Lantus - huge ad campaign?

Type 2
1

What do you others on oral meds think of the recent ad campaign urging T2's to go on insulin? While I've seen the suggestion before and it may make sense in the context of an overall plan, the full-page newspaper ads make me suspicious. I didn't think there was much profit in insulin, but I suspect the Lantus formula and delivery mechanism are patented for maximum revenue. So if a T2 decides to "talk to their Dr. about insulin," does it necessarily follow they will end up on Lantus? I'm sure that Dr. offices are another prong of the campaign, so it probably does.

Have any of you had insulin suggested to you? How was it to be used?

This whole pharmaceutical mare's nest is very vexing to me.

2

No way. Insulin puts on weight and I still need to lose weight. I’m on metformin and my A1C is 5.3. I really doubt my endo would put me on insulin unless I was completely out of control and then that would only be after repeatedly nagging me about excercise and low carb eating. So I can’t see it happening because it would be counterproductive and she is a hard ■■■ and I’m sure she is not swayed by pharm. companies.
I can see some type 2 using it if weight is not an issue and in order to give their beta cells a break while they make the necessary lifestyle changes.

3

Insulin is the route when oral meds & diet don’t work, or for people who have severe side effects from meds. More doctors are prescribing basal insulin (Lantus or Levemir) for T2s to keep BG level. Some T2s also take rapid acting insulin with meals.

No reason to take insulin if someone has success with meds.

Lantus or Levemir are injected either once or twice a day.

Agree with you about pharm companies & doctors. I’ve never been to any doctor where there wasn’t a parade of pharm reps. Patients are waiting for appointments while the reps are ushered in. Big profit margin in insulin.

4

My doc has been hesitant about talking Insulin. However, I (T2) think we will be having that talk this month. I’m currently on Januvia (100mg) and metformin (2000mg) each day, with fasting bGs still over 150. My doc understands my medical background and respects my opinions on my healthcare. After much research, I think I will recommend Levemir over Lantus.They are very similar, but I like the fact the Levemir is less likely to have the associated weight gain.

5

I am ok with Lantus ads like this. Other drugs do this in a “big” way. And I have talked to my doctors for two years asking for insulin and still have not gotten a prescription. Some well respected drs like Ralph DeFronzo clearly argue that when medications are not effective, T2 patients should be moved quickly to insulin, it is far better to do that than let them spend years with damaging high blood sugars.

In my case, I concluded quite a while ago that I would never achieve blood sugar targets over the long term with any diet, exercise or medication regime. And I am aggressive with all these, following Dr. B, exercising and on three oral medications. I can meet the HbA1c goals, but my fasting numbers are way too high. I would frankly be pleased if this ad had some effect that would help me get access to a basal insulin.

6

I was under the impression that oral meds burn out T2s beta cells faster. Not Metformin so much, but the other ones. I wouldn’t mind taking a basal insulin, since my endo has told me that my underlying insulin production is too low.

7

With all the crazy side effects that I have had from oral meds, Lantus would be my next step. I was on Lantus and Humalog when I was first diagnosed and I was able to drop 40 pounds once my bg’s were under control. So I would not mind Lantus if the meds stopped working. Too many side effects like heart problems, liver problems. A little weight can be dealt with with enough excercise

8

One has to be their own advocate with this condition if you want to normalize your blood sugars. Agree with Geri, when other things dont work there is always insulin and Drs should give it if to a T-2 if they dont have normal blood sugars after trying everything else. Many T-2’s also have side effects to the orals and cant handle them.

My cousin is a T-2 who has to use rapid acting insulin for meals because everything else didnt work for him. I thought I was going to mealtime insulin until I found Victoza.

I dont like the ads and feel Dr’s should be more in-tune with your individual needs to achieve normalized blood sugars.

9

Shrek,

Levemir has advantages over Lantus. For many, Levemir is more stable & level. Past discussions about them both here you can search. I had lows with Lantus even after changing the dosage several times. The Lantus pharm literature says it’s steady & docs get their info from this, but Lantus has definite peaks. My BG improved when I changed to Levemir.

Lantus stings when injected because it’s acidic. Levemir doesn’t sting. Lantus expires in 28 days. Levemir is potent for 6-8 weeks.

10

I was on Byetta for 18 months and had stopped loosing weight/gained weight/lost control of BG’s and I was on Lantus/Novolog(38units/8units)MDI for about 18 months. My last ENDO visit July 21st he put me on Victoza. My ENDO told me I might have to reduce my Lantus I took my first shot at 6pm on 7-21-10 @ 3am I was 65 adjusted and at 5am I was 66 and I over corrected and 231 @ 8am. On 7-22-10 I reduced the Lantus from 38 to 35 units but was still low early the next morning. 7-23-10 I stopped Lantus all together.
After all settles down I believe that I take one shot a day and only test once or twice a day. I am low carb/no carb diet and to not have to worry about testing/adjusting each day will be a big load off my mind.

11

All very interesting. I just wondered about everyone’s impressions. my a1c just came down a bit more from 6.2 to 6.0, and with the addition of Actos i have better waking numbers finally, but i can see the validity of having insulin as an option that’s not stigmatized. Ironically, the advertising push would have the effect of pushing me away if I thought I needed it at all at this time. I am just contrary I suppose.

