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C-Peptide results

I really can't see Tresiba working for me as I need to adjust my evening basal on a night by night basis, so I think my option would have to be Humulin I or a Glargine insulin which I have never tried before, so can't really argue against that, but I would most likely have to split it and it is going to be a lot of upheaval to find a good split that works for me. Really pleased I got this info before my appointment tomorrow morning. Also pleased that I did that experiment earlier in the year with dropping the Levemir and just using Fiasp as at least it gives me some data to discuss.

Don't understand why Novo Nordisk would drop Levemir as it provided more flexibility for those people who don't want or qualify for a pump. Maybe I will get hit by a bus crossing the road before 1026 and the point, for me at least, will be moot!
 
rebrascora said:
Well that now gives me a big question to ask my consultant tomorrow. Really quite devastated that is is official, as I really love Levemir and moving to Humulin I (if I can get them to agree to that replacement) will mean my NovoPen Echo will no longer be useful and I really find the half unit function helpful for my evening dose as well as the memory function. @Robin and @Bruce Stephens are you guys aware of this? We had all hoped it was just going to be restricted to the US but seems they are extending the discontinuation. I'm gutted!! Having Levemir was one of the reasons I didn't/don't want a pump.
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There are other isophanes too (and do we still have NPH?) so hopefully there’ll be a basal that works for you @rebrascora Don’t let them railroad you into an insulin you don’t want. I recommend doing your research about all the basals available and being politely pushy.
 
Is Insulatard still available? That’s another isophane basal, I think, and it’s made by Novo Nordisk. So, would it fit in their pens? I presume so @rebrascora
 
Thanks @Inka. Believe me I will be prepared to fight my own corner on this although it seems I am going to have to try different ones to see what works best for me, but I will have a list of things I would like to try and it seems sensible to start with Humulin I, but I intend to hang on to my Levemir as long as I absolutely can. Is it your experience that they don't like to prescribe Isophane and if so, why?
 
Oh, don’t get me started @rebrascora ! They don’t like to prescribe any of the older insulins to Type 1s! They’re obsessed with analogues even if they’re c**p. Some consultants are better, but they still question you when you ask for something different, like they think you must have made a mistake or something 🙄
 
Inka said:
Is Insulatard still available? That’s another isophane basal, I think, and it’s made by Novo Nordisk. So, would it fit in their pens? I presume so.
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Also being discontinued, according to this.
cpe.org.uk

Medicine Supply Notification: Insulatard® (isophane insulin, human) Penfill® 100units/ml suspension for injection 3ml cartridges - Community Pharmacy England

Department of Health and Social Care (DHSC) has issued a medicine supply notification for Insulatard® (isophane insulin, human) Penfill® 100units/ml suspension for injection 3ml cartridges TO NOTE: This is the second of three MSNs covering discontinuations of Novo Nordisk insulin products...
cpe.org.uk cpe.org.uk
 
Robin said:
Also being discontinued, according to this.
cpe.org.uk

Medicine Supply Notification: Insulatard® (isophane insulin, human) Penfill® 100units/ml suspension for injection 3ml cartridges - Community Pharmacy England

Department of Health and Social Care (DHSC) has issued a medicine supply notification for Insulatard® (isophane insulin, human) Penfill® 100units/ml suspension for injection 3ml cartridges TO NOTE: This is the second of three MSNs covering discontinuations of Novo Nordisk insulin products...
cpe.org.uk cpe.org.uk
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Typical 🙄 I’m sure it fits the Novopens. It looks like Novo Nordisk are concentrating on new insulins like that weekly one aimed at Type 2s.
 
Insulatard is also being discontinued in June next year and Humulin I is only going to have enough extra production in disposable pens not cartridges, so I may be in a situation where I have to choose between my environmental standards and what might be best for my diabetes management.
 
Why not use Hypurin isophane @rebrascora ? It’s what I use for pump breaks and I use a reuseable pen for it. It’s not made by Novo Nordisk.
 
