UK Glargine newbie

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sweetcherrypie

Member Since 2010
Hello,
I have finally changed to a holistic vet who is prepared to give me Glargine for Carbonel. (It is very difficult to get Glargine for cats in the United Kingdom, I had to sign a disclaimer). Carbonel was initially on Caninsulin and then on Protamine zinc (which has now been discontinued in the UK) . The vet then insisted that the only option was for Carbonel to go back onto Caninsulin. She was back on the Caninsulin for a month when I decided it was time to see another vet.

I have bought five 3ml prefilled SoloStar Pens (It says Lantus solostar 100 units/ml solution. Each pen contains 3ml of solution for injection equivalent to 300 units in the literature. Is this the same as what you are using?) However,I still have some u-100 syringes that I previously used with the PZI. I did not realise, when I bought the pens, that I could use these for the glargine. I hope, as they are unopened, that the pharmacy will take them back.

The literature that came with the pens suggests that pens should be kept out of the fridge once opened. However your Sticky seems to say they should be kept in the fridge at all times. Can you please tell me why you keep it in the fridge? The info on the pens said it was painful to inject cold Insulin. Also,I presume I start on 1 unit twice a day (as recommended by my new and lovely vet )in the u-100 syringe as Carbonel weighs 4 kg's.
Many thanks,
Carol and Carbonel
 
Good Morning Carol and Carbonel,

Welcome to Lantus Land! I'm glad you are reading the stickies at the top of the forum! That is a great place to start. Is does indeed sound like you have the great pens too! Make sure you read how to draw off insulin for the pens, it is different than using a vial.

Are you also set up and able to home test?

You will find lots of great help here and so glad to read you new vet is on board with you too!

Edit: If you haven't done so you will want to set up aSpreadSheet, it will prove invaluable to you and your support network. It proved invaluable to my vet as he can log in a view it too!
 
Welcome Carol & Carbonel to Lantus Land...You have gotten good advice & have read our stickys which is a very important step--
I also use the pens, they are excellent, easy to use, and last for a good while. As far as dosing is concerned, yes there is the weight to dose info, but the usual starting dose is 1.00U..We have dosing helpers here who I am sure will stop by here to help you. Lantus glargine is a very gentle insulin, with softer curves than you have experienced with the other insulins. With lantus, you must monitor the BG more frequently as the onset begins at +3, then continues to the nadir(lowest point of the cycle) and then back up--I test on a usual day at amps, +3,+6, pmps and before bedtime..Of course, everyone has a different schedule.
Dose increases or decreases are done usually in 0.25U increments. We have a spreadsheet where we log our cats' bgs for the day, and someone will be along to help you with this--We all help each other here and are like a family-Ask questions, post a new condo everyday, and post your numbers in the heading, so we can see where Carbonel is going during the day, and read the stickys--I am sure you have done the right thing by using lantus
Again, Welcome to lantus land!
 
Welcome to Lantus Land!

I hadn't realized that Lantus was so out of the ordinary in the UK. We've had a few members from the UK and I don't think they mentioned it. In any event, it's a great insulin that has a wonderful success rate.

You asked about refrigerating Lantus. Unopened Lantus should be kept refrigerated. I actually just went to look at the package of pens I picked up from the pharmacy yesterday and it's labeled to keep refrigerated -- both opened and unopened pens. I do think that the rationale for keeping our kitties' pens refrigerated is that most cats typically need only a fraction of what a human diabetic would need. As a result, the pens can last longer with our cats than the manufacturer's recommended 28 days. Keeping the pens refrigerated has the potential of extending the life of the insulin.

It sounds like your vet is knowledgeable about Lantus. With due respect to Roni, not all cats are started at a dose of 1.0u. However, given the weight of your cat, the starting dose appears to have been based on the initial dose formula (i.e., starting dose = 0.25 x ideal weight in kilograms).

I do hope you are home testing and feeding a low carb, canned food diet to Carbonel. If you've had a chance to look at the "New to Lantus/Lev" sticky, a "typical" curve is outlined. The value of home testing is that it will inform you as to when Lantus onset and nadir are in the cycle as well as what kind of duration you're seeing. Onset and nadir vary for each cat and can vary from day to day. Nadir is particularly important since, unlike with both PZI and Caninsulin, Lantus dosing is base on the nadir, not the pre-shot blood glucose value.

Please let us know how we can help. The people here are very generous with their time and information. I hope you will be posting often.
 
Thank you so much everybody. I work mornings and so I am going to miss Carbonel's nadir if I inject at 7.00 am. I could feed and inject at 7.45 before leaving for work but will still miss +6, as I only get in at 2.15pm.
Does one feed at the time of the shot?
Where do I find the info on loading the syringe from the pen please? I see lots of people seem to be having problems with this.
Many thanks,
Carol Buchanan
 
Good morning (evening?) and welcome! I've not used the pens, so I can't answer your most recent question on how to maneuver the syringe. Generally, folks do feed with the shot. Many of us feed small meals, so I typically let Willie eat his small meal after we test, then give his shot afterwards.

Don't worry about getting the nadir every day... Most of us aren't able to do that on a daily basis. Once every couple weeks, it is a really good idea to get a curve (measuring every 2 hours for 12 hours, or 1 cycle) so you know roughly how Carbonel typically responds to insulin. For example, with my work schedule, I can leave for work as late as 9:30, so I shoot at 7am. Lets me get a + 1 and +2 if I have concerns, or I can leave and get home earlier for more checks. I also can come home over lunch and get anything from a +4.5 to a +6.5. On days where our numbers are lower, I like to get a +11 or +11.5 to ensure that numbers aren't still dropping at the time I give the shot.

I know several other LL'ers work... Nicole and Baby come to mind. Take a look at some spreadsheets (links are in people's signatures) and you can see how often different people test. I try to get as much info as I can on days off from work... the more data you have, the more informed you are when needing to make key decisions about dosing, whether or not to shoot a particular number, etc.

We've been diagnosed for about 6 weeks now, and I can say without question you are in great hands here! Please feel free to continue to ask questions!! :)

Have a great day!
 
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