Strange Question

[Mom to Smoke]

Has anyone ever used a pen of Lantus insulin that seems impotent? Smoke has been on Lantus for a little over 4 weeks. First three weeks he was at 1U X 2 day. However after 3 weeks and then doing a BGC it appeared it was having little effect. Vet upped to 2U X 2 day and he has been on for 7 days. I'm doing a BGC again today and once again, very little fluctuation in BG. 6am (prior to food or insulin)= 267. Fed, gave insulin, 2 hours later at 8am 345, 10am 341, noon 356, 2pm 356. Yes, I'm sure the insulin went in this morning. Yes, I've calibrated the AlphaTrak2 that I'm using. These numbers are consistent with what they've been prior to his injections each morning and night for the last week. Always mid 300s. I was excited to see it at 267 this morning!

Of course, I'm sending in the BGC to his internal med vet tomorrow, but I'm down to thinking that I possibly have a bad vial of insulin. I ordered it from VetRXDirect and it came delivered overnight, cold. I have a diabetic friend who uses Lantus. She's going to let me use hers tonight to give him, and then I'll test 2 hours after that one just to see if there is any difference.

So just wondering -- anyone else run into this?

Thanks,
Teresa

 

[tiffmaxee]

We wouldn’t double the dose here. We increase in .25 units usually. Too much insulin can look like not enough. I’m not saying that is the case here but you can miss the best dose by increasing too fast. Have a look at the yellow stickies on TR and SLGS. We need to see a spreadsheet with test results to really be of help. In answer to your question on insulin losing potency are you keeping it in the fridge? I did and used every pen to the last drop. Are you using syringes? That’s the only way to increase in less than unit increments and that is very important. Max was so sensitive once regulated get I increased often by 1/8 unit and used digital calipers

 

[Mom to Smoke]

Yes, I'm keeping it in the fridge, and yes, I'm using syringes.

 

[Sienne and Gabby (GA)]

Ditto what Elise (tiffmaxee) said.

I have had a bad pen or two. In one instance, an idiot of a pharmacy tech proceeded to bang the box of pens on the counter despite my yelling at him to stop doing so. I've also had one pen in a box that seemed to not have potency.

Without seeing a spreadsheet, it's very hard to know if your insulin is toast. Depending on how much you're testing (e.g., how many tests per day and when), it could appear that pre-shot numbers are high and lead you to conclude the insulin isn't having the desired effect. With Lantus, you really need some tests during the cycle. If numbers are dropping around nadir, you could be seeing a bounce back into higher numbers at pre-shot which could easily allow you to conclude the insulin has lost its potency.

 

[Mom to Smoke]

My diabetic friend just gave me the last of her lantus in her pen to try with him - enough for 7 days. I gave him one at 6pm (his 4pm number was 417, and 6pm number was 438 - so the lowest number today was 267, the first thing this morning, and beyond that it has continually increased - there was no drop). He received the dose at 6pm, so I'm going to keep checking every 2 hours until I go to bed tonight to see if this drops it, and will continue using the new pen tomorrow and check as often as I can (difficult when you work full time) tomorrow. - Thank you Sienne and Gabby for letting me know that there is a possibility that you can get a pen without potency.

 

[Chris & China (GA)]

Can we get you to start using our special spreadsheet? We really are very data driven here and we are used to seeing things in our own format.

Here are the Instructions on getting the FDMB spreadsheet, but if you need help, please feel free to ask! You can send me a Private message by clicking on my name and choosing "Start Conversation" ...Only takes me about 30 seconds to set it up once I have some information from you!