Type 1 and another autoimmune condattioms

[Benny G]

There are always options, although getting your consultant or specialist nurse on board is another matter.

GM Vs Animal Insulin - IDDT

Choices – The Evidence Evidence from people with diabetes A little bit of history Facts Action and duration times of animal and GM ‘human’ insulins Hypoglycaemia and loss of warnings...

www.iddt.org

 

[Bruce Stephens]

However, if you ask to go on to an older type of insulin, HCPs will insist newer is better and you’ll have a fight on your hands. That’s what I meant. It’s ignorance. Different insulins suit different people. Just because something is new doesn’t automatically mean it’s better.

True, and I'm sure some people don't get on with the insulin analogues. But they do have genuine advantages (for the majority of us who can tolerate them): just look at the lovely (mostly) flat graph for Levemir and the shorter activity period of NovoRapid (compared to Insulatard and Actrapid or similar). https://www.diabetes.org.uk/resourc...20of%20Leicester%20-%20Insulin%20Profiles.pdf

 

[rayray119]

Novorapid and Levemir are both insulin analogues. They might not be super-new now but they’re still in the newer group and still have the potential to cause issues for a small number of people.

However, if you ask to go on to an older type of insulin, HCPs will insist newer is better and you’ll have a fight on your hands. That’s what I meant. It’s ignorance. Different insulins suit different people. Just because something is new doesn’t automatically mean it’s better.

Can I am ask what insulin you switched to and form

 

[Inka]

True, and I'm sure some people don't get on with the insulin analogues. But they do have genuine advantages (for the majority of us who can tolerate them): just look at the lovely (mostly) flat graph for Levemir and the shorter activity period of NovoRapid (compared to Insulatard and Actrapid or similar). https://www.diabetes.org.uk/resources-s3/2017-10/University%20Hospitals%20of%20Leicester%20-%20Insulin%20Profiles.pdf

A flat graph basal wouldn’t suit me as my basal needs vary a lot over the day. When I take a pump break, I use an isophane insulin. Not flat but works best for me. As for the NR compared with Actrapid, to me it’s swings and roundabouts, so to speak. The longer-acting fast insulins can be useful. As quoted above, the newer insulins haven’t brought any improvements in HbA1C, and all the spiel about ‘inject right before you eat - amazing!’ has turned out to be totally inaccurate anyway. That was the big selling point of the very fast-acting analogues and yet it’s simply not true. As the insulin patents expire, there’s always a new and ‘totally amazing’ insulin - Fiasp being one example - that turn out to be not all they’re hyped up to be. Perhaps I’m a cynic, but I see the motivation as largely money.

 

[Bruce Stephens]

As quoted above, the newer insulins haven’t brought any improvements in HbA1C, and all the spiel about ‘inject right before you eat - amazing!’ has turned out to be totally inaccurate anyway.

True, but I still like that NR has a short enough activity that it's more or less gone before the next meal (depending, obviously). I'm sure I could get used to Actrapid again, but NR feels a bit simpler.

 

[Inka]

True, but I still like that NR has a short enough activity that it's more or less gone before the next meal (depending, obviously). I'm sure I could get used to Actrapid again, but NR feels a bit simpler.

Which is great, if it works for you. I believe we should maintain a wide choice of different types of insulin so we can choose what suits us as individuals. I’d also like more recognition of the fact that some insulin families can occasionally cause issues.

 

[Inka]

Can I am ask what insulin you switched to and form

I changed from analogue insulin to animal insulin.

 

[Bruce Stephens]

Which is great, if it works for you. I believe we should maintain a wide choice of different types of insulin so we can choose what suits us as individuals. I’d also like more recognition of the fact that some insulin families can occasionally cause issues.

Sure, I'm not really disagreeing. More saying that I don't think it's crazy for DSNs to prefer to encourage the newer insulins. (When they don't work so well, it's important for the others to still be available.)

