? Humulin N vs. Lantus

So I would appreciate some advice/opinions about this. We are currently giving Victor Humulin N but might have the option to switch him to Lantus, which I've been hesitant to do. I know that in general Lantus is better for cats than Humulin but I have a few other concerns.

1) Our vet told us that Lantus could be more likely to cause low blood sugar, and since he has already gone lowish on occasion with Humulin, I'm a bit worried about that.

2) The only way we could afford to start him on Lantus, and possibly even just continue getting test strips, is if we get help with Diabetic Cats in Need, which we are looking into. My concern with that is how often would we be able to get test strips through them? The last thing I want is to run out of strips at a crucial time. I would appreciate anybody's input about this who is getting or has gotten help through them, and just their experience in general with it.

3) I would think that since Lantus is a longer-lasting insulin I would have to test him more than I do with Humulin - which ties into my concern above - and I'm barely getting enough sleep as it is so I'm not sure how I would go about handling that. How do you guys do it?

Any responses/advice, etc. about these things really would be appreciated. Thanks

 

Hi Heather! I'll try to give you answers to most of your questions.

Actually, it's the reverse: Humulin is more able to drop BG quickly and low because it has a stronger action than Lantus. Lantus is gentler in its action, slower in onset and longer in duration so with good monitoring (which you already do!) and careful dosing following the very clearly laid out guidelines on the Lantus forum you're *more likely* to ease Victor's numbers down into a better range and avoid deep dives - eg. from pink into green. It can take time to get there but the Lantus forum has a ton of very experienced advisors to help you.

They've helped a lot of people. I suggest you PM @Chris & China with your concerns. She actively involved with them and will likely have that information.

Lantus has two guidelines for dosing. One is called TR (Tight Regulation) and is more aggressive, requiring more testing and more frequent dose changes. A dose is held until BG drops below 50 on a human meter - stressful for new folks! The other is called SLGS (Start Low Go Slow) and is probably where you'd want to begin, at least until you become more comfortable and familiar with Lantus. It's less rigorous, you reduce the dose at a higher BG boundary (90 on any meter), you keep a dose longer and do a weekly curve. Those are capsule versions. I recommend that while you're thinking about it, you go to the Lantus forum and read the yellow info stickies a few times over. There's a ton of information there and it IS overwhelming. You could introduce yourself on that forum, say you're thinking of making the switch and ask for input.

Now here is where it gets a bit *uncomfortable* : the first thing that will be addressed is Victor's dry food diet. You and I have discussed it quite often and I've tried to encourage you to switch to all canned low carb food. I strongly encourage you again to consider making that change. I think you'd be amazed at Victor's progress with a change to canned food and to Lantus insulin. I truly understand sticking to what you're familiar with but w/d kibble is very high in carbs and almost works at cross purposes with what you want to achieve with Victor. If you want the ONE THING that's most likely to have a positive effect on Victor's progress, that's it.

I hope this helps and I hope you're not offended by me addressing the food issue again.

 

If you do decide to switch to Lantus, ask your vet for prescription for the pens instead of a vial. The reason I am making the suggestion is that a vial of Lantus usually starts becoming ineffective around 2 to 2 1/2 months, long before you can use all of it. The pens you use as a mini vial and will be able to use almost every drop. One package of pens will give you enough insulin, depending on your dose, nine months or more. You end up saving more money this way.

 

Will the Pens last 9 months after you start using the insulin? I read it should be discarded after 28 days, so definitely wondering how long it will keep after you start using it?

 

When stored properly, Lantus pens usually last longer. My pen is almost a year old, but I'm sure it varies for people.

 

And is that after you started using it? I'm planning to ask my vet for a prescription tomorrow so I can order a pen. Based on my cat's recent numbers I don't think his pancreas is working all day.

 

My situation is different than most- I had a human friend that was no longer insulin dependent and gave me her pens. One was partially used and was opened last january.

 

I have no answers to your questions, but a neighbor of mine recently was telling me that Humulin N was the same as Lantus. I tried to compare Lantus to the Humulin N, but could not find the ingredients to Humulin N on line. I do use Lantus and buy it from Canada, which is cheaper than buying in the states. You will find a lot of support on FDMB for Lantus users and one of the most knowledgeable on all of the insulins is Kris & Teasel.

 

We did N and Lantus with Frank. I do not remember any notable difference in testing frequency beyond the first little bit, when we were observing the differences between the actions of the two. I do remember his numbers being more erratic and him being more bouncy on the N.

 

The expiry is much later for unopened pens. Mine is exp 2020

 

The manufacturer states 28 days - first, it's for humans that use a huge amount more, second it's designed to be left out in a pocket or purse while we refrigerate and last, that's the length of time the manufacturer will take responsibility for anything happening when using it. They have to file an 'expiry' statement when they file for FDA approval. I've used a single pen for many months without it losing it's effectiveness.

Humulin/Novalin N (NPH) is very different than Lantus. NPH is a single cycle insulin that begins working fully at onset driving numbers down in a steep drive. When it's gone, it won't help anything any longer. Lantus is a depot insulin, only a portion of each dose can actually be used in that cycle - it can take 3 days for a single dose to fully 'melt' to be used. Each dose given builds on the previous dose. As said above, Lantus will give you a much gentler, longer curve than NPH does.

DO NOT buy the 'pen needles' - you'll use the same U100 syringes you've been using the NPH. Most pharmacists don't even realize this. When you remove the cap, there's the same little rubber seal as a vial.