Lantus can actually start to “wear out” somewhere before 24 hours. That’s why it is often split into two doses to provide a more constant & consistent background basal delivery of Lantus.
Levemir has a much shorter duration than Lantus. Usually it is around 12 hours and, thus, two doses per day. But some people split their Levemir into three doses. Unlike Lantus, for most people Levemir generally should be taken as at least two doses about 12 hours apart. Levemir just doesn’t persist long enough to take it only once a day.
What makes Tresiba different from the other two is that its duration is apparently much longer than 24 hours. The claim Google stumbled upon was 42 hours.
Actually, I think Tresiba starts to fade and trail off much sooner than the claimed “42 hours”. But since people structure their day around a 24 hour clock, Tresiba feels easier since it only has to be taken once a day to overlap its duration of activity and smooth out the effective basal.
Until you can accomplish the script wrangling needed to try Tresiba, can’t you just take your morning Levemir shot earlier? Say, when you get up and then take the second Levemir dose sometime in the late afternoon/early evening after school?
This shtuff about having to go to the nurse’s office is from my perspective a bunch of bureaucratic stupidity. You do it yourself the rest of the time, but suddenly while you are in school someone else needs to “help” you? Spare me. Puh-lease.
(Huh. It feels strange that you are now in the same time zone as I am. Oh, well. )
I understand the risk, but this is going way overboard to cover the school’s posterior. It’s not an arrangement that’s meant to do any good; only to look good-ishy, possibly in hindsight.
When I lived in Tokyo and went to The American School, they said I had to go to the nurse’s office to inject. Here in DC it was my choice to inject my basal in the nurse’s office. I even showed the nurse the right way to inject insulin. Here I inject my bolus in the lunchroom.
When I was first put on insulin, it was lantus, and it stung so bad, it would bring tears to my eyes. 6 years later, I was told that i was type 1 and put on humalog, i was petrified at all the injections, not because of the needle, but the burn. To my great surprise humalog did not sting. I then found out lantus is implicated in pancreatic cancer, and, made by the people who make the abortion pill, told the doctor that i’ll never take it again, she gave me levemir. Works even better than lantus, with no peak. Lantus had a terrible peak 6 hours after injection. In March 2016 i asked to be put on tresiba. After the first dose, I got a horrible cold. Got worse by the day until it was the worst cold in the history of man. But, after no one was catiching it from me, and the doctor telling me i don’t have a cold, my lungs were crystal clear, i suspected tresiba, the only new thing i did. Went back to levemir. After 12 hours, the cold began healing, until about 60 hours later when it was miraculously cured. it is also interesting to note that novolog did this to me too, I had to go back to humalog and this time the cold was cured in a day. I do not recommend lantus for ANYONE. Seems that people in clinical trials of lantus in the 90s are coming down with pancreatic cancer at what the cdc and ama calls “an alarming rate”,
This illustrates an important point that is seldom communicated either by the manufacturers of insulin or the doctors who prescribe it. Not all insulins are the same and not all people react to them in the same way. Although nearly everyone reports that Lantus stings, people generally praise it for its very flat, even action with little or no peak. But for you, it doesn’t work that way.
Here’s another example: Humalog does nothing for me. Absolutely nothing. Might as well be a placebo. The other insulins (at least the ones I’ve used—R, Apidra, Novolog, Levemir—work just dandy. Individual variation again.
Every physiology is potentially unique, and just because something works for you doesn’t mean it will work the same way (or at all) for the next person. But very few people are told that by their health care team. The tendency is to treat all insulins as equivalent, and they’re not. It actually goes beyond simple person-to-person variation, too. For most people, R and, say, Novolog do not have the same carb-handling power even though both are labeled U100. In my case, a unit of R will neutralize about 11 carbs. A unit of Apidra will take care of 16. Something else we’re never told.
Diabetes has to be managed on a case by case basis, and the only way to know what works is to try it and note the results. If ever there was a strictly empirical discipline, this is it.
like it or not, lantus has been implicated in pancreatic cancer. it is
said that an ALARMING number of people who were in clinical trials for
lantus in the 90s are coming down with pancreatic cancer. So when you get
pancreatic cancer from your “wonderful” lantus, don’t say i didn’t warn
you. My doctor NEVER PRESCRIBES apidra or lantus for this very reason
Who says this, or more to the point, can you tells us (or find out from your doctor if you don’t know firsthand) what studies provide evidence of this? There are a lot of people on this forum who would be interested in the evidence, the studies, the peer-reviewed literature etc…
I’d be interested in hearing from some of our scientists/researchers here of any credible studies they know of that were done the Gold Standard for scientific research: a randomized and controlled trial.
I’m not aware of any randomized controlled studies on insulin glargine and cancer, and I’d be totally shocked if such were found. The reason why we don’t have many of those in the medical research field is because it is almost impossible to do in an ethical way. You can’t, for example, take two groups of Type 1 diabetics of similar age, assign one to Lantus and one to placebo, run the trials over long periods, and then compare results. Why? Because those assigned to inject placebo would be dead. That being said, there are some ways to look at such things, and long-term cohort studies are pretty solid, methodologically.
Of those, I can find a couple of relevant results. From a Scottish study, you have this conclusion:
Overall, insulin glargine use was not associated with an increased risk of all cancers or site-specific cancers in Scotland over a 4 year time frame. Given the overall data, we consider the excess of cases of all cancers and breast cancer in the subgroup of insulin glargine only users to more likely reflect allocation bias rather than an effect of insulin glargine itself.
In fully adjusted models, nonglargine use was the referent; glargine was not associated with significant increased risk of any cancer measure. In secondary analyses including only the top quartile of daily insulin dose patients, glargine was not associated with any cancer risk difference; combination insulin was associated with higher breast cancer risk (HR 1.75 [95% CI 1.10–2.78]) and lower colon cancer risk (0.33 [0.13–0.80]).
I’ve not heard of the association before, and I can look more carefully into it. But from a perusal of the lit, it appears unlikely that an increased rate of pancreatic cancer in patients derived from use of insulin glargine. It was more likely to be selection bias or the underlying increased rate in Type 2 diabetics.
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