 

[rayray119]

it doesnt seem like short acting insullin rather then "rapid"(i sure everyone will get way i put in actully acting insullin would actullty sort my needs(episailly with work when i go back to work when i fainlly sorted this out) always seem be brought on by taken insullin its seems to be trigeered at other times for eaxmaple earlier jelly babbies because i was ate 4.4 and thats seems to have or it could be the ice cofffe i was drinking.( so i may well be IBS and just not all that willing to accept a diffanate diginougous of someone who's never even seen of spoken to me and and has gone off paper

 

[rayray119]

If it was innsullin intolerance wouldn't it have been more likely for it to have happened straight after diagnosis and that 6 months afterwards

 

[Inka]

If it was innsullin intolerance wouldn't it have been more likely for it to have happened straight after diagnosis and that 6 months afterwards

Mine came on a while after I started using an analogue insulin. I think it depends on the individual. My consultant thought my intolerance developed gradually.

 

[rayray119]

I wonder if it's possible to be intorllsnt to one type of that insulin and not the others because I've father not go; on aminal insulin unless I absolutely had to I feel like I would lose so much flexibility obervoulsy if that was problem and it was the only way slpve it I would have to put up with it.

 

[rayray119]

Mine came on a while after I started using an analogue insulin. I think it depends on the individual. My consultant thought my intolerance developed gradually.

I was started on those straight away though started on novorapid and trisiba then switched to livimer in Novermber for more flexibility

 

[Inka]

I wonder if it's possible to be intorllsnt to one type of that insulin and not the others because I've father not go; on aminal insulin unless I absolutely had to I feel like I would lose so much flexibility obervoulsy if that was problem and it was the only way slpve it I would have to put up with it.

What flexibility do you think you’d lose? The main difference is bolusing more in advance but apart from that, it’s fine, and Novorapid needs pre-bolusing anyway. 🙂 The human insulins were modelled on the animal insulins. The original human insulins were a kind of modified porcine insulin.

 

[rayray119]

What flexibility do you think you’d lose? The main difference is bolusing more in advance but apart from that, it’s fine, and Novorapid needs pre-bolusing anyway. 🙂 The human insulins were modelled on the animal insulins. The original human insulins were a kind of modified porcine insulin.

Yes that's something I struggle with qllrwady at times. Like I waiting 30 minutes would sometes not be at all possible

 

[Inka]

Yes that's something I struggle with qllrwady at times. Like I waiting 30 minutes would sometes not be at all possible

As with your Novorapid, you do the best you can in the situation with advance bolusing. Also, I can bolus 20 mins in advance eg for my evening meal, and my blood sugar is fine. There’s nothing wrong with animal or regular human insulins. In fact, human insulins (that is, not analogues) are often prescribed for Type 2s.

An advantage is your hypo signs will often improve. I noticed that even though I have good hypo awareness.

 

[rayray119]

So it's looking like I've for appointment with an actual consultant on the 16th of August in a different city hopefully this one won't decide they don't need to see me.

 

[rayray119]

and finely i have more investigations arranged, I have dates for an endoscopy and colonoscopy not the most comfortable things to have done but I'm pleased things being looked into. i might be getting closer to finely knowing whats going out or at least completely rule things out. looks like i should have asked to be refereed to this hospital a while ago they actually seem to be on it.

 

[rayray119]

Im coming back to this because I know have less confidence in the healthcare system where live and the reference rangw started.in there. teat results don't match the nice guidelines. Nice guidelines sat it supposed to be above 400 which mine still is but i feel like the reference range is wrong comparing it to nice guidelines.

 

[everydayupsanddowns]

I’ve had a quick look back through my results as I know I was checked for Addisons at some point, but sadly the NHS app list of results isn’t searchable, and I can’t find the reference range that was used.

A local trust lists >350nmol/L 8-10am as excluding insufficiency.

The lab in Exeter suggests >320.

Cortisol Exeter Clinical Laboratory International

www.exeterlaboratory.com

Not sure if @Pumper_Sue has anything to add as she has experience with Addisons