My stock of Lente has run out!

Hi everyone. I'm a t1 (46 years) who has been injecting my whole life (with
a little help from my mom until I was old enough to do it myself). I have
over the years refined my insulin intake to a very high degree, to where my
A1cs are consistently 6.0-6.4, and have been for the past 25 years. I took
NPH from the time I was born until about 16 or 17, at which point my endo
started experimenting on me until we settled on Lente + R + (eventually)
Humalog. I've been doing very well on that combination, and when I first
heard L was being discontinued I stocked up on as much as I could and kept
it in very cold storage. The end is very near for the last of my L, however.

My current doc said that if I wanted to try and stay as close to the
activity curves as possible to what I'm used to I should go back to NPH
(yuk). I had some very bad experiences on NPH that I'm sure many of you have
had yourselves. The thing is, strictly from a curve POV he's right, as long
as you don't take the reality of N's varying behavior into account. I may
explore trying to get a non-U.S. source for Beef Lente, but right now I'm
willing to try alternatives using readily available formularies here in the
states.

I could go to a more basal type, but in reading about Lispro, Lantus, and
Levemir the only one I'd be willing to try is Levemir. I mix my morning
long-acting with Humalog, and based on what I've read Lantus does not play
well with others. I'm not sure a true basal type would work for me, though,
without having to add yet another shot. I already take three (L+H morning, R
before dinner, L evening - I know, it doesn't follow the standard
suggestions but I can't argue with the results). If I go with Levemir at a
bit below the .4u/kg rate (according to
http://www.levemir-us.com/prescribing_information.pdf ) it seems as though
it would be very close to NPH (and then hopefully Lente) but again hopefully
with N's nasty unpredictability and side effects. Does anyone have a profile
close to mine that can shed any light on whether this might be a reasonable
method?

-Tony

"Tony" <none@none.com> wrote in message
news:OPqdnaXpN4Az9IjbnZ2dnUVZ_riknZ2d@comcast.com. ..
> Hi everyone. I'm a t1 (46 years) who has been injecting my whole life
> (with a little help from my mom until I was old enough to do it myself). I
> have over the years refined my insulin intake to a very high degree, to
> where my A1cs are consistently 6.0-6.4, and have been for the past 25
> years. I took NPH from the time I was born until about 16 or 17, at which
> point my endo started experimenting on me until we settled on Lente + R +
> (eventually) Humalog. I've been doing very well on that combination, and
> when I first heard L was being discontinued I stocked up on as much as I
> could and kept it in very cold storage. The end is very near for the last
> of my L, however.
>
> My current doc said that if I wanted to try and stay as close to the
> activity curves as possible to what I'm used to I should go back to NPH
> (yuk). I had some very bad experiences on NPH that I'm sure many of you
> have had yourselves. The thing is, strictly from a curve POV he's right,
> as long as you don't take the reality of N's varying behavior into
> account. I may explore trying to get a non-U.S. source for Beef Lente, but
> right now I'm willing to try alternatives using readily available
> formularies here in the states.
>
> I could go to a more basal type, but in reading about Lispro, Lantus, and
> Levemir the only one I'd be willing to try is Levemir. I mix my morning
> long-acting with Humalog, and based on what I've read Lantus does not play
> well with others. I'm not sure a true basal type would work for me,
> though, without having to add yet another shot. I already take three (L+H
> morning, R before dinner, L evening - I know, it doesn't follow the
> standard suggestions but I can't argue with the results). If I go with
> Levemir at a bit below the .4u/kg rate (according to
> http://www.levemir-us.com/prescribing_information.pdf ) it seems as though
> it would be very close to NPH (and then hopefully Lente) but again
> hopefully with N's nasty unpredictability and side effects. Does anyone
> have a profile close to mine that can shed any light on whether this might
> be a reasonable method?
>
> -Tony
>

One more thing. The instruction on Levemir and my endo say it cannot be
mixed with other insulins, but when I searched the newsgroups I've seen
posts from oldal and other that seems to suggest otherwise. For those who
have done it successfully, does it have an adverse effect similar to when
mixing N and R?

On Thu, 5 Apr 2007 17:27:25 -0500, "Tony" <none@none.com> wrote:

><snipped for brevity>

> Does anyone have a profile
>close to mine that can shed any light on whether this might be a reasonable
>method?
>
I've been on Lente, NPH, Regular, and various combinations and timings
thereof over the years, and, like you, I was very conservative when it
came to changing. But I think you should keep an open mind about the
current insulin therapies. I'm now taking Lantus as a basal and
Humalog for boluses, and I'm doing better on this than on my previous
regimens.

One thing to point out is that with Lantus/Humalog, you don't have to
worry so much about "action curves." That is, you're no longer
"feeding the insulin," but are taking insulin to cover what (and when)
you eat. The whole paradigm is reversed.

Yes, you would have to take up to four shots a day (one more than what
you're currently taking). On the other hand, you would no longer have
to worry about mixing insulins. Bottom line is that your life is
greatly simplified.

[Default] On Thu, 5 Apr 2007 18:31:01 -0500, "Tony" <none@none.com>
Giggled into the madness of usenet:

>
>
>One more thing. The instruction on Levemir and my endo say it cannot be
>mixed with other insulins, but when I searched the newsgroups I've seen
>posts from oldal and other that seems to suggest otherwise. For those who
>have done it successfully, does it have an adverse effect similar to when
>mixing N and R?
>

what adverse effect do you get by mixing N and R?


