecipitates get into the system.

(If everything were sitting in one spot, what would happen if your cat bumped up against the location where the shed was located? Would your cat then OD? It doesn't work that way.)
 
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