Just started Lantus

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Wendums60

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Type 1.5 LADA
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Hi everyone,
I’ve just started the Lantus insulin injections
10 units once a day in the evening.
I’m also continuing to take 500 mg of Metformin three times a day.
Also have the Libre sensor fitted . Which is working really well.
What are peoples experience with Lantus ?
The consultant that I saw prescribed Novomir , but my diabetic nurse, said that there’s a shortage because of the pens which are being used for ozempic over in America , !! My sugars have been up and down Since October last year so I guess my body is probably going to be adjusting to the fact that they’re gonna be more regulated. Feeling really rough as this morning achy, headaches sicky , is this just my body adjusting to the insulin? My levels are normal and within range at the moment . Hoping this is just temporary so would be grateful for other experiences.
Thank you so much.
 
Apologies , I meant Levemir , just the basal one a day , because my levels werent consistently high and would dip down into normal then shoot up again, they decided to start on this to prevent me going into hypos . The diabetic nurse said that my consultant should’ve known that Levemir was very difficult to get. And she was not impressed that she forgot to sign the prescription anyway and 2 weeks on there’s still no letter from her with her recommendations, so my nurse had to take Matters into her own hands!
 
As far as I am aware there is no problem with Levemir availability although I use cartridges rather than disposable pens so that is unaffected by the Ozempic situation, but there has been no mention of Levemir being affected by this on this forum, just FIasp.
Is this a diabetes nurse (DN) at your GP practice or a specialist diabetes nurse (DSN) from the diabetes clinic?
As regards feeling rough, could this be because your levels were high before and your body had got used to them being high and is now complaining as your levels are coming down into range or could you be coming down with something like a virus? I am assuming it is not overnight hypos causing it since you have Libre and would surely have mentioned having hypos if that was the case?
It is very unusual to have any reaction to insulin but if you are one of the rare people who do, then changing to another brand or type of insulin can resolve it. I would give it some time to see if it settles down. I appreciate that it isn't nice feeling rough like that but there is a lot of adjustment for the body and hopefully it will settle.
 
Wendums60 said:
Apologies , I meant Levemir , just the basal one a day , because my levels werent consistently high and would dip down into normal then shoot up again, they decided to start on this to prevent me going into hypos . The diabetic nurse said that my consultant should’ve known that Levemir was very difficult to get. And she was not impressed that she forgot to sign the prescription anyway and 2 weeks on there’s still no letter from her with her recommendations, so my nurse had to take Matters into her own hands!
Click to expand...

As @rebrascora says, I haven’t heard of a problem obtaining Levemir. You don’t need the disposable pens. The re-useable ones are better anyway 🙂 It sounds like the consultant knows a lot more than the nurse (unsurprisingly). As you’re early on in your diagnosis, Levemir would probably be a better option anyway as you take two doses and thus can have less/more in the morning/at night, reducing the risk of hypos and giving you more flexibility.
 
rebrascora said:
As far as I am aware there is no problem with Levemir availability although I use cartridges rather than disposable pens so that is unaffected by the Ozempic situation, but there has been no mention of Levemir being affected by this on this forum, just FIasp.
Is this a diabetes nurse (DN) at your GP practice or a specialist diabetes nurse (DSN) from the diabetes clinic?
As regards feeling rough, could this be because your levels were high before and your body had got used to them being high and is now complaining as your levels are coming down into range or could you be coming down with something like a virus? I am assuming it is not overnight hypos causing it since you have Libre and would surely have mentioned having hypos if that was the case?
It is very unusual to have any reaction to insulin but if you are one of the rare people who do, then changing to another brand or type of insulin can resolve it. I would give it some time to see if it settles down. I appreciate that it isn't nice feeling rough like that but there is a lot of adjustment for the body and hopefully it will settle.
Click to expand...
Thank you, Barbara. Apparently it’s just the prefilled pens that are the issue. There’s plenty of the drug itself but not in the pre-fill pen version. It’s a specialist diabetic nurse at my GP Surgery, she’s absolutely lovely. To be honest, I have only just started and there were no hypos overnight so I probably just need to give it a bit of time. Yes, I have been erratic for so long that my body is probably saying hang on this is not normal for me ha ha!
Many thanks for answering so quickly, it’s great to hear other peoples experiences . my father, grandfather and my uncle were all type one so I didn’t have much chance of avoiding it really, my aunt, my grandmother on my mums side and my cousin on my mum side are all Type 2
Oh joy
 
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Wendums60 said:
Thank you, Barbara. Apparently it’s just the prefilled pens that are the issue. There’s plenty of the drug itself but not in the pre-fill pen version.
Click to expand...
Ask to be prescribed two of Novopen 6 (two, one for backup!), which can dispense 1-60 units in whole units, or two of Novopen Echo Plus (ditto), which can dispense 1-30 units in half units. Both take the 5ml Levemir cartridges - which I've never had a problem obtaining.
NovoPen® ................. PIP Code
NovoPen® 6 Blue .......... 419-6697
NovoPen® 6 Grey/Silver ... 419-6689
NovoPen Echo® Plus Blue .. 419-6663
NovoPen Echo® Plus Red ... 419-6671
 
Helpful @John Gray 🙂 IMO, the issue is that many GP nurses don’t know much about the reuseable pens so prescribe disposable ones out of ‘laziness’ or worry about getting it wrong.
 