--
Mâck©® Deltec CoZmore Pumper
Type 1 since 1975
http://www.alt-support-diabetes.org
http://www.diabetic-talk.org
http://www.insulin-pumpers.org
http://www.pandora.com enter "Jason & Demarco"



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(o ô)
--ooO-(_)-Ooo--------------------

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and I like less than half of you
half as well as you deserve."
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DISCLAIMER If you find a posting or message from me
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..

"Tony" <none@none.com> wrote in message
news:_I6dnZHHbp8L5YjbnZ2dnUVZ_v6tnZ2d@comcast.com. ..
>
> One more thing. The instruction on Levemir and my endo say it cannot be
> mixed with other insulins, but when I searched the newsgroups I've seen
> posts from oldal and other that seems to suggest otherwise. For those who
> have done it successfully, does it have an adverse effect similar to when
> mixing N and R?

I'm not too sure I completely understand your last question. Do you mean,
mixing Levemir with N or R? If so, then *NO* you cannot mix anything with
Levemir, it's to be taken by itself, in it's own syringe and the syringe
shouldn't
be used with any other insulin.

As for your other question. Yes, I have a simular profile, from what I've
seen
what you've said. Lantus didn't play well with me either. Max I got from it
was
19hrs and had to suppliment with NPH for the rest of the night/morning time.
I also have weird readings with Humalog (basically I developed Insulin
antibodies)
and switched to Novolog and they went away and I'm actually super sensitive to
Novolog. Average drop with 1u is 50mg with Novolog and I get 65-75mg drops
within a hours time. The other day I was at 159 (my fasting) took .7u and I
dropped to 76mg within 50mins. I had eaten yet either. Then some days I
can't
get a 1mg drop with no matter how much I take. Makes control really fun.
*not!*
Anyhow, with my control issues, I finally said screw it and opted to pumping
which
has helped me quite a bit.

If you're having high readings after you eat, you might want to try Symlin.

HTH. Levemir is a good basal, I've used it as well when I've been on my short
pump
vacations and it works much better for me then Lantus did and seems to last me
the
full 24hrs.


--
Reisa, T1
dx-5/00 asd-7/00
Animas IR1250 pumper
TDD: 36-38u
Last A1C: too damn high!

Tony wrote:

> My stock of Lente has run out!
>
> Hi everyone. I'm a t1 (46 years)


i'm 6 months short of 50 years


> a little help from my mom until I was old enough to do it myself). I have
> over the years refined my insulin intake to a very high degree, to where my
> A1cs are consistently 6.0-6.4, and have been for the past 25 years. I took
> NPH from the time I was born until about 16 or 17,


almost certainly Lilly's beef/pork NPH (mostly beef)

right?


> at which point my endo
> started experimenting on me until we settled on Lente + R + (eventually)
> Humalog. I've been doing very well on that combination, and when I first
> heard L was being discontinued I stocked up on as much as I could and kept
> it in very cold storage. The end is very near for the last of my L, however.


that's human lente, right?

what is the expire date on it?

fwiw, the last of my Lilly pork lente
(purchased mail order from Canada (pork/porc)
@ $18/vial) has an expire date of Oct. 1, 2003

i still have quite a lot of it and it still
works great.

the traditional insulins (beef/pork/human)
all have incredible time length with only
5% potency loss (see p.s.). this is still
unknown for the new analog insulins


> My current doc said that if I wanted to try and stay as close to the
> activity curves as possible to what I'm used to I should go back to NPH
> (yuk). I had some very bad experiences on NPH that I'm sure many of you have
> had yourselves. The thing is, strictly from a curve POV he's right, as long
> as you don't take the reality of N's varying behavior into account. I may
> explore trying to get a non-U.S. source for Beef Lente, but right now I'm
> willing to try alternatives using readily available formularies here in the
> states.


i've used pork NPH, which afaik is very close
to human NPH in it's profile, for 10 years and
agree with your "yuk"

it was what got me to using an insulin pump
for 8 years (with 100% synthetic insulin)

now that i understand my basal needs (from
8 years of insulin pump usage), i could do it
with pork NPH, but it'd take 2x and still
wouldn't be as easy as either beef or pork
lente (used 1x)

in my own experience, there's a fair chance
you'd be safer all around to move to CP's
current beef lente, but you'll have to buy
it from the UK. it's likely still a better
(and long term safer) 1x background insulin
than any of the analog background insulins

also, beef-lente used 1x is better than pork-lente
(for background) and far better than human-lente,
at least in my experience/knowledge

bill t1 since '57, ex 8-yr pumper, beef-L 1x, simple MDI

p.s.

this is from a post that i did on misc.health.diabetes
in june'04:

<synthetic "human" insulin lasts close to
100 years with good refridgeration and
5% potency loss (same is true for pork and beef):

Jens Brange's '87 "Galenics of Insulin" has Table 16/p.59
time of storage of insulin preparations at various temperatures
until biological potency is reduced by 2% and 5% respectively

i believe that these are all (?) "human" insulins as beef and pork
appear (to me) to be either named directly or ref'd as "monocomponent"
(if i'm wrong about this, chances are someone will say so. )
another question is what brands were used for the SL and L and UL?
afaik, Actrapid and Rapitard are Novo. one other point worth
mentioning is that prior to '87 Novo's "human" insulin was
semi-synthetic and not rDNA

