Switching from ProZinc to Glargine?

[Justine & Caesar]

Caesar's on a switch from ProZinc to Glargine. Is there anything I should know about besides the 24 hour wait period? (And obviously restarting him at 1 unit...?)

 

[Carl & Polly & Bob (GA)]

Definitely more you should be aware of.
Lantus (glargine) dosing is based on the numbers you see at nadir, where Prozinc is usually based on the preshot tests. Your SS shows you have been getting mid-cycle tests, so that's great, and you definitely want to continue doing so.

Doses should be equal AM and PM, as close to 12 hours apart as you can manage. They should be held for several days before adjusting, and then the adjustments (usually in increments of .25u) are made based on the nadir numbers.

You never want to roll or shake the container of Lantus like you would with Prozinc. You should be using U100 syringes (if you were using U40's with the Prozinc) which should have the orange caps instead of the red ones the U40's have.

Normally, the starting dose of Lantus would be based on what your latest doses of Prozinc have been. You should definitely post in the Lantus TR forum for dose advice to start, but 1u sounds like a good start. If that is significantly less than what you've been shooting with Prozinc, you should be testing for ketones daily whenever you reduce the insulin dose.

And go to the TR forum and read all the stickied threads, starting with the "new to the group" one. There's a ton of great info there.

Carl

 

[Larry and Kitties]

There is no reason for a 24 hour wait period. At the next scheduled shot time just start with 1 unit of Lantus if the BG is as expected.

 

[Justine & Caesar]

So I *don't* roll the bottle? Geesh, that would've been nice to know. I'm glad I didn't do anything yet.

 

[Carl & Polly & Bob (GA)]

Nope, no rolling, shaking or otherwise mixing is required. It's more "delicate" than Prozinc. Keep refrigerated, but most people don't store it on the door in case someone slams the door shut.

PROPER HANDLING OF LANTUS and LEVEMIR

Lantus and Levemir should be inspected visually prior to administration and should be used only if it appears clear and colorless.
- Never shake or roll your vial, cartridge, or pen.
- In-use and unopened Lantus and Levemir should be stored in the refrigerator between 36 to 46 degrees F (2 to 8 degrees C).
- Be careful your refrigerator is not so cold that the insulin freezes. Do NOT use Lantus or Levemir if it has been frozen.
- Never reuse syringes. You'll run the risk of contaminating the whole vial/cartridge/pen.
- Do not inject air into cartridges or pens. Cartridges and pens are designed to work on a negative pressure principle.
- If you draw up too much insulin in the syringe... squirt excess either into the air dramatically like they do on TV or into a paper towel... anywhere but back into vial/cartridge/pen. There is a silicon coating inside the syringe. It may contaminate the insulin vial with silicon (this is probably what makes "floaties", it forms a white precipitate). Better to waste a drop than ruin whole vial, cartridge, or pen.
- Pre-filling Syringes with Lantus (see page 3) is NOT recommended.
- Lantus and Levemir should not be diluted or mixed with any other insulins or liquids.

http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151

Carl