John Gray said:
Ask to be prescribed two of Novopen 6 (two, one for backup!), which can dispense 1-60 units in whole units, or two of Novopen Echo Plus (ditto), which can dispense 1-30 units in half units. Both take the 5ml Levemir cartridges - which I've never had a problem obtaining.
NovoPen® ................. PIP Code
NovoPen® 6 Blue .......... 419-6697
NovoPen® 6 Grey/Silver ... 419-6689
NovoPen Echo® Plus Blue .. 419-6663
NovoPen Echo® Plus Red ... 419-6671
Click to expand...
Thavkyou so much ,
I’ll relay that to my nurse , one other question , I lost a lot of weight very rapidly ( 2 stone ) which is classic symptom , when you started therapy , did you gain any weight ? I’m actually the correct weight for my height now , so don’t really want to put on the pounds but I guess my body will now be storing my glucose correctly and not gobbling up my fat and muscle !
 
Inka said:
Helpful @John Gray 🙂 IMO, the issue is that many GP nurses don’t know much about the reuseable pens so prescribe disposable ones out of ‘laziness’ or worry about getting it wrong.
Click to expand...
I have also wondered whether single use pens are initially prescribed in case the insulin does not suit the patient. I can imagine an accountant worrying about the cost of reusable pens when they are only used for a short time. I realise the budgeting is wrong if the patient sticks with the insulin but can imagine the message to the nurses is “simplified”.
Pure speculation of course.
 
Inka said:
Helpful @John Gray 🙂 IMO, the issue is that many GP nurses don’t know much about the reuseable pens so prescribe disposable ones out of ‘laziness’ or worry about getting it wrong.
Click to expand...
Yes , I hadn’t thought of that , definitely something to raise . Thavkyou
 
Good to hear you have a lovely practice nurse, although she is likely a qualified nurse who has been given in house training by a DSN from the clinic. They are known as DN here on the forum or nurses with a special interest in diabetes, as oppose to the fully qualified DSNs (Diabetes Specialist Nurses) at the clinic who have studied to degree level specifically in diabetes management. I know it can be a bit confusing.
I have a very good DN at my practice and she is lovely too, but she doesn't really know enough about Type 1 to advise me, although she is learning. She oversees/supports the management of the diabetic patients at the practice, but unless the Type 1/LADA patients are competent to manage their diabetes themselves, she should not be advising them or changing prescriptions except in an emergency.

I can understand them not prescribing reusable pens until things are a bit more settled as different makes of insulin need different pens, so the NovoPens will not be suitable with Lantus, but would be suitable with Levemir and Tresiba basal insulins as well as NovoRapid and Fiasp fast acting insulins. The NovoPens are about £40 each so if Levemir didn't suit you and neither did Tresiba then that would be wasted and maybe she has a limit/price cap on what she can prescribe or is simply not familiar with which pens are suitable for which insulins.
I think it is the Lantus SoloStar for Lantus or the SoloStar Junior for the half units but I may be mistaken as I have never used Lantus. I Love Love Love my Levemir though and the NovoPen Echoes are fab!!
 
rebrascora said:
Good to hear you have a lovely practice nurse, although she is likely a qualified nurse who has been given in house training by a DSN from the clinic. They are known as DN here on the forum or nurses with a special interest in diabetes, as oppose to the fully qualified DSNs (Diabetes Specialist Nurses) at the clinic who have studied to degree level specifically in diabetes management. I know it can be a bit confusing.
I have a very good DN at my practice and she is lovely too, but she doesn't really know enough about Type 1 to advise me, although she is learning. She oversees/supports the management of the diabetic patients at the practice, but unless the Type 1/LADA patients are competent to manage their diabetes themselves, she should not be advising them or changing prescriptions except in an emergency.