Insulin-prep 4° C 15° C 25° C 40° C
Actrapid 36 / 92 yrs 5 / 13 yrs 12 / 31 months 5 / 14 weeks
Semilente 45 / 115 yrs 4 / 11 yrs 7 / 18 months 2 / 5 weeks
Lente 36 / 91 yrs 3 / 9 yrs 5 / 14 months 1 / 4 weeks
Rapitard 22 / 55 yrs 3 / 8 yrs 7 / 17 months 3 / 7 weeks
Ultralente 19 / 48 yrs 2 / 5 yrs 4 / 10 months 1 / 3 weeks

although UL (UltraLente) looks "weakest" here, another
chart in the book shows a similar table specific to
"breakdown "toxins"," and in that table the protamine
containing insulins (NPH and PZI) look "bad" (relatively
speaking ) compared to the other insulins
(i think "Rapitard" (above) is a.k.a. NPH)

worth noting is that at 40C (slightly above body temperature),
Actrapid (aka "human"-Regular), lasts for 14 weeks with only
5% potency loss (zowie!)

finally, toxin build-up (due to age/temperature) have only been
a very minor issue with insulin over the 80+ years of insulin
(at least with regard to beef and pork and "human" insulins)

finally, it is likely that acidic insulins have a very
short shelf life, especially Lantus

rk wrote:

> HTH. Levemir is a good basal, I've used it as well when I've
> been on my short pump vacations and it works much better for
> me then Lantus did and seems to last me the full 24hrs.


afaik, occasional use of an insulin (like
maybe once a year) is likely to lead to
an insulin allergy

trust me, you don't need that

better to pump buffered beef-R and do
your vacations with beef-Lente.

bill t1 since '57, ex 8-yr pumper, beef-L 1x, simple MDI

Tony wrote:

> "Tony" <none@none.com> wrote in message
> news:OPqdnaXpN4Az9IjbnZ2dnUVZ_riknZ2d@comcast.com. ..
>
>>Hi everyone. I'm a t1 (46 years) who has been injecting my whole life
>>(with a little help from my mom until I was old enough to do it myself). I
>>have over the years refined my insulin intake to a very high degree, to
>>where my A1cs are consistently 6.0-6.4, and have been for the past 25
>>years. I took NPH from the time I was born until about 16 or 17, at which
>>point my endo started experimenting on me until we settled on Lente + R +
>>(eventually) Humalog. I've been doing very well on that combination, and
>>when I first heard L was being discontinued I stocked up on as much as I
>>could and kept it in very cold storage. The end is very near for the last
>>of my L, however.
>>
>>My current doc said that if I wanted to try and stay as close to the
>>activity curves as possible to what I'm used to I should go back to NPH
>>(yuk). I had some very bad experiences on NPH that I'm sure many of you
>>have had yourselves. The thing is, strictly from a curve POV he's right,
>>as long as you don't take the reality of N's varying behavior into
>>account. I may explore trying to get a non-U.S. source for Beef Lente, but
>>right now I'm willing to try alternatives using readily available
>>formularies here in the states.
>>
>>I could go to a more basal type, but in reading about Lispro, Lantus, and
>>Levemir the only one I'd be willing to try is Levemir. I mix my morning
>>long-acting with Humalog, and based on what I've read Lantus does not play
>>well with others. I'm not sure a true basal type would work for me,
>>though, without having to add yet another shot. I already take three (L+H
>>morning, R before dinner, L evening - I know, it doesn't follow the
>>standard suggestions but I can't argue with the results). If I go with
>>Levemir at a bit below the .4u/kg rate (according to
>>http://www.levemir-us.com/prescribing_information.pdf ) it seems as though
>>it would be very close to NPH (and then hopefully Lente) but again
>>hopefully with N's nasty unpredictability and side effects. Does anyone
>>have a profile close to mine that can shed any light on whether this might
>>be a reasonable method?
>>
>> -Tony
>>
>
>
> One more thing. The instruction on Levemir and my endo say it cannot be
> mixed with other insulins, but when I searched the newsgroups I've seen
> posts from oldal and other that seems to suggest otherwise. For those who
> have done it successfully, does it have an adverse effect similar to when
> mixing N and R?
>
>

Mixing insulins is never a good idea, IMO. When I used a basal insulin
(I use Novolog for basal in a pump at the moment) I always operated
under the assumption that the basal was to be injected at a site where
the absorption would be the slowest (bum) and the bolus went into sites
where absorption was fastest (belly, arms).

Using a pen for bolus insulin makes this much easier, not no mention it
makes eating out or shooting at the table a breeze.

Separating basal and bolus is closer to the normal body's reaction,
makes for far fewer dosing errors, and greatly reduces the amount of
"insulin feeding" you have to do. Helps control bgs and weight better.

Because of it's high acidity and mitogenic potential, I have decided not
to use Lantus. That leaves Levemir should I decide not to use my pump
once my stash of UL is exhausted.
Using 5-year-old UL doesn't make me uncomfortable but using Lantus does.
Am I wierd? :-)

Vicki

"Alexander Arnakis" <invalid@address.none> wrote in message
news:68ta13hgq98bqh85m7l863vlabfou7dmjn@4ax.com...
> On Thu, 5 Apr 2007 17:27:25 -0500, "Tony" <none@none.com> wrote:
>
>><snipped for brevity>
>
>> Does anyone have a profile
>>close to mine that can shed any light on whether this might be a
>>reasonable
>>method?
>>
> I've been on Lente, NPH, Regular, and various combinations and timings
> thereof over the years, and, like you, I was very conservative when it
> came to changing. But I think you should keep an open mind about the
> current insulin therapies. I'm now taking Lantus as a basal and
> Humalog for boluses, and I'm doing better on this than on my previous
> regimens.
>
> One thing to point out is that with Lantus/Humalog, you don't have to
> worry so much about "action curves." That is, you're no longer
> "feeding the insulin," but are taking insulin to cover what (and when)
> you eat. The whole paradigm is reversed.
>
> Yes, you would have to take up to four shots a day (one more than what
> you're currently taking). On the other hand, you would no longer have
> to worry about mixing insulins. Bottom line is that your life is
> greatly simplified.
>

Yeah, I've considered this for some time, Alex. I suspect you appreciate how
hard it is to break a pattern, in my case one that has kept me quite
complication-free my whole life (so far). It's the "if it ain't broke don't
fix it" approach. Even my doc is impressed enough with my status to only
talk about a pump as an option, and not as something that is of great need.
I'm not sure I'm ready for changing my shot frequency. I may use a trial
period of a couple of weeks with either NPH or Levemir (or a longer period
to try them one after the other) to see if I can get results that will keep
me in my current method. If not, I may have to move to an additional
injection.

