Weee're Baaaack...

Discussion in 'Lantus / Levemir / Biosimilars' started by Bruce & Simon, Nov 17, 2012.

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  1. Bruce & Simon

    Bruce & Simon Well-Known Member

    Joined:
    May 28, 2011
    Hi Everyone

    After 19 months or so Simon's back on the juice :-x.
    At our quarterly testing for his HT, his T4 had strayed out of range and his dose of Tapazole
    was doubled, but I think it was too late, FD triggered again (my inexpert opinion) Anyway, a brief question;
    I had Lantus left from before in fridge which doesn't expire until 12/2013, however 3 days in and I'm
    not seeing anywhere near the effect I expected (see SS).

    Could the Lantus be degraded? I still have 3 unused vials plus the one I just started. I don't want to
    be too impatient (Me?? :lol: ) but I also don't want to waste our time.
     
  2. Michelle & Scrabble (GA)

    Michelle & Scrabble (GA) Well-Known Member

    Joined:
    Feb 10, 2010
    Hi guys I feel ya! Scrabble was otj for 2 and a half years and we just came back 3 weeks ago. The lantus that you are using was it opened? If so I would use a new vial if it were me. Sorry you had to come back.
     
  3. Bruce & Simon

    Bruce & Simon Well-Known Member

    Joined:
    May 28, 2011
    Hi Michelle

    When Simon went OTJ, I threw out the vial we were using, so this one's brand new, (with three more in stock)
    What I might do is start one of the other 3, although they were all together in the same fridge. No power failures that
    I recall, so they should be good.....

    Sorry about Scrabble
     
  4. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Good Morning :D
    I don't see any night time tests.. You'll start to get those, right?

    I think you said you're using a fresh vial, and if the insulin isn't expired, it should be okay.

    You want to be more agressive when coming back from a remission.
    I would stick with this dose another cycle, and see what others have to say about when to increase.

    He's eating wet low carb only, I'm sure.
     
  5. Bruce & Simon

    Bruce & Simon Well-Known Member

    Joined:
    May 28, 2011
    Thanks Dyana

    I will get some PM tests, and yes, Simon's on wet lowcarb diet, and the vial is new.

    I wasn't aware of having to be more aggressive, so started low. I'll stick with this dose today,
    if AMPS not improved, I'll up it... .75u or a full unit ?
     
  6. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Wait and see what others say about the dose increase. I'm sure it will only be by 0.25, so up to a sk0.75.
    I'm not sure about whether you should wait for the full 3 days or 6 cycles before increasing, as we normally do.
    I would wait for more advice on that.
     
  7. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Sorry to see that you're back!

    I agree with Dyana. It's likely that your Lantus is fine.

    I think you may not be recalling that Lantus needs several days for the insulin depot to form and for numbers to start coming down. It usually takes 5 - 7 days for the depot to form. At the minimum, you want to hold the dose for 4 cycles (2 days). I also suspect you started Simon on a bit low of a dose. For now, I would not fatten doses. I'd suggest that when you increase, you increase by 0.25u.
     
  8. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Hi Bruce

    Also sorry to see you back. Hopefully you can get him back into remission ASAP.

    I'd like to see you be more aggressive since he is coming back from remission. I would give him tonight at the current dose and then take him up to .75u in the morning if he stays flat.....but you must have some nighttime tests.

    I'd like to reference a post I made in Scrabble's condo:

    Also...take a look at how aggressively Michelle dosed Scrabble when first coming back because we suspected he was started too low. But in order to dose that aggressively, you have to get a few tests at night.....at least a +2 and mid cycle.
     
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