The worst of it is that I don't know the new consultant and they don't know me, so I don't feel they are likely to be on my side or see where I am coming from. I am now really not looking forward to this appointment tomorrow and feel under prepared!
 
What is the difference between Hypurin Isophane and and Humulin Isophane? Are they just different makes of the same insulin?
 
rebrascora said:
What is the difference between Hypurin Isophane and and Humulin Isophane? Are they just different makes of the same insulin?
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They’re both isophane insulins @rebrascora but Humulin is human insulin whereas Hypurin is the original porcine insulin. Hypurin Isophane is made in the U.K. I’ve found it very good. It uses the Autopen, which has a nifty little side button. No half units but I find that ok even though I’m only on small doses of basal.

Some people find the original insulins give better hypo signals too. I personally think they do.
 
rebrascora said:
I intend to hang on to my Levemir as long as I absolutely can
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How long of a use by date is there on insulin? Haven’t any to hand to check but it’s a while till 2026, maybe you could get spare in and put off the switch till 2027
 
What sort of profile do you get from Hypurin... ie how similar is it to Levemir?
 
Like all the isophanes, it’s an intermediate-acting insulin @rebrascora Levemir’s profile of action is longer (because it’s a long-acting basal not an intermediate) but I find the intermediates convenient for twice daily. Depending on the individual, the isophanes last from 10 to 18hrs. I take my Hypurin morning and evening, choosing the times that work for my blood sugar.

Edited to add that the profiles of action show Levemir as flatter and the isophanes as declining, but in day to day use, they’re not too disimilar used twice daily.
 
Lucyr said:
How long of a use by date is there on insulin? Haven’t any to hand to check but it’s a while till 2026, maybe you could get spare in and put off the switch till 2027
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I guess I could start ordering every month instead of every 2-3 months. I am not one for strictly following use by dates on anything anyway, so if something gets a few months out of date, it wouldn't concern me. Just looked and my current ones and they expire Sept 2026, so if I can amass a bit of a stock pile I should be able to eek it into 2027 at least. If I went back to only using it at night and just using Fiasp during the day, I could probably make it last a lifetime, but each cartridge would be going well over the 28 days doing that as well as the use by on the box being well over.... I am planning on living to 100 if that bus doesn't get me! 🙄
 
Inka said:
Like all the isophanes, it’s an intermediate-acting insulin. Levemir’s profile of action is longer (because it’s a long-acting basal not an intermediate) but I find the intermediates convenient for twice daily. Depending on the individual, the isophanes last from 10 to 18hrs. I take my Hypurin morning and evening, choosing the times that work for my blood sugar.
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The intermediates might actually suit me better then because my morning Levemir can cause hypos overnight even when I don't take an evening dose due to increased exercise.
 
Ah, yes - I’d forgotten that! Excellent point @rebrascora Your morning isophane will run out quicker than your morning Levemir. I don’t notice my isophane working after 12hrs really.
 
Inka said:
Ah, yes - I’d forgotten that! Excellent point @rebrascora Your morning isophane will run out quicker than your morning Levemir. I don’t notice my isophane working after 12hrs really.
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My morning dose will likely be considerably bigger than yours though (20 units) so will perhaps last longer.
 
rebrascora said:
I guess I could start ordering every month instead of every 2-3 months. I am not one for strictly following use by dates on anything anyway, so if something gets a few months out of date, it wouldn't concern me. Just looked and my current ones and they expire Sept 2026, so if I can amass a bit of a stock pile I should be able to eek it into 2027 at least. If I went back to only using it at night and just using Fiasp during the day, I could probably make it last a lifetime, but each cartridge would be going well over the 28 days doing that as well as the use by on the box being well over.... I am planning on living to 100 if that bus doesn't get me! 🙄
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Just ordered another box - will do every 3 weeks
 
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