Lanky changing to Lantus from Humulin N

We (Lanky & Susan) will be switching to Lantus within the next several days -- probably Friday, 4/9/2010, as I continue to get my act together. My vet is very supportive & I plan to chat with him tomorrow getting the prescription for Lantus. Because there is so much information on this site & because I needed to develop confidence I can do this, I have compiled a "crib sheet" of information I have been digesting & my notes. This is my way to keep me straight & minimize my confusion. I created the file on a MAC using "Numbers", its version of a Microsoft Excel Spreadsheet. I've also saved the file as a pdf. I want to upload a shared/editable version on Google Doc as soon as I figure that out. I would appreciate if you experienced caregivers will take some time to review/comment making corrections, etc. as needed. I can then get it finalized for our Friday start date. I was also thinking the crib sheet might help other newbies with information overload particularly for those who share my learning style and find this overwhelming.

The pdf link is:
https://docs.google.com/fileview?id...zgtZjVhNi00MWY4LThkYzgtM2Q2YmZkYmYzNzYz&hl=en

I'll keep working on the editable version & post that as soon as possible.

Walmart quoted me a price today on Lantus:
Vial - $159
5-3ml prefilled SoloStar Pens - $215.30
5-3m OptiClick cartridges - $239
Yikes! Any known discounts/coupons other sources? Should I go for the cartridges @ $239???

Thanks everyone.
Susan

PS I just took Lanky's BG at 3 PM (+9 245 after a AMPS of 543!). He demanded to go out, promptly caught a lizard & ate half before I could intercept. That boy!

 

Link to the Crib Sheet file version you can edit - hopefully. Let me know.

http://docs.google.com/leaf?id=0B1Nz6Hy4gn9UZjY4NGI4YzMtNzYwNS00MmEyLTlhMTAtZWNhNzM1MGFkMTky&hl=en

 

I would go with the SolaStar pens since they are a little less expensive than the cartridges. I would also show around since you may be able to find it a little less expensive. Try Coso since you do not have to be a member to use their pharmacy.

 

You can try a free prescription drug card: http://www.felinediabetes.com/phorum5/r ... ?8,1946184 (or viewtopic.php?f=3&t=8482) It might save you a couple dollars or so. Some people buy from Canadian pharmacies for less than what a US pharmacy charges. You can look into that. GlobalDrugsDirect.com is one place.

 

Welcome to Lantus Land!

I think Larry meant to "shop" (vs. show) around for prices. I found that the cartridges and pens were the same price. Fundamentally, ask your vet to write a prescription for either the cartridges or pens vs. the vials. There is too much potential waste with the vials. I prefer the pens since the glass cartridge is in a plastic sleeve so there's more protection.

The crib sheet is fine. It's a little hard for me to wrap my head around since I didn't create it and I'm not entirely sure how you are using the consecutive cycle information, for example. What I would suggest is to use it as your guideline. If you get suggestions here that you don't understand, ask. People will be more than happy to explain their thinking. Just as an example, while a new Lantus user may not be encouraged to shoot with numbers less than 150, many of us will routinely shoot a number lower than this once we have the data.

The Google file wouldn't open. The pdf was fine.

 

For sure stay clear of the vials as 10ml is just too much waste; once you open the vial, it may be good for around 28 days or so. Others may have their containers last longer but generally it loses its punch around that time. Better to go with the cartridges or pens that are 3ml so you will like use most of it in a month's time.

I used the cartridges of Lantus for Shadoe, and then cartridges of Levimir.
When I adopted Oliver, he arrived with two pens of Lantus and I rather like the pens too, but I don't know if they are available in Canada.

 

Welcome to Lantus (I'm a former Hum. U and N user)
Briefly looked at crib sheet -- looked good.
Wanted to tag along to what Sienne/Gabby was saying.
Protocol is a great guideline. Life experience comes from the peeps and cats here.

 

Good luck with your insulin change. We switched from PZI just over 2 weeks ago, so I understand you wanting to get organized first. Be sure and read the protocols - we printed Tilly's out and refer to it frequently. If you follow that protocol, I'm sure you'll be happy with your change. I've found it comforting to have the protocol to guide me.

 

Just added Lanky's pic, isn't he handsome?!

I moved showtime up from Friday to tomorrow, Wednesday - Apr 7th - to make the change from Hum N to Lantus. I bought Lantus SoloStar pens @ Walmart today w/ my AAA discount (almost 20 bucks) for $198.96. They are safely stowed in my frig. Now, tomorrow when I go to draw 2 units (I have read the Lantus stickies), no shaking, rolling etc. I just take the pen & with my syringe draw out my dose -- NO insertion of air, NO mixing, rolling or shaking -- if I overdo it, NO returning any insulin from syringe to pen--CORRECT?, I just dump it...then I understand there is NO pre-filling the syringe BUT can it sit (refirgerated??) 5 or 10 minutes while I do other chores? And, it is best to draw with the pen stabilized on the counter as in the sticky picture???

Also, I have been shooting between the shoulder blades -- OK??

I plan to test BG @ 5:30 AM, feed Lanky & the others (Otis, Miss Nubbins, & Bruski) for 30 minutes as it is quite a ritual shifting positions, pausing & coming back in 5, getting a fluff up w/ a little warm H2O, checking out the other guy's dish etc, etc, AND finally shoot @ 6 AM. Let me know if this is OK--my Hum N dose was 3 and the Vet has asked me to start Lanuts @ 2 units. Check out my numbers and see if you agree.

Fortunately, I am home all day tomorrow, most of Thur, and then all Fri, Sat, & Sun to monitor & observe. I am planning to test at least every 3-4 hours between AMPS & PMPS and then I'll be up until ~ 11PM in the evenings for a few more BGs if needed. I am pretty well exhausted by then. Any suggestions to do it differently?

That's it for now -- thanks for all of you insights & assistance.

Susan & Lanky

 

All of the Lantus handling info you noted is on target. You can leave a filled syringe sit out unrefrigerated for 5 or 10 minutes. It should be fine.

Just out of curiosity, how did you establish 2.0u as your starting dose? One way to determine starting dose is based on ideal weight (i.e., starting dose = 0.25 x ideal weight in kg). Lanky's current dose of Humulin may also be a factor.

I shoot in the scruff. I suspect that we're pretty evenly divided here with some people shooting in the scruff and others in the flank. Either place is good.

Unlike with Humulin, you don't need to have a delay with respect to feeding then shooting. Lantus does not have the quick onset that N has. If you test during the early part of the cycle, you will probably see that Lantus onset is typically at around + 2 or +3. I test, feed, and shoot all within a few minutes. I wait to see Gabby's head in her bowl of food and shoot while she's eating.

Don't be worried if you don't see much change in numbers the first several days. It will take a while for the shed to build. You are likely to start to see something happening by around day 5 or so.

 

The Vet called for 2 units of Lantus. The prior time we spoke, we were banting around 2.5 units. The Vet has a colleague who always uses Lantus & they chat alot. I surmise that + Lanky's spreadsheet and his vet records contributed to Doc's Rx. I gave him a current spreadsheet today and he had one from just over a week ago. I recall the Humulin Rx being based on weight. I'll pick his brian when next we speak. Dr. P really likes the FDMB spreadsheet.

 

If your vet likes the SS (yay for your vet!!), you might want to print out the Tight Regulation Protocol and/or the Rand/University of Queensland Protocol. The two dosing protocols largely overlap. I find the Tight Regulation Protocol easier to read.

If your vet hasn't used Lantus a great deal, it will give you both a common ground for discussion.