Hi everyone.
I wanted to know if anyone here ever mixes lantus with humalog. I know they tell us not to etc etc.
Here is my situation. When I take off my pump for a short time to shower or whatever, my sugars go up very fast, like 10 min later I see it climbing. After 20 min and I’m over 200.
If my site clogs or stops absorbing, it’s the same deal it’s fast and I fear DKA a little. I know my insulin resistance is high when I go over 200mg/dL and it takes more insulin to combat it.
So I tried to spike my humalog with lantus.
I put 190 units of humalog in with 10 units of lantus.
I figured this could be a disaster and I was prepared to dump the idea.
However after a day and a half, my sugars are flatter and I’m at 100% in range.
I got a pump alarm that I haven’t touched any buttons on my pump for 12 hours, which has not happened before since I’ve had it.
I went into my shower at 113 and I left the shower at 117.
So I’m really happy with this.
I’m waiting for he other shoe to drop,
Has anyone else ever attempted something like this ?
Am I playing with fire?
I have one day of data here. I’m not ready to say my issues are solved by any means.
What you are doing is similar to someone on a pump adding a daily long acting insulin dose – the untethered regimen. It may be that your pump-delivered basal insulin is too weak.
Lantus has a very unusual pH which is important to its action. If you mix it in small amounts with other faster acting insulins then who knows how it might work? Maybe in your case it gets turned from a 24 hour insulin to a 1 hour insulin,
If you wanted to take Lantus shots(not in pump) once or twice a day as “basal help” that would be much more conventional and understood.
What I’m saying is that the drug companies tell us to not do some things to cover their own asses. Not necessarily because it’s the best choice.
I’ve thought about taking a small lantus dose via syringe.
The reason I decided to try this is because I wanted my lantus to be a portion of my humalog. In this case 5%.
This has been nearly 2 days. It’s seems to be working but I’ll see how my third day goes.
I haven’t noticed any lag in my humalog. It’s as usual.
98% in range for 2 days. That is a tiny bit better than my usual around 95%
I’m not suggesting anyone else does it. It might not work this way for you. I just wanted to see if anyone else has tried it
The amount of Lantus you are mixing in is so small that I might think it has no consequence but if you can reliably repeat this then maybe you are on to something.
Is it possible that the “hang time” of your usual short-acting insulin is so short, that mixing in any insulin that’s slower acting helps tide you over when unhooked? I.e. maybe plain old regular or NPH (which can be mixed although nobody I’ve ever heard of mixing Iin pump) would be just as good.
As @Tim12 noted, Lantus has different action, based on low pH and crystallization in subcutaneous tissue, for subsequent long-term release. I’m not an expert, but this seems incompatible with other pH-neutral insulins.
I’m all for responsible experimentation! 100 years of little advancement in type 1 medications means it’s up to us to figure out what works. I’m very curious to see how this plays out, though I wouldn’t really have a use for it myself since I prefer baths and don’t disconnect for them.
I don’t know why I go high without insulin pretty fast.
Of course this never happened when I was taking Regular insulin.
I think I just use it up fast. I average 50 units total per day. I don’t really know if that’s a lot or not but it’s been pretty close to that my whole life.
This mornings shower ended up spiking a bit.
I entered at 109 and left at 133.
I know warm water used to drop me a little so I don’t think that’s playing into it.
I have a pre dawn bump but maybe I’m getting a feet on the floor reaction delayed. I don’t know.
I think nph in a pump would be a bad idea because it settles out and needs to be constantly mixed
My approach might be to give myself a small daily dose of Toujeo - say 5 units at bedtime. And reduce my basal by 0.2 u/hr. But that might throw Control-IQ for a loop and I’m pretty happy with my control right now. And I guess I don’t absorb insulin as quickly or use it up because I can have a hot tub for an hour and I don’t see much rise at all.
I would add some of the standard advice given to us by doctors, nurses, CDEs and large advocacy organizations. Of course, some of what they tell us is crucial for our well-being but their credibility is eroded when they tell us things like:
Never reuse a needle.
Never reuse a lancet.
Don’t use any insulin that’s been unrefrigerated for 28 days.
Don’t use any insulin past its expiration date.
Disinfect every needle and lancet site with isopropyl alcohol.
Never inject insulin through clothes.
Wait until IOB (insulin injected but not working yet) is zero (or close to it) before correcting a high glucose level. OMG, stacking!
You need to consume at least 130 grams of carbohydrates per day or your brain will suffer.
I could go on but you get the idea. These ideas and practices are not inherently dangerous and we as a community have long known that fact. Drug companies and the mainstream medical advisors degrade their credibility with the patient community when they emphasize that we must avoid these practices to stay safe and healthy.
I’ve pretty much broken every one of those rules hundreds of times.
I’ve also broken the predictions.
1 pretty much all type 1 will have retinopathy after 20 years.
2 kidney function will be around 50% after 25 years
3 your life span is reduced by 25% out the gate.
4 there will be a cure in 5 years
5 PAD neuropathy and amputations are pretty much guaranteed if you live to 60. ( I’m not 60 yet, but calling it BS 5 years early)
I was at 60u yesterday. So, we are pretty close on dosage (I’m 30 basal, 30 bolus). I tend to think I’m a little high due to high carb diet (vegetarian). I split the NPH into a PM and AM dose, but I kinda like the bump because that’s how my dosages run anyway. I need a huge increase between 6am and noon.
Yeah, I wouldn’t put NPH into a pump. If my pump breaks, I use NPH MI.
It takes me 2 or 3 hours before I hit the bad highs when pump breaks.
If you mix Lantus with other insulins (as in, combine them in the same syringe or reservoir), you ruin it and it becomes short acting, which is part of why hitting larger blood vessels with Lantus injections can be dangerous (turns the whole thing to short acting, because without the pH contrast, which is lost when diluted by other liquid, Lantus doesn’t crystalize in fat tissue and won’t work appropriately). This is not equivalent to pharma having conservative expiration dates and temperature recs, etc.
So basically, you are taking 95% Humalog and 5%… messed up Lantus that is likely functionally Regular or Humalog now. Maybe if it devolves to something closer to Regular, that’s why you are seeing a difference if any (I would expect marginal at most), but you may as well get cheap R to do that with then. My guess is the minute effect you are seeing is not the result of the insulin though, just typical variability.
If you want a tiny bit of Lantus, inject a tiny dose of it, so it can work as intended. In contrast, you may be able to use Tresiba as described, I’m not sure, but I would still think you’d be better off injecting it in very small amounts.
While I still think that Pharma and other authorities have misled us in many ways, I am persuaded by the logic you and others have presented. I also think that injecting a long-acting insulin separately from the pump regimen is a much better idea than mixing these two insulins in the pump reservoir.
So what seems to have happened in my pump is the effect of lantus wears off after 2 days. And I’m pretty much where I started by day 3.
Still 2 days isn’t bad. But maybe an injection would be better. I’ll have to try it. But it means an injection every daw which I was trying g to avoid.
I spoke to a Lilly research scientist this morning.
She says the insulin will degrade as it sits with the humalog it isn’t inherently dangerous but it can act differently every time I bolus. So there is that.
It certainly seems to be the case in my small experiment.
