Life has been busy lately - between having gum surgery (will write about that experience later) - and just the fact that suddenly "summer" is upon us with temperatures of 32C / 90F - no time to sit down and type out my usual entertaining thoughts.
Most of you know, I'm taking a break from my pump aka Salvador Dali and back to my grassroots so to speak - of MDI (multiple doseage injections). I started back in April - and so far - the experience has been interesting - and the results of my next A1C in July will show if all of what I have learned while using the insulin pump. I have much more awareness of how my insulin(s) work - along with carb counting. It also has helped with having other MDI experts helping me out when I ask for help.
I finally finished up my Lantus supply of insulin - and began to use Levemir insulin. I wanted to go onto Levemir mainly for the fact it is not supposed to cause weight gain which Lantus has a reputation for. I've read though in forums that Levemir doesn't have as long a life span in our body as Lantus does and wondered how it would work. With Lantus, I was taking 2 shots a day and my blood glucose (BG) have been pretty good and not many hypos which is one reason I had gone onto the pump in the first place.
I had to stop after 7 days sad to say with the Levemir. I was waking up with fasting BG's between 8-13 mmol/l (144-234 mg/dl) - and having problems with bringing them to my normal range of 4-7 mmol/l (72-126 mg/dl). I've read in some forums that with Levemir they have to use double the amount of insulin that they used with Lantus, and they still did not have good BG control.
Also, one thing I'm curious about, has anyone experienced hard/hot/swelling in the site that they inject their Levemir? I was getting this a few times with Levemir injections, and on those days, of course, BG's were out of whack. I have a feeling that the insulin wasn't being absorbed properly at that point. The picture below my thigh, and it remained like this for a few days (swelling was about 3.8 cm/1 1/2" in diameter).
One thing that I'm still having to do some research on is that one reason for my wanting to go onto Levemir was due to the news release last year that Lantus could cause cancer. One of the diabetic forums I belong to has mentioned that the actual research done on Lantus was funded by Levemir. Hmm, can pharmaceutical companies be this nasty with getting their market share? It makes me shudder to think so.
On the bright side of this post, have a laugh at what I woke up to on my face today. No, I did not have any nip tuck done, this is how I woke up this morning. I just seem to be a gal prone to swelling lately don't I? Perhaps due to the heat we are having here in Montreal? I have no idea, all I know is, Lady Gaga look out, you've got competition. Revlon if you need a lip model - you know who to come to!
By: FatCatAnna: Nov, 12, 2010 10:35 AM
Hi KatieBug! We are opposites - I have been MDI (poor mans pump) for 40 years - only 3 years pumping (I'm a pump virgin <lol>). Curious - did you report the problem to NovoNordisk yourself? I did, and they'd never heard of any problems with Levemir like mine, though as I written above, other diabetics have told me they had same issues.
Before the pump, I was on Lantus, and did very well with using it as my basal insulin! Your endo may insist you use it once a day (usually at night) - but you may want to suggest 2 shots a day. You'll probably use the same amount of basal insulin you did in your pump as well. I found splitting the shots (smaller dose before bedtime and larger dose in a.m. worked for me). I could also adjust my a.m. doseage depending on my activity level. Inbetween that, I used my rapid insulin for any BG corrections.
Don't worry about the cancer issue of Lantus. From the reports I've read (and the study was done by the competitor NovoNordisk - makes you wonder their about the monopoly that drug companies have over us "guinea pigs") that a human would have to take large doees of insulin over many years to perhaps get cancer. As we age anyway, cancer is something that occurs in us, so it never really worried me that much.
Curious, you say you developed scar tissue. I'm hoping if I continue with the method of 1" over with infusion sets, I will not have scar issues. With MDI I was averaging 8 shots a day - in stomach, legs, arms, buttocks. With my pump sites, I'm using stomach, legs, upper buttocks, and above my pant line of my back (I'm lucky to be well endowed with fleshy bits).
Sorry, lots of questions - just nice to meet up with someone who has had diabetes as long as I have!
By: : Nov, 11, 2010 19:45 PM
I've been type 1 for 40 years and just went off the pump after 25 years of it. Scar tissue, bumps, etc. so little insulin absorption and poor control. I'm back on MDI and my doctor put me on the Levemir too. I've had severe allergic reactions to it - the big red bumps and horrible itching. Their site says the ingredient metacresol could be the problem. Google metacresol and it's a little disturbing as to what the chemical is. It looks like I'm going to have to try Lantus. I've tried the Levemir for about 3-4 weeks now and the allergic reaction at the site isn't any better. My sites look like the picture of your thigh (mine are even worse). I'm so excited to have a vacation from my pump after 25 years. I hope the Lantus works and that it's not linked to cancer.
By: Kelly59: May, 30, 2010 15:01 PM
I will do mine in two replies also since I tend to write a book!
Your lips must have known that he would be your husband and behaved themselves (or didn’t!) that night!
