Anyone switched to Lantus from another insulin?

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furballsmom

Member Since 2011
Just asking here too in case there are some who may just come here. I'm looking for info on other cases who have switched from another insulin to Lantus and what results you had. I'm thinking of switching from PZI (over a year, and Vetsulin and ProZinc before that) to Lantus and want to know more about other people's experiences with switching, if there are any!
 
we switched from ProZinc to Lantus without any issues. As i recall, the vet told me to drop from the 4u on ProZinc to 2u on Lantus, but he didn't tell me to buy different needles. the outcome was the the actual amount of insulin increased, but in punkin's particular case that didn't matter.

just a heads-up on needing u-100 needles if you didn't already know that!
 
we switched from ProZinc to Lantus without any issues. As i recall, the vet told me to drop from the 4u on ProZinc to 2u on Lantus, but he didn't tell me to buy different needles. the outcome was the the actual amount of insulin increased, but in punkin's particular case that didn't matter.

just a heads-up on needing u-100 needles if you didn't already know that!
 
We switched from Humilin to Lantus.

Only issue was learning that the action of Lantus is entirely different from any other insulin I was familiar with. So there was a huge impatient learning curve on my part.
 
Yes, we started on ProZinc, and switched to Lantus after 3 months. Mr Tinkles had a chronic URI, and the wide swings we were getting with PZ made it impossible to get rid of the infection. I was pretty happy with PZ overall, but I'm much happier with Lantus...it has worked very well for us. Switching was not a problem, very smooth transition for us.

As Beth (Blue) said, Lantus is very different from Vetsulin, PZI and ProZinc, it requires a very different approach. However, there is a ton of info here, and plenty of people to help you. The hardest part is probably getting your head around how the shed affects things. I would encourage you to read the stickies at the top of the forum.

Feel free to take a look at Tinkles' SS. There is a tab on the top of the SS for last year, which includes the PZ/Lantus switch.
 
Thank you very much Julie, Laurie, "Blue". This is very encouraging! I will read the Lantus stickies as advised. I've heard some horror stories about some others who switched and had even worse results, so am trying to get a more balanced picture. We've switched before (twice -- now on third insulin over two years) but to Lantus will be different, as you've pointed out.

I'm worried about those long spells when numbers stay high and you can't give more insulin to bring them down. Has anyone had problems with DKAs during that time? Have you done any home testing for that? Do you stick to +12s or has anyone done +10s?
 
furballsmom said:
Thank you very much Julie, Laurie, "Blue". This is very encouraging! I will read the Lantus stickies as advised. I've heard some horror stories about some others who switched and had even worse results, so am trying to get a more balanced picture. We've switched before (twice -- now on third insulin over two years) but to Lantus will be different, as you've pointed out.

I'm worried about those long spells when numbers stay high and you can't give more insulin to bring them down. Has anyone had problems with DKAs during that time? Have you done any home testing for that? Do you stick to +12s or has anyone done +10s?
Click to expand...


Very good questions. And this is where the whole Lantus is a different kind of insulin comes into play.

The shed/depot is filling at that time, this means you need at least 3 days to see any true action. Look at Atlas's spreadsheet for the last month. He broke and failed to hold a reduction. So every 3-5 days his dose needs to be evaluated. Which really is not much different that many insulins and vets wanting things to settle in before increasing. The tough part is when they break down to lower numbers ...and then bounce back up. It is an interminable 72 hour wait to see if it is rebound or too low of insulin.

There is a section of the protocol that states if you are consistently above 300 at all test times increases can occur every 3 days and at half unit doses. In the time I've been here, I've only seen one case of that...and it lasted less than a week. Couple that with a history of DKA concern and some great advisers will jump in and help you out!

I often say in my posts...I'm shooting for the overlap. That overlap with Lantus can range from 12-14 hours. Again, reference Attie's SS. He is a late nadir at +10-+12. But, once he is past that +12, if I miss the shot he is up in zooming numbers.

Lantus and Levemir are whole different kinds of insulin. The most important thing to ease the transition for the human bean...is to put aside everything you ever thought you knew about curves and insulin action. With Lantus you are shooting for the flat...not the curve.
 
What great info -- thanks again, "Blue". I will check out Atlas' SS to see what you're talking about. I did read and print out the Lantus/Levimir TR protocol sticky and will study it more, and other stickies. After being on other insulins, mainly two different PZIs for over two years, this will be quite a departure! I'm still letting it all marinate in my brain, but as erratic as Furball's numbers are I feel like I should be doing something else.

The risk of DKA and hypos (altho' she's not prone to these, even when very low, like 20s or 30s) are still kinda scary. So far any DKA home tests have been negative, but she's never been in high numbers for as long as 72 hrs. That will really be a challenge!

She does have pancreatitis and I'm wondering if that will complicate a transition for her. The Spec feline pancreatitis test results recommended no treatment for now, but to retest periodically.

I really appreciate your info and advice!
 
This is where our protocol is designed from more or less: http://www.tillydiabetes.net/en_6_protocol2.htm


I found this graph from their website very helpful. It is the graph of a cat after 1.5 months on the protocol...