12

There are two arguments about oral meds burning out beta cells. First there are the Sulfonylurea’s which push the pancreas to constantly produce insulin. These drugs have long been claimed to accelerate beta cell destruction although the research has not been conclusive. The second effect is constantly elevated blood sugars. There is evidence that blood sugars above 140 mg/dl are toxic to beta cells and that leads to accelerated beta cell loss. Well, if you have an HbA1c of 6.5%, that is an average of 140 mg/dl and you are spending about half your day above 140 mg/dl perhaps accelerating your beta cell destruction.

Many doctors are “insulin resistant,” primarily fearing liability. They believe can be sued for prescribing insulin and bad things happening, but they don’t think they will be liable ten years down the road when you lose a leg and die of a heart attack because of high blood sugars. I wish they would put me as a patient first, rather than just protecting their own *ss.

13

Actually, I skipped the pills and intentionally asked for insulin.

I am having trouble with spikes due to the summertime heat.

The bolus they gave me was too much, so I decided to use the DAFNE system.
(Take 1 unit with a meal). If I needed another unit 2 hours later, I still can take it and not exceed my maximum dosage for that 4 hour period.

By doing this, instead of spiking to 180, 200 or so, my 2 hour post was 106.

DAFNE stands for Dose Ahead For Normal Eating.

Pills mess with your liver and depending on the pill, your pancreas too, down the road.

Insulin use has very few drawbacks.
Each time you take too much you go hypo as well as increase your insulin resistance a tiny bit.
Each time you don’t take enough, your blood sugars are higher and you get long term body damage.
A balancing act to say the least.
If you rely on any form of insulin just to eat bad foods or drink for example Mountain Dew, you then become dependent on insulin to return to your former lifestyle (which probably got you here in the first place).
Abuse of insulin makes you an ‘Insulin Junkie’.

If you decide to go on Lantus, you CAN split the dosage into 2 - 1/2 at night, the other 1/2 in the morning (12 hours apart). That was you avoid the nighttime lows and wild swings in blood sugar.

The doctors are not always right ya know. You have to do what works best for you and best for your blood sugar control.

Note:
Here’s how I went directly to insulin (Humalog) -
I called the doc and said I was having problems with heat sensitivity and spiking blood sugars over 200 to nearly 300 when I went outside. In the a/c I don’t spike but maybe 1/2 that amount.

I said "Before we talk about this (me wanting insulin), can I ask you a question?"
She said "of course, what is the question?"
I asked "Why do people keep Band-Aids in their house?"
She laughed for nearly 30 seconds, then replied “I don’t know, why DO they keep Band-Aids in their house?”

I replied “Just in case you need them, this is why I want insulin”

She said come in in a few days as we can’t prescribe insulin over the phone without a checkup.

I went in, they check blood pressure, pulse, weight, and verified my claims about my blood sugars from my meters.

Next thing I know, she handed me a Humalog Pen and some needles, then asked me if I knew how to take a shot.
I said ‘Yep, I learned it in the Military and from other diabetic friends and that I only needed to know the bolus for blood sugar correction’.

It took ONE time for me to go hypo (56) and I decided to use DAFNE. With DAFNE, I can’t go low for my usual carb intake.

Also, if I get really good with the DAFNE system, I can get my A1c down to 5.0, which is exactly in the middle of the normal range. I am at 5.3 right now, even with frequent spikes into the upper 100’s & 200’s.

Not fun drinking 1/2 gallon of water and exercising for 2 hours to bring blood sugars back down, then to eat and do it all over again, meal in, meal out, day in, day out.

If I eat less or change my carb intake, I rapidly lose weight to the tune of up to 5 pounds in a single night.

Rule of thumb: Excess insulin makes you FAT, low insulin makes you BURN fat.

Just be sure to drill the doctor until you get enough info to make your own decision.

Either you control diabetes or it WILL control you!

14

that’s very interesting. It’s very much what i thought a comprehensive management scheme would look like. would it help for stress highs when i’m chained to the desk and can’t walk it off? or is that “hunting rabbits with an elephant gun” as buggs bunny would say? walking is what i usually do for highs (above 140)

15

I read those things, as well. IMO, Levemir has the definite edge over Lantus, at least for me. I don’t even mind the switching to shots everyday, if I can get my bG in check.

16

If you are a T2 and your pancreas is in fair shape, you might want to use Victoza since it’s more of an automatic blood sugar control.

Another item you might want to consider is asking your doctor for some Citalopram.

Also, did you know that I never went to a single diabetes education class nor was I ever asked to go?

I learned most of what I know from sites like this one.

And I have been a T2 for only 10 months!

To answer your question, yes it can help with the stress highs, provided you know you’re high and you take a TINY bit of insulin. Stress highs aren’t like food highs that can take a long time to come down from.

Another thing you can try is an all meat breakfast & lunch of stress gets to you. No carbs that way, and eventually your liver will deplete it’s excess glycogen stores.

-OR-

You could just strangle whomever is nearest to you? LOL (J/K)