I can understand them not prescribing reusable pens until things are a bit more settled as different makes of insulin need different pens, so the NovoPens will not be suitable with Lantus, but would be suitable with Levemir and Tresiba basal insulins as well as NovoRapid and Fiasp fast acting insulins. The NovoPens are about £40 each so if Levemir didn't suit you and neither did Tresiba then that would be wasted and maybe she has a limit/price cap on what she can prescribe or is simply not familiar with which pens are suitable for which insulins.
I think it is the Lantus SoloStar for Lantus or the SoloStar Junior for the half units but I may be mistaken as I have never used Lantus. I Love Love Love my Levemir though and the NovoPen Echoes are fab!!
Click to expand...
Yes , I’ve got the Lantus, solo star , I wouldn’t have thought she would’ve been able to change the prescription herself. I think it was probably sent to the GP for approval because of the shortish of Levemir. But she’s referred me onto a proper specialist in East surrey Hospital so if they want to change it if it’s not working then we can cross that bridge when we get to it is very interesting, I’m just glad I’ve got the chance to manage it, which sadly my dad never did because he was in denial, and he was here one week and gone the next due to a massive heart attack my grandfather, drove steam engines and wasn’t allowed to inject insulin on the foot plate and from what I’m told he had a hypo and fell off. Subsequently he had to stop driving and sadly had both legs amputated due to neuropathy and gangrene. I’m obviously in a much better position now with all this technology for which I’m very thankful, it’s early days for me so I’m sure the consultant is at East Surrey will advise me accordingly in the future
 
I used Lantus for about 12 years and it is still my backup basal in case my pump fails. It was fine for me and was the standard basal insulin for decades for good reason.
There are a few minor issues
- many find it does not last a full 24 hours. For me, I think it lasted about 21 hours but as that was the days before CGM, it is only an estimate. I overcame this by injecting basal with my evening meal and covering the gap with extra basal. Dosing first thing in the morning would mean the gap would be whilst asleep and coincide with Dawn Phenomenon. Some people split the dose..
- the profile of Lantus is not as flat as newer slow acting insulins. There is a slight peak in the activity after about 5 hours. As a result, some people find their BG drops at this point so it is good to take the Lantus at least 5 hours before going to sleep.
- there is a very very small risk of Lantus pooling and causing an instant hypo. This never ever happened to me.

I have no experience of Levemir or Tresiba. @rebrascora loves her Levemir and @Proud to be erratic loves his Tresiba.
Levemir is shorter acting so most people need to take it twice a day. The benefit of this is that you can adjust if your basal need is different during the day and night.
Tresiba is much longer acting. The benefit of this is that it is much more robust if you forget to take it. The downside is that a change of dose can take 3 or 4 days to notice the effect.
 
Very sad to hear about your Dad and Grandad but times have changes enormously and managing diabetes has been made much easier thanks to modern insulins and technology and also education and patients being encouraged to engaging with their diabetes management at an individual level rather than relying on a nurse or consultant to set doses at your annual or biannual appointment and blindly follow that dosing.
You clearly have the mentality and motivation to engage and self manage and I am pretty certain you will not suffer the same health issues as your near ancestors as a result. In fact I think there is every possibility that we may actually end up healthier than our peers who don't have diabetes because we have lots of regular tests to keep an eye on various aspects of our health, we are probably much more conscious of what we eat and drink because we have to inject for it and we know that keeping active is more important for our diabetes management. I fully expect to live at least 10 years longer than I would have done if I hadn't been diagnosed and I want my money back if I don't!! 😉
 
helli said:
I have also wondered whether single use pens are initially prescribed in case the insulin does not suit the patient. I can imagine an accountant worrying about the cost of reusable pens when they are only used for a short time. I realise the budgeting is wrong if the patient sticks with the insulin but can imagine the message to the nurses is “simplified”.
Pure speculation of course.
Click to expand...

I think clinics get them free - or did when I last got a new one. I don’t remember the disposable pens being around at all when pens first came in (I started with syringes). I assumed they were developed for Type 2s on insulin.

In my experience, the knowledge about reuseable pens is minimal in surgeries. I doubt the cost enters their mind. If it did, they’d initially prescribe syringes which are pence.
 
Wendums60 said:
Feeling really rough as this morning achy, headaches sicky , is this just my body adjusting to the insulin?
Click to expand...

I took Lantus for years and never had the symptoms you are describing @Wendums60

Though I notice they are listed on this page here:

www.drugs.com

Lantus Side Effects: Common, Severe, Long Term

Learn about the side effects of Lantus (insulin glargine), from common to rare, for consumers and healthcare professionals.
www.drugs.com www.drugs.com

More common​

  • Blindness
  • blurred vision
  • cough or hoarseness
  • decreased vision
  • diarrhea
  • dizziness
  • fever or chills
  • general feeling of discomfort or illness
  • headache
  • joint pain
  • lower back or side pain
  • loss of appetite
  • muscle aches and pains
  • nausea
  • nervousness
  • painful or difficult urination
  • pounding in the ears
  • runny nose
  • shivering
  • slow or fast heartbeat
  • sore throat
  • sweating
  • swelling of the hands, ankles, feet, or lower legs
  • trouble sleeping
  • unusual tiredness or weakness
  • vomiting
[my emphasis]

Which suggests you should go back to whoever prescribed it to you in case you are having an adverse reaction to the Lantus, or any of its ingredients.

If Lantus isn’t suiting you, there are many other options you can try, and as others have said, don’t be put off by disposable pen shortages - there are other ways you can get your doses 🙂
 
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