"Ma¢k" <stopthespam@shootspammers.com> wrote in message
news:1s8b131br00gifgugn6f3k6pjmqn1199ed@4ax.com...
> [Default] On Thu, 5 Apr 2007 18:31:01 -0500, "Tony" <none@none.com>
> Giggled into the madness of usenet:
>
>>
>>
>>One more thing. The instruction on Levemir and my endo say it cannot be
>>mixed with other insulins, but when I searched the newsgroups I've seen
>>posts from oldal and other that seems to suggest otherwise. For those who
>>have done it successfully, does it have an adverse effect similar to when
>>mixing N and R?
>>
>
> what adverse effect do you get by mixing N and R?

My apologies (that was dangerous). I meant N and H.

"rk" <p_haha_medium@gmail.com> wrote in message
news:T8-dnU3M-uYMKYjbnZ2dnUVZ_sSmnZ2d@wideopenwest.com...
> "Tony" <none@none.com> wrote in message
> news:_I6dnZHHbp8L5YjbnZ2dnUVZ_v6tnZ2d@comcast.com. ..
>>
>> One more thing. The instruction on Levemir and my endo say it cannot be
>> mixed with other insulins, but when I searched the newsgroups I've seen
>> posts from oldal and other that seems to suggest otherwise. For those who
>> have done it successfully, does it have an adverse effect similar to when
>> mixing N and R?
>
> I'm not too sure I completely understand your last question. Do you mean,
> mixing Levemir with N or R? If so, then *NO* you cannot mix anything with
> Levemir, it's to be taken by itself, in it's own syringe and the syringe
> shouldn't
> be used with any other insulin.
>

Right. The instructions make this quite clear. But I'm not sure then how to
interpret postings from those who say it's possible.

http://groups.google.com/group/misc....4de415a28d35ac

http://groups.google.com/group/misc....b4ec23c500acdb

I wish oldal would jump in and provide some insight into this. BTW, in my
case I would be mixing Levemir with Humalog, and only just before injection.

Interestingly, the NPH instructions indicate clearly that it can be mixed
only with R, yet my endo had no problem with me mixing it with H, barring a
small adjustment to the amount of NPH versus the amount of L that I have
been taking.

> As for your other question. Yes, I have a simular profile, from what I've
> seen
> what you've said. Lantus didn't play well with me either. Max I got from
> it was
> 19hrs and had to suppliment with NPH for the rest of the night/morning
> time.
> I also have weird readings with Humalog (basically I developed Insulin
> antibodies)
> and switched to Novolog and they went away and I'm actually super
> sensitive to
> Novolog. Average drop with 1u is 50mg with Novolog and I get 65-75mg
> drops
> within a hours time. The other day I was at 159 (my fasting) took .7u
> and I
> dropped to 76mg within 50mins. I had eaten yet either. Then some days I
> can't
> get a 1mg drop with no matter how much I take. Makes control really fun.
> *not!*
> Anyhow, with my control issues, I finally said screw it and opted to
> pumping which
> has helped me quite a bit.
>

Reisa, see my other response to Alex. I've been doing too well to want to
change that much. My last A1c was 6.2, and the one before that was 5.9. I'm
not consistently below 6.0 like some, but over the course of my lifetime
I've been able to work out a system that allows me some freedom in what I
eat and how I live without having to consider trying something new. No
neuropathy, no retinopathy (thank God). All I want to do is try to keep this
in balance.

"percy" <vbeausoleil@nowhere.bum> wrote in message
news:4615e01e$1_3@x-privat.org...
> Mixing insulins is never a good idea, IMO. When I used a basal insulin (I
> use Novolog for basal in a pump at the moment) I always operated under the
> assumption that the basal was to be injected at a site where the
> absorption would be the slowest (bum) and the bolus went into sites where
> absorption was fastest (belly, arms).
>

Vicki, it's funny how there are many ways to skin this problem, but none of
them actually involves a cure! ):-( While you are textbook correct in how
you do things, I've been mixing (when I say that I mean always just before
injection) for going on 26 years and have had excellent results. The body is
an odd thing.

> Using a pen for bolus insulin makes this much easier, not no mention it
> makes eating out or shooting at the table a breeze.
>
> Separating basal and bolus is closer to the normal body's reaction, makes
> for far fewer dosing errors, and greatly reduces the amount of "insulin
> feeding" you have to do. Helps control bgs and weight better.
>
> Because of it's high acidity and mitogenic potential, I have decided not
> to use Lantus. That leaves Levemir should I decide not to use my pump once
> my stash of UL is exhausted.
> Using 5-year-old UL doesn't make me uncomfortable but using Lantus does.
> Am I wierd? :-)
>
> Vicki

I don't think so. My last bottle of Lente is 4 years old. I've kept it (and
all of them) as close to 39F as possible. According to the data that should
make it usable for at least another few years! :-)

"willbill" <trek@worldwide.net> wrote in message
news:ev4dl101e8i@enews1.newsguy.com...
> Tony wrote:
>
>> My stock of Lente has run out!
>> Hi everyone. I'm a t1 (46 years)
>
>
> i'm 6 months short of 50 years
>

Another old timer. At what age were you dx'd?