Notice it is about flattening out the curve to the nadir, not so much about the peaks(high numbers).

http://www.tillydiabetes.net/images/Lantus_Start_Graph.jpg

Lantus functions best when based on nadirs. Which is the converse of any other insulin.

Like I said in my first post...I was pretty much the most stubborn and impatient with Lantus. But, long run...if I can get Atlas to stop the fast drops and subsequent long-term rebound...it is better for him!
 
Thanks for the Tilly's diabetes page. I will print that out and read it more carefully. Looks like great info! That was an impressive graph! If only we could all achieve that! I'm still worried about the high numbers for several days. Furball already tends to do high numbers in the extreme and if she had to go for several days, she would just hang out there in the outer atmosphere! DKA would be waiting to happen!

How close do most people stick to dosing schedules. Are they usually +12s or do some dose at +10s or later than +12s sometimes? I guess all that depends on individual cats and home situations.
 
we stick as closely as possible to 12-12 dosing. you can vary by 15 minutes without a problem, or once in 24 hours by 30 minutes, and of course life happens so sometimes a dose gets missed or you just have to do what you have to do. in general, though, we try to do 12=12 - i'm surprised at how you can make that happen.

i just read this article today on the difference in lantus and levemir: http://www.diabetesclinic.ca/en/diab/2treat/lantus_vs_levemir.htm

i thought it was really helpful to understand how/why these long-lasting insulins work. maybe you'll find it helpful. if you decide to switch people here can help you figure out the "how" and the appropriate dose to go to. you can tell that DKA and hypos aren't a regular problem because so many of us use these long-lasting insulins for better control for our cats. they are very gentle compared to the older quicker-acting insulins.
 
Lantus and Levemir like consistency. The 12 hour cycle is the norm, I really don't know of anyone who does a different schedule. There may be a few. Shooting early acts like a dose increase and shooting late like a decrease. The shed will drain or become over full with too much time shifting, then you can get son screwy numbers. Sometimes it happens, life does interfere, but we really try to stay on the 12 hour cycles.

levemir is said to be a little more forgiving than Lantus. It does tend to have a later onset and nadir than Lantus. I was getting very early drops and a lot of subsequent bounces w/ Tess. It has leveled out really well with Levemir.
 
furballsmom said:
Thanks for the Tilly's diabetes page. I will print that out and read it more carefully. Looks like great info! That was an impressive graph! If only we could all achieve that! I'm still worried about the high numbers for several days. Furball already tends to do high numbers in the extreme and if she had to go for several days, she would just hang out there in the outer atmosphere! DKA would be waiting to happen!

How close do most people stick to dosing schedules. Are they usually +12s or do some dose at +10s or later than +12s sometimes? I guess all that depends on individual cats and home situations.
Click to expand...

You keep bringing up DKA. Is Furball prone to DKA? Has Furball ever been DKA? Or are you just concerned about it?

Yes, that 12/12 schedule is pretty much a requirement of the insulin. Shooting 2 hours early is like shooting a dose increase! This is again, because of the insulin shed/depot. You will need to figure out a time that can be shot consistently. For me that is a 6am/6pm routine.

Believe it or not, those high numbers will come down faster than you realize. What I saw with Atlas on Humilin was he spent 16 hours in numbers under 300, but then 8 hours daily over 300 because the insulin simply did not have the duration he needed.

If you take a look at Attie's 2010 SS. We converted in Sept. to Lantus. You can see where he starts to drop down into lower numbers about the 23rd day. You can also see where I am trying to make Lantus act like PZI or Humilin too! ohmygod_smile . I think if I had not been so stubborn and just followed the advice and protocol Attie would have responded much better and sooner. But, even in my flawed way...those nasty 400 and 500 numbers went away and even the 300 numbers finally fell off too. We monitored with the ketostix for ketones.

Attie is back in the pinks now because he didn't hold the reductions and a suspected URI by the vet.
 
Thanks again, "Blue" and Ann. I will also check out that info about Lantus/Levimir.

Furball has not had any ketone problems, which is pretty amazing as much time as she has spent in high numbers over the last several months. She has gone through spells of coming down only every third or fourth shot. I do check at home with the Diastix. But from what I've heard about it, it sounds scary.

I'm wondering too -- maybe it's different for each cat -- but what is considered "regulated" with Lantus? I'm used to TR from my experience with PZI where we hope for numbers in the 100s and even high double digits. I've heard some vets say that 200s is OK and that doesn't sound right to me.

I will probably go ahead and try this, but not right away -- will need to make plans in advance. I have a lot of cats from many years of fostering, absorbing the ones who never made it to "adoptable" status and have medical and behavior issues of their own! Anyway, there's one now with advanced cariomyopathy who is having some liver issues (discovered during routine blood test to monitor kidneys on lasix & other meds) and some inflammantion & fluids in his belly. He's on still more meds now and not eating well so having to be slurried 2-3 three times a day. I will wait until his meds run their course and he gets back to eating on his own before devoting full attention to a Furball switch. I also want to take time off from my part time job so I don't have to be gone two whole days during her first week of transtition.

Will continue to read and research to know as much as possible about this before actually doing it. Will go check out that link now.

Thank you all again!
 
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