Re: Insulin Advice - Revisited

[Guest guest]

A couple of thoughts...

First, the pens, whether disposable (containing 300 units of insulin) or

reusable with cartridges, dispense insulin according to the amount you dial them

to -- that's how you get the right amount. The pens make it much easier to

carry your insulin with you if you're not at home for a lot of your meals. With

the pen, you use a pen needle (I use a new one each time) which come in boxes

of 100.

Regular insulin ® is available without a prescription, usually it costs

somewhere in the neighborhood of $30 for a vial. Then you also need syringes,

which come 100 to a box.

The negative of regular is that it takes longer to peak (meaning you need to

take it well in advance of eating), and it has a longer tail (meaning its

effects last from 5-8 hours). The rapid insulins (humalog and novolog) peak

earlier and are usually out of your system by 4 or 5 hours (3.5 for me). They

more closely match what your pancreas would do if it were working properly. You

take them anywhere from 15 minutes prior to eating to just after eating.

Given that actos has worked well for you, what about increasing the dose to

45 mg to see if that gets you the results you're looking for?

I'm not sure what the price is for the pens -- they come 5 to a pack, and one

pen, once in use, is good for 28 days, so if you're using only a few units a

day, the pen might well last you the month or close to it, so you could get

4-5 months out of one prescription which totals 5 pens. I'm not sure if the

cartridges come 5 to a box also, Vicki?

I think the rapid insulins are easier to deal with -- though lots of people

here would have more experience with having used regular and can offer their

advice.

Stacey

[Guest guest]

My problem is that there are times in my life when I just don't

have the time, energy, and dedication that it would take to stay

" on plan. " When you're working a 9 1/2 hour day without breaks,

the last thing you want to do afterwards is go to the gym or come

home and prepare 5 meals for the next day. There were, litterally,

a couple of times last week where I was crying at work, and

ready to give my resignation. It's just hell when the co-worker's

on vacation, as we're really understaffed as it is.

If the pens are 5 to a prescription, I might ask for the Humolog,

then, and just keep them on-hand for those days when the actos

just isn't cutting it. Looking at the peak chart for Humolog, it very

closely matches my post-prandial spikes/needs! (I actually did a

test for several days where I tested every 1/2 hour to get the

chart. Ouch, my poor fingers!) I probably WOULD be able to

make a prescription last 4-5 months, as I can go for days and

days without any real issues. It's only when life gets topsy-turvey

that I lose good control.

Thanks for the help!

SulaBlue

> Given that actos has worked well for you, what about

increasing the dose to

> 45 mg to see if that gets you the results you're looking for?

>

> I'm not sure what the price is for the pens -- they come 5 to a

pack, and one

> pen, once in use, is good for 28 days, so if you're using only a

few units a

> day, the pen might well last you the month or close to it, so you

could get

> 4-5 months out of one prescription which totals 5 pens. I'm not

sure if the

> cartridges come 5 to a box also, Vicki?

>

> I think the rapid insulins are easier to deal with -- though lots of

people

> here would have more experience with having used regular

and can offer their

> advice.

>

> Stacey

>

>

>

[Guest guest]

Sula B, the cartridge goes into a pen that is designed for it. I refill

my carts from an insulin vial; however, that would not be a good option

for you as the insulin starts to lose potency after 30 days.

Lilly has discontinued the 1.5 (150 unit) cartridge; I don't know if

Novalog makes one.

They come five cartridges to a box and you would have to purchase a pen.

Most insurances do not cover the refillable pen. I bought one

yesterday and it was $41.99 at Walgreen's. Assuming you get either the

Lilly disposable or the Novalog something, one cartridge would probably

last you a month, if you actually use the insulin as you plan. It does

not die instantly after 30 days, tho my experience shows a big

degradation of potency after about 35 days.

Therefore, the $50 charge would cover insulin for five months. You will

need to find out what the insurance will cover. I like the way the

Lilly disposable pens work and feel, Vicki does not like them at all.

At one a month, the environment would not be a big concern.

Helen

[Guest guest]

> Sula B, the cartridge goes into a pen that is designed for it. I

refill

> my carts from an insulin vial; however, that would not be a

good option

> for you as the insulin starts to lose potency after 30 days.

Ah, thanks

> Lilly has discontinued the 1.5 (150 unit) cartridge; I don't know

if

> Novalog makes one.

Weird. My Insurance is still listing the coverage for the 1.5mL

cartriges as " Humalog Cart 1.5ml 5'S  " I'm guessing the 5's is

the indication that it's 5 cartriges?

It also has the Humalog 3ml carts, 5's and a " Humalog Mix Pen

3ml, 5's " and is listed as strength 75u/25u (Humalog and

Regular, I'm guessing?) in a " Disp Syrin " (Disposable pen

syringe?)

> They come five cartridges to a box and you would have to

purchase a pen.

> Most insurances do not cover the refillable pen. I bought one

> yesterday and it was $41.99 at Walgreen's.

Looking at my insurance's website

Assuming you get either the

> Lilly disposable or the Novalog something, one cartridge

would probably

> last you a month, if you actually use the insulin as you plan. It

does

> not die instantly after 30 days, tho my experience shows a big

> degradation of potency after about 35 days.

If the 1.5 cart is 150 units, then a 3 ml cart should be 300 units. I

believe I saw a 'starting range' of 1 unit per 15g of carbs (or so?)

Right now, when all is right with the world, I stay 'on plan' for 30

meals out of 35 for the week, without needing anything more

than the Actos provides.

I try to " be good " even when I have to eat off plan (Low-carb/low

fat wraps from Subway, etc.) so I should be able to start trying to

dose with only 1-2 units per meal if I stay on the Actos (Generally,

if I go TOTALLY off-plan, I spike up to about 200 and come down

slowly, so I don't want to over-correct!)

Who knows, she may give me Prandin, instead. I know she has

samples of that on hand

> Therefore, the $50 charge would cover insulin for five months.

You will

> need to find out what the insurance will cover. I like the way the

> Lilly disposable pens work and feel, Vicki does not like them at

all.

> At one a month, the environment would not be a big concern.

> Helen

Thanks, Helen!

I see my Doc on Thursday. I'm SO excited (how weird, eh?)

SulaBlue

[Guest guest]

Yes, five cartridges in a box and/or five disposable pens in a box. The

disposable pens have always been the 3ml, 300 units. I don't know what

the mix is, some of them have NPH.

Last I knew, the retail price, without insurance, was around $125 for

the Humalog pens, $80 something for the 1.5 cartridges. There may be

some of those left; however Vicki spoke to Lilly and they are being

discontinued.

Ron has all kinds of insulin tutorials posted at DSM, but the starting

dose I was given was 1 unit of H for each 15 grams of carbs. However, a

lot depends on what kind of carbs and what food sensitivities you may

have. As part of the tutorials he has a set-up for figuring glucose

load and dosing according to your own particular need for particular

quantities of food. I hope this makes sense, it can be hard to

understand, therefore hard to explain.

I tend to eat basically the same GI foods, rather than go thru all these

calculations. I already know what foods spike me more and dose

appropriately when eating them. I am dosing a unit of H for each 5

grams of carb. Stacey is 1 to 4. We both take a long term insulin.

Prandin did not work well for me; brought me down too slowly and then

boom! I was having a low. I never could work it out. YMMV.

Helen