>
>> a little help from my mom until I was old enough to do it myself). I have
>> over the years refined my insulin intake to a very high degree, to where
>> my A1cs are consistently 6.0-6.4, and have been for the past 25 years. I
>> took NPH from the time I was born until about 16 or 17,
>
>
> almost certainly Lilly's beef/pork NPH (mostly beef)
>
> right?
>

Bingo.

>
>> at which point my endo started experimenting on me until we settled on
>> Lente + R + (eventually) Humalog. I've been doing very well on that
>> combination, and when I first heard L was being discontinued I stocked up
>> on as much as I could and kept it in very cold storage. The end is very
>> near for the last of my L, however.
>
>
> that's human lente, right?
>

One more for the man!

> what is the expire date on it?
>
> fwiw, the last of my Lilly pork lente
> (purchased mail order from Canada (pork/porc)
> @ $18/vial) has an expire date of Oct. 1, 2003
>
> i still have quite a lot of it and it still
> works great.
>

Oh, my L "expired" a while ago (at least a year), but at 39F in storage it
seems to have had no ill effect.

> i've used pork NPH, which afaik is very close
> to human NPH in it's profile, for 10 years and
> agree with your "yuk"
>
> it was what got me to using an insulin pump
> for 8 years (with 100% synthetic insulin)
>
> now that i understand my basal needs (from
> 8 years of insulin pump usage), i could do it
> with pork NPH, but it'd take 2x and still
> wouldn't be as easy as either beef or pork
> lente (used 1x)
>
> in my own experience, there's a fair chance
> you'd be safer all around to move to CP's
> current beef lente, but you'll have to buy
> it from the UK. it's likely still a better
> (and long term safer) 1x background insulin
> than any of the analog background insulins
>
> also, beef-lente used 1x is better than pork-lente
> (for background) and far better than human-lente,
> at least in my experience/knowledge
>
> bill t1 since '57, ex 8-yr pumper, beef-L 1x, simple MDI

Bill, I hesitate with the route of getting CP-L from England for a couple of
reasons. First, will it be covered by my HMO? I suspect not, but I could
probably check. Next, would I be assured of a steady and regular supply?

I have been taking Lantus for better than a year with no problems. I
also take Novolog. Lantus is slow acting and the novolog is fast acting.
I take Lantus 2/day and the Novolog 3/day. No problems. I also take
Byetta. the BS is getting better, but the A1c is terrible.


Tony wrote:
> Hi everyone. I'm a t1 (46 years) who has been injecting my whole life (with
> a little help from my mom until I was old enough to do it myself). I have
> over the years refined my insulin intake to a very high degree, to where my
> A1cs are consistently 6.0-6.4, and have been for the past 25 years. I took
> NPH from the time I was born until about 16 or 17, at which point my endo
> started experimenting on me until we settled on Lente + R + (eventually)
> Humalog. I've been doing very well on that combination, and when I first
> heard L was being discontinued I stocked up on as much as I could and kept
> it in very cold storage. The end is very near for the last of my L, however.
>
> My current doc said that if I wanted to try and stay as close to the
> activity curves as possible to what I'm used to I should go back to NPH
> (yuk). I had some very bad experiences on NPH that I'm sure many of you have
> had yourselves. The thing is, strictly from a curve POV he's right, as long
> as you don't take the reality of N's varying behavior into account. I may
> explore trying to get a non-U.S. source for Beef Lente, but right now I'm
> willing to try alternatives using readily available formularies here in the
> states.
>
> I could go to a more basal type, but in reading about Lispro, Lantus, and
> Levemir the only one I'd be willing to try is Levemir. I mix my morning
> long-acting with Humalog, and based on what I've read Lantus does not play
> well with others. I'm not sure a true basal type would work for me, though,
> without having to add yet another shot. I already take three (L+H morning, R
> before dinner, L evening - I know, it doesn't follow the standard
> suggestions but I can't argue with the results). If I go with Levemir at a
> bit below the .4u/kg rate (according to
> http://www.levemir-us.com/prescribing_information.pdf ) it seems as though
> it would be very close to NPH (and then hopefully Lente) but again hopefully
> with N's nasty unpredictability and side effects. Does anyone have a profile
> close to mine that can shed any light on whether this might be a reasonable
> method?
>
> -Tony
>
>

Tony wrote:

> "willbill" <trek@worldwide.net> wrote
>>in my own experience, there's a fair chance
>>you'd be safer all around to move to CP's
>>current beef lente, but you'll have to buy
>>it from the UK. it's likely still a better
>>(and long term safer) 1x background insulin
>>than any of the analog background insulins
>>
>>also, beef-lente used 1x is better than pork-lente
>>(for background) and far better than human-lente,
>>at least in my experience/knowledge


> Bill, I hesitate with the route of getting CP-L from England for a couple of
> reasons. First, will it be covered by my HMO? I suspect not, but I could
> probably check. Next, would I be assured of a steady and regular supply?


you're thinking wrong, but see p.s.

as you said "don't fix it if it ain't broke"

out of honest curiosity, roughly what year did
you switch over to only using synthetic insulin?

for myself, i used 100% human-R (via pump) '91-'97,
and 100% Humalog (via pump) '97-'98

i was lucky that i have an allergy with Humalog.
my endo was so clueless that he had no idea that
my strange symptoms were due to his new wonderdrug

if it weren't for that, i might never have returned
to beef and pork, and i'd likely be dead now coz
my problems with human insulin were too subtle to
cause me to switch back to beef/pork

bill t1 since '57, ex 8-yr pumper, beef-L 1x, simple MDI

9 out of 10 vampires prefer diabetics

another p.s.