I knew you said not too many people were on pumps in Canada, but I didn’t realize that your endo didn’t want you to go on one. Everyone here pushes pumps. It figures when I finally decided I wanted one, my doctor didn’t want to sign! At least I encouraged him to sign.
I wish I had discovered forums a lot sooner also. Not just because of pumping, but I have learned so much in general by talking to other people.
By: Kelly59: May, 30, 2010 14:57 PM
I saw that you can have up to 12 different basal settings & there are 4 different programs (like the weekend one). I probably won’t need the weekend one type one because I am also pretty consistent. Back in my younger days, I could have used that. Even on the old NPH, Regular fixed dose regimen, my doctor recognized that I was more active on the weekends and needed less insulin.
It seems like it is common for trainers to start people off on one basal rate but I want to start off with at least 3 - I am used to that with Levemir and have 3 very different amounts. I have DP so want my morning one to start working early but then cut back about 9 AM and go back up in the afternoons. Once I get started and can do some basal testing, I am sure I will have a lot more than 3!
That is nice Animas gave you Pumping Insulin. I have the Using Insulin book (the MDI version of Pumping Insulin) and planned to order Pumping Insulin. When my doctor didn’t send the paperwork in, I spent the money I planned on buying the book with and have to wait until next week to get it. I mentioned to the Animas sales guy I was going to get it and he didn’t say they would be giving me a copy - I will order it just to be safe & can always give someone the extra copy.
I use 3 different carb ratios also - I am really bad in the AM and am 1:6, believe it or not! Lunch isn’t too bad, I am 1:12 and then 1:15 for dinner.
I don’t think that I ever had the C-peptide before but the insurance wanted it for the pump. I guess if I had to flunk a test, that was a good time to do it!
My Levemir doses are close to what you are doing and I didn’t have a reaction. On normal days, I do 10 at 7 AM, 3 at 3 PM & 8 at 11 PM. When my thyroid is attacking, I do 16, 6 & 10. Then I crash & go back to normal for a couple weeks and then need more a couple weeks. It is like a ro
By: FatCatAnna: May, 29, 2010 21:29 PM
I have 5 basal settings on my pump - some people have more. You can even set different basal setting for exercise, weekends (you get up later - different routine). I've never had to use a weekend basal rate as I'm pretty consistent. You also should do some reading up on carb to insulin ratio (I:C) - so when you bolus for meals - you don't overdue it and go into la-la land (low BG). I have 3 different bolus settings for various times of the day. For example, mroning when I need more insulin, my ratio is 1:12.
One thing, when I did get my Animas 2020 back in 2008, I was given the 4th edition of the Pumping Insulin book. I don't know if Animas does that with every new client, but I was given a copy. My older 3rd edition (but still useful) now resides at my public library for others to take and use!
I'll have to ask next time I have my blood work done (for A1C, thyroid, etc.) - if they could do a C-peptide test. Just for curiosity sake (I'll probably need approval from my endo). I hear alot about this test on diabetic forums in the USA.
One thing with the Levemir reaction, Doris who we both know (she only posts comments on Facebook - not here), has told me with smaller shots (she's like you - does 3 a day) - no issues. Also, she has better control of BG's since she was saying Levemir for her (not sure if it's for all of us that use it ) peaks at 8 hours. It has a shorter life span then Lantus, so in a big dose like I do (8-10 at night, 8-10 in morning) it might cause what it did for me in swelling, and also not perform as well. Everyone is different tho' in how we use our injected insulin.
Part 2 of 2 - The End
By: FatCatAnna: May, 29, 2010 21:28 PM
LOL Kelly - on your question of if I knew my husband before our first date. I had met him briefly at a party a year before - and then had an "official" date with him about a year later. No swelling of the lips during either of those "dates". :)
One book, if you don't have it already - John Walsh's Pumping Insulin. I was actually using that book prior to pumping, since it's a useful tool for even the non pumping diabetic who is just on MDI (multiple doseage injections). It made me understand how insulin works, carbs, etc. It made the progression to the pump an easy transition. It contains a worksheet to figure out your baseline basal rate - which you will tweak as you get used to the pump and do basal tests, etc.
Again, like you, my endo didn't want me to go on pump since I was well controlled, but I was curious, and in the end I went ahead without his approval, but eventually when I purchased the pump, I had to have his signature. He doesn't handle many diabetics with pumps (very expensive here to own in Canada unless you have private insurance from work) as well. I was self taught on my pump like you will be, but with the manual, very easy to understand. I only discovered forums a year later. I wish I'd discovered them earlier (like you have been doing - good to get feedback from other pumpers).
Part 1 of 2 in reply - Body 1 is not allowing me to post such a large comment back to you.
By: Kelly59: May, 29, 2010 13:57 PM
I changed my password so hopefully, I can get back in here! If that works, then I won’t have any excuses to not respond.