anyhow, assuming you do a basal/bolus routine
(i do; also known as MDI and/or DAFNE),
this is my current profile ("hr" = hour)
for my 2 R insulins (i carry the profile
with me 24/7 with my written daily log):

pork-R:
3 hr = 50% left
4 hr = 37%
5 hr = 25%
6 hr = 17%
7 hr = 10%
8 hr = 5%

beef-R:
4 hr = 45-to-50% left
5 hr = 38%
6 hr = 28%
7 hr = 23%
8 hr = 18%
9 hr = 14%
10 hr = 10%
11 hr = 6%

one of the really nice things about beef-R
is that you get it "for free" when you use beef-L
(without having to use another insulin molecule
type) and i can carry 3 30unit syringes in
my shirt pocket (preloaded to 20units) which
can get me thru more than 5 days at basal only
(with small amounts of dark chocolate and raw nuts
and a lot of water/tea/black coffee)

i call it 2x pseudo pumping (coz all you use
is R and no background; totally convenient
to not have to carry around any vials)

another thing that 99% of everybody thinks is
that synthetic insulin has no risk of mad cow.
nothing could be further from the truth coz
afaik every synthetic insulin uses beef product
in the production process

in another thread a couple of years ago another
person stated:
<"I know for a fact that upper management would
like nothing other than to discontinue
all human insulin as soon as possible.

^^^^^^^^^^^^^^^^^^^^^^^^^

i can believe this coz there's
no longer much profit in "human"-insulin

interesting that "human"-inslin was touted
25 years ago as being the best for humans

but somehow that got lost with profits,
not to mention poor results

the analogs are all new, and the big pharmas
(Lilly/Aventis/Novo) have patents on them, and
profits on them are MAJOR for the next 10+ years

the main open issue is whether the analog insulins
will be safe in the long run for human beings.
tune in again 15 years from now for the answer


also, see Human, Porcine and Bovine Ultralente Insulin, by D.R.
Owens, et al, Diabetic Medicine, July/Aug, 1986, p. 326-329

| time Pork-UL beef-UL "human"-UL
| 0 hrs
| 2 .01 inch .00 inch .15 inch
| 3 xx xx .30
| 4 .46 .00 .80
| 5 .55 .23 .98
| 6 .62 .25 .98
| 7 .68 xx 1.23
| 8 .68 .30 1.30
| 10 1.01 .42 1.54
| 12 1.17 .52 1.56
| 14 1.33 .55 1.72 (corresponds 0.05 nmol/L)
| 16 1.41 .55 1.66
| 18 1.23 .60 1.66
| 20 1.14 .57 1.41
| 22 .86 .49 1.11
| 24 .73 .50 .98
| 26 .65 .49 .92
| 28 .54 .47 .86
| 30 .48 .39 .80
| 32 .48 .39 .74
| 34 xx xx .68


the thing to keep in mind with Lente is that
it is 70% UL (Ultra Lente) and can be dosed
1x for it's action at 24 hours

Tony wrote:

> I wish oldal would jump in and provide some insight into this.


both oldal and guy have been quiet for some time

it wouldn't surprise me if they both kicked the bucket

whatever it was that got them, odds are that it got
written off to them having long term diabetes and
not to the real cause

(and no, this is NOT another slam by me on synthetic
insulin, only that death certificates seldom ID the
real cause of death; which in their case might just
be old age;

me... i should have another 15+ years,
if i don't do anything stupid)

bill t1 since '57

the difference between dumb and stupid
is that stupid has two syllables

[Default] On Fri, 06 Apr 2007 10:25:43 -0500, willbill
<trek@worldwide.net> Giggled into the madness of usenet:

>Tony wrote:
>
>> I wish oldal would jump in and provide some insight into this.
>
>
>both oldal and guy have been quiet for some time
>
>it wouldn't surprise me if they both kicked the bucket
>
>whatever it was that got them, odds are that it got
>written off to them having long term diabetes and
>not to the real cause
>
>(and no, this is NOT another slam by me on synthetic
> insulin, only that death certificates seldom ID the
> real cause of death; which in their case might just
> be old age;
>
> me... i should have another 15+ years,
> if i don't do anything stupid)
>
>bill t1 since '57
>
>the difference between dumb and stupid
>is that stupid has two syllables


Have a little more faith in something, anything, other than your
pessimism.

--
Mâck©® Deltec CoZmore Pumper
Type 1 since 1975
http://www.alt-support-diabetes.org
http://www.diabetic-talk.org
http://www.insulin-pumpers.org
http://www.pandora.com enter "Jason & Demarco"



"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."
....Theodore Roosevelt

(o ô)
--ooO-(_)-Ooo--------------------

"I don't know half of you
half as well as I should like;
and I like less than half of you
half as well as you deserve."
....Bilbo Baggins


DISCLAIMER If you find a posting or message from me
offensive, inappropriate, or disruptive, please ignore it.
If you don't know how to ignore a posting, complain to
me and I will be only too happy to demonstrate...
..

Ma¢k wrote:

> willbill

>>Tony wrote:
>>
>>
>>>I wish oldal would jump in and provide some insight into this.
>>
>>
>>both oldal and guy have been quiet for some time
>>
>>it wouldn't surprise me if they both kicked the bucket
>>
>>whatever it was that got them, odds are that it got
>>written off to them having long term diabetes and
>>not to the real cause
>>
>>(and no, this is NOT another slam by me on synthetic
>> insulin, only that death certificates seldom ID the
>> real cause of death; which in their case might just
>> be old age;
>>
>> me... i should have another 15+ years,
>> if i don't do anything stupid)
>>
>>bill t1 since '57
>>
>>the difference between dumb and stupid
>>is that stupid has two syllables
>
>
>
> Have a little more faith in something, anything, other than your
> pessimism.


at least i'm never unhappy; i admit i was
when i found out what goes on in the med biz
(pharmas and docs)

but i got over the worst of it

optimists are never happy

too bad for the t1s that make mistakes
with synthetic insulin coz imho a subset
of them die for it

i have faith in profits and human nature

bill t1 since '57, ex 8-yr pumper, beef-L 1x, simple MDI

Ma¢k wrote:

> Mâck©® Deltec CoZmore Pumper
> Type 1 since 1975 > >


i'm curious if you have retinopathy
or really bad eyesight, coz afaik
that's the only real reason for a t1
to pump (after they've learned what
their basal needs really are)

there are far more convenient shot
routines that are far less expensive
than using an insulin pump

safer too

all ears

bill t1 since '57, ex 8-yr pumper, beef-L 1x, simple MDI

"willbill" <trek@worldwide.net> wrote in message
news:ev5q9g0v39@enews4.newsguy.com...
> Tony wrote:
>
>> I wish oldal would jump in and provide some insight into this.
>
>
> both oldal and guy have been quiet for some time
>
> it wouldn't surprise me if they both kicked the bucket
>
> whatever it was that got them, odds are that it got
> written off to them having long term diabetes and
> not to the real cause
>
> (and no, this is NOT another slam by me on synthetic
> insulin, only that death certificates seldom ID the
> real cause of death; which in their case might just
> be old age;
>
> me... i should have another 15+ years,
> if i don't do anything stupid)
>
> bill t1 since '57
>
> the difference between dumb and stupid
> is that stupid has two syllables

Possible, but I hope not the case. When my wife and I were going out (we
were both in high school) I made sure one of the first things she understood
was that I was most likely going to die before her. She has the advantage of
having come from a long lived family; I come from a family with lesser
fortune, and in my particular case a near guarantee (the same one we all
have in this group). Once the shock wore off and reality came on she was
ready to move along with a more pragmatic sense of what lay ahead of us.
That was 30 years ago. I do my best to control the situation but the outcome
is, as they say, inevitable.

You go just a bit further back than I do. Remember when the rhetoric was "a
cure in 5 years"? I stopped believing that before I got out of college.

For those who are about to flame me for having a negative attitude, please
rest assured it is neither positive nor negative. It is simply realistic
when weighed against the current state of affairs.

[Default] On Fri, 06 Apr 2007 12:52:51 -0500, willbill
<trek@worldwide.net> Giggled into the madness of usenet:

>Ma¢k wrote:
>
>> Mâck©® Deltec CoZmore Pumper
>> Type 1 since 1975 > >
>
>
>i'm curious if you have retinopathy
>or really bad eyesight, coz afaik
>that's the only real reason for a t1
>to pump (after they've learned what
>their basal needs really are)
>
>there are far more convenient shot
>routines that are far less expensive
>than using an insulin pump
>
>safer too
>
>all ears
>
>bill t1 since '57, ex 8-yr pumper, beef-L 1x, simple MDI


your ignorance is truly blinding you. type 1s are pumping at all ages
and long before any complications are setting in.

the youngest pumpers are infants and have zero diabetic complications.

--
Mâck©® Deltec CoZmore Pumper
Type 1 since 1975
http://www.alt-support-diabetes.org
http://www.diabetic-talk.org
http://www.insulin-pumpers.org
http://www.pandora.com enter "Jason & Demarco"



"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."
....Theodore Roosevelt

(o ô)
--ooO-(_)-Ooo--------------------

"I don't know half of you
half as well as I should like;
and I like less than half of you
half as well as you deserve."
....Bilbo Baggins


DISCLAIMER If you find a posting or message from me
offensive, inappropriate, or disruptive, please ignore it.
If you don't know how to ignore a posting, complain to
me and I will be only too happy to demonstrate...
..

"willbill" <trek@worldwide.net> wrote in message
news:ev5q9i1v39@enews4.newsguy.com...
> Tony wrote:
>
>> "willbill" <trek@worldwide.net> wrote
>>>in my own experience, there's a fair chance
>>>you'd be safer all around to move to CP's
>>>current beef lente, but you'll have to buy
>>>it from the UK. it's likely still a better
>>>(and long term safer) 1x background insulin
>>>than any of the analog background insulins
>>>
>>>also, beef-lente used 1x is better than pork-lente
>>>(for background) and far better than human-lente,
>>>at least in my experience/knowledge
>
>
>> Bill, I hesitate with the route of getting CP-L from England for a couple
>> of reasons. First, will it be covered by my HMO? I suspect not, but I
>> could probably check. Next, would I be assured of a steady and regular
>> supply?
>
>
> you're thinking wrong, but see p.s.
>

What's the best source for U.S. purchasers of the CP-L?

> as you said "don't fix it if it ain't broke"
>
> out of honest curiosity, roughly what year did
> you switch over to only using synthetic insulin?
>

Jeez, honestly I'm not sure I remember. Somewhere between 15-20 years ago.
Maybe a bit longer.

> for myself, i used 100% human-R (via pump) '91-'97,
> and 100% Humalog (via pump) '97-'98
>
> i was lucky that i have an allergy with Humalog.
> my endo was so clueless that he had no idea that
> my strange symptoms were due to his new wonderdrug
>
> if it weren't for that, i might never have returned
> to beef and pork, and i'd likely be dead now coz
> my problems with human insulin were too subtle to
> cause me to switch back to beef/pork
>

What were the symptoms of your allergic reactions?