I am sure that 4 days is long enough for the Levemir to be out of your system. I have to confess though, when I typed the comment about the swelling being from the Levemir, I “forgot” that you said you had stopped! I have a very short memory these days, thank you thyroid!
Since you said that the swelling can be nerves like before a date or something, I have to ask, did you already know your husband when you had your first date?
A lot of people say that they need more Levemir than Lantus for some reason. I didn’t have that problem. I wonder too if people find they were waking up high like you were, they up the dose instead of doing basal testing to find out that it wasn’t lasting 12 hours.
I can’t say that I would want to inject something into me that I had an allergy to, so I would say you gave it a good try! Not your fault that happened!
The supply company submitted the paperwork to my insurance last week. My doctor was reluctant to sign the paperwork so I convinced him that Animas would be doing all the training and he would not have to do anything. Hopefully, that will get approved without a problem. I had to go get a C-peptide test to prove I wasn’t making insulin - I flunked that test so that passed for my insurance! Mine came back as < 0.1 with the range being 0.9 - 4.3. They then rechecked it and that one said < 33 with the range being 297 - 1419. I guess I really am diabetic - good to know after 26 years of taking insulin!
I am working up what I want my settings to be on the pump. My doctor won’t be any help on that since he knows nothing about pumps. I already have 3 basal rates so I hope the trainer doesn’t try to push one rate on me! Any suggestions you have their would
By: FatCatAnna: May, 28, 2010 19:15 PM
You are like another friend of mine who MDI's (multiple dosage injecting) - with Levemir 3 times a day due to it not having as long life as Lantus. I was hoping to try that method - before the allergic reaction occurred, but for me, the main reason for stopping it was due to blood glucose levels that were high, and I knew going back onto the old familiar Lantus, I would be on the right track again.
The lip swelling is something I've had periodically over the years, ever since a teenager (used to think it was due to nerves before a date or important event <lol>). I have a feeling this had nothing to do with the Levemir since I had stopped using it 4 days before. Unless it can remain in the body that long to cause what happened to the lips.
I may try to contact my endo next week just to see what suggestion(s) he might have with what happened, since I really don't feel I can complete this experiment I've been doing, of going back to MDI, if I can't at least say I gave Levemir a good try.
Again, to clear up any confusion, as one person responded to me privately saying "The question is ... has your body stopped rejecting either the insulin or infusion sets (whichever was causing the problem) so you can go back to pumping?" I had no issues like this when on the pump with skin irritation, etc. I'm just taking a break from the pump to prove mainly to myself, that with the knowledge gained from being on the pump the past few years it can can be applied to MDI as well.
I have to admit Kelly, I'm having second thoughts about going back on the pump, since so far, my control of BG's seems to be going well (except for today - but that's another blog for another day <lol>).
BTW, when are you going to be starting on the Animas pump? You know I'll be there to help yo
By: Kelly59: May, 28, 2010 15:07 PM
Anna, I worked with a guy that had a very bad allergic reaction to Lantus - that was before Levemir came out so he had to go back to NPH (remember those good ole days!). He ended up in the hospital because of it.
I do the Levemir 3 times a day and that works really well for me (other than having to hear alarms at 11 PM & 7 AM). I did basal testing and found out that it only lasts 7 hours for me. If you read the prescribing information for it, it can last a little less than 6 hours up to 23. If you are someone that is getting even 10 hours out of it, then 12 hours won’t work for you. Since you are a pump, you probably know how to do basal testing. I actually do 3 very different amounts - the most during the day, the least from 3-11 PM & about the middle over night. But you know we are all different so what works for me necessarily won’t work for you!
Are you sure your swelling isn’t from the Levemir?
By: FatCatAnna: May, 27, 2010 13:21 PM
Hi Brigitte - yes - I was taking the Levemir every 12 hours. I did the same with Lantus. I'm hoping a friend of mine who also uses Levemir, but uses it 3 times a day - may have an answer for me. More so with trying to keep my blood sugars more stable like they were with Lantus. I really want to use the Levemir if I can, mainly due to the weight issue that comes from using Lantus.
I did have lows at night with Lantus, which is why I went onto the pump, but when I went back to injections last month, the knowledge I've gained from using the pump has made me understand how to control how much insulin I give at night (Lantus) in order to have no hypos or lows at night.
I may have to wait until I see my endo in July to question him OR after I've done more research myself - try the Levemir again.
Do you take 2 shots a day of Levemir?
By: : May, 27, 2010 13:06 PM
I have no allergy with Levemir! Nothing like what you show on the picture. And yes it's hard with Levemir to wake up with good number! I have some good days and sometimes bad ones. But with Lantus I used to have lows in the middle of the night, around 2H30 and also in the afternoon. Did you try to made 2 injections of Levemir? Many people who used Levemir made 2 injections (every 12 hours) and it works well. Holger ( the ambassador of Germany on TuDiabetes) helped me when I started to become an addict of Levemir. But if you made allergy don't use it. Please, my twin, take care of you.
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