On Thu, 05 Apr 2007 21:35:03 -0400, Ma¢k
<stopthespam@shootspammers.com> wrote:

>[Default] On Thu, 5 Apr 2007 18:31:01 -0500, "Tony" <none@none.com>
>Giggled into the madness of usenet:
>
>>
>>
>>One more thing. The instruction on Levemir and my endo say it cannot be
>>mixed with other insulins, but when I searched the newsgroups I've seen
>>posts from oldal and other that seems to suggest otherwise. For those who
>>have done it successfully, does it have an adverse effect similar to when
>>mixing N and R?
>>
>
>what adverse effect do you get by mixing N and R?

Mixing N and R isn't really a problem, mixing N and Humalog is a
problem.

Most N is made with an excess of Protamine, and as a result, can
convert some H or Novolog to the N analog of Novolog Humalog (NPL).
It isn't really bad, but most people want a particular level of fast
acting component of their insulin, so converting part of the fast
acting to slow acting wasn't the general idea. So premixed N/R, or
Novolog/N, Humalog/NPL are calibrated to insure that when the 'smoke'
clears, they really are 75/25 or 70/30 or 50/50 (humalog mix 50).

Lantus, and perhaps Levemir are a different story. Lantus is highly
soluble only a low pH. You get the long last effect because at body
pH, it forms a slowly dissolved micro precipitate. the pH of N is high
enough that it will happen in the syringe instead of in your body, or
in the vial if you aren't careful. Probably not a good idea.

I don't know enough about Levemir to know how it behaves.

On Fri, 6 Apr 2007 16:22:18 -0500, "Tony" <none@none.com>
wrote:

>
>"willbill" <trek@worldwide.net> wrote in message
>news:ev5q9g0v39@enews4.newsguy.com...
>> Tony wrote:
>>
>>> I wish oldal would jump in and provide some insight into this.
>>
>>
>> both oldal and guy have been quiet for some time
>>
>> it wouldn't surprise me if they both kicked the bucket
>>
>> whatever it was that got them, odds are that it got
>> written off to them having long term diabetes and
>> not to the real cause
>>
>> (and no, this is NOT another slam by me on synthetic
>> insulin, only that death certificates seldom ID the
>> real cause of death; which in their case might just
>> be old age;
>>
>> me... i should have another 15+ years,
>> if i don't do anything stupid)
>>
>> bill t1 since '57
>>
>> the difference between dumb and stupid
>> is that stupid has two syllables
>
>Possible, but I hope not the case. When my wife and I were going out (we
>were both in high school) I made sure one of the first things she understood
>was that I was most likely going to die before her. She has the advantage of
>having come from a long lived family; I come from a family with lesser
>fortune, and in my particular case a near guarantee (the same one we all
>have in this group). Once the shock wore off and reality came on she was
>ready to move along with a more pragmatic sense of what lay ahead of us.
>That was 30 years ago. I do my best to control the situation but the outcome
>is, as they say, inevitable.
>
>You go just a bit further back than I do. Remember when the rhetoric was "a
>cure in 5 years"? I stopped believing that before I got out of college.
>
>For those who are about to flame me for having a negative attitude, please
>rest assured it is neither positive nor negative. It is simply realistic
>when weighed against the current state of affairs.
>

There's realism and there's miserablism. Yeah, you won't
find it in the dictionary. I just made it up.

I'm realistic and I'm constantly aware at the back of my
mind that with leukemia and type 2 diabetes it's probable
I'll go before she does. I have done the research, I've read
"The Median is Not the Message" and I'm encouraged by
current research and my improved health since diagnosis -
but I'm just as realistic as you. So I've done some
realistic planning of finances, insurance and so on. But I
haven't lived the five years since diagnosis constantly
reminding her of that fact - or the resulting depression may
cause the opposite effect.

You also conveniently forget that life has no certainties
except death; you may both go in a car accident or a tsunami
or either might meet the wrong people down a dark alley at
the wrong time.

So, what is miserablism? I loved my mother-in-law but she
had it as she aged. As SWMBO's parents entered their 80's
her dad had a couple of minor heart attacks. Her mother
placed him on a strict low-fat diet, banned him from smoking
and regularly discussed, in front of him, the arrangements
she was going to have to make when she lived alone after he
went. Well, she went suddenly at 88 and he's now 95. He
loved her dearly but he bought a pack of smokes the day she
died and went back to the foods he loved.

I'll continue to be a realistic optimist, planning in
reality but looking forward to the future with hope. If that
dooms me to occasional major disappointments I prefer that
to continual gloom.

Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com/
http://loraltravel.blogspot.com/
latest: Epidaurus

On Fri, 06 Apr 2007 10:25:43 -0500, willbill
<trek@worldwide.net> wrote:

>Tony wrote:
>
>> I wish oldal would jump in and provide some insight into this.
>
>
>both oldal and guy have been quiet for some time
>
>it wouldn't surprise me if they both kicked the bucket
>
>whatever it was that got them, odds are that it got
>written off to them having long term diabetes and
>not to the real cause
>
>(and no, this is NOT another slam by me on synthetic
> insulin, only that death certificates seldom ID the
> real cause of death; which in their case might just
> be old age;
>
> me... i should have another 15+ years,
> if i don't do anything stupid)
>
>bill t1 since '57
>
>the difference between dumb and stupid
>is that stupid has two syllables

You're a bit quick to write people off Bill. Many of us take
long breaks from the groups, including you and I. See my
reply on "miserablism" to Tony.

I sincerely hope you're wrong. If anyone is in touch with
Old Al or Guy please see if you can reassure us on that.

Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.

The reports of my death have been greatly exaggerated.
Mark Twain