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Is Lantus And Novolog The Same?

How Long Should Insulin Be Used Once A Vial Is Started?

How Long Should Insulin Be Used Once A Vial Is Started?

Editor’s comment: The commentary by Dr. Grajower has such important clinical relevance that responses were invited from the three pharmaceutical companies that supply insulin in the U.S. and the American Diabetes Association, and all of these combined in this commentary. The commenting letter and individual responses were authored separately and are completely independent of each other. Diabetic patients treated with insulin, whether for type 1 or type 2 diabetes, are prone to often unexplained swings in their blood glucose. These swings can vary from dangerously low to persistently high levels. Most diabetic patients, and most physicians, will adjust insulin regimens so as to avoid hypoglycemia at the expense of hyperglycemia. Among the “textbook” reasons for variable glucose responses to any given insulin regimen are 1) site of administration, 2) exercise, 3) bottles not adequately mixed before drawing the insulin (for NPH, Lente, or Ultralente), and 4) duration of treatment with insulin (1). A new insulin was marketed by Aventis Pharmaceuticals about 1 year ago, insulin glargine (Lantus). The manufacturer seemed to stress that patients not use a started bottle of this insulin for >28 days (2). Two patients of mine highlighted this point. L.K. is a 76-year-old woman with type 2 diabetes, diagnosed at 55 years of age, and treated with insulin since age 56. Her insulin regimen was changed to Lantus at night together with Novolog before meals. She monitors her blood glucose four times a day. She used a bottle of Lantus until it ran out; therefore, a bottle lasted for 2 months. Her recent HbA1c was 7.6%. I retrospectively analyzed her home glucose readings by averaging her fasting blood glucose levels for the first 15 days of a new bottle and the last 15 days of tha Continue reading >>

High-alert Medications - Novolog (insulin Aspart)

High-alert Medications - Novolog (insulin Aspart)

Extra care is needed because NovoLog is a high-alert medicine. High-alert medicines have been proven to be safe and effective. But these medicines can cause serious injury if a mistake happens while taking them. This means that it is very important for you to know about this medicine and take it exactly as directed. Top 10 List of Safety Tips for NovoLog When taking your medicine 1. Know your insulin. NovoLog is a rapid-acting form of insulin that should be injected below the skin 5 to 10 minutes before meals. Have food ready before injection. After injecting the insulin, do not skip a meal or delay eating. 2. Prepare your insulin. An intermediate- or long-acting insulin is often prescribed with NovoLog. NovoLog can be mixed with insulin NPH (intermediate-acting insulin), but always draw NovoLog into the syringe first. Never mix NovoLog with Lantus. Do not mix NovoLog with other insulins if using an insulin pen or external pump. Do not vigorously shake insulin before use. 3. Don't reuse or recycle. Dispose of used syringes/needles, pens, and lancets in a sealable hard plastic or metal container (e.g., empty detergent bottle, special sharps container from your pharmacy). When the container is full, seal the lid before placing it in the trash. Do not reuse or recycle syringes/needles or lancets. 4. Don't share. Even if you change the needle, sharing an insulin pen or syringe may spread diseases carried in the blood, including hepatitis and HIV. To avoid serious side effects 5. Avoid mix-ups. If you use more than one type of insulin, make each vial or pen look different by putting a rubber band around one type of insulin. 6. Check your medicine. NovoLog can be confused with Humalog (another rapid-acting insulin). When you pick up your insulin at the pharmacy, be sure it's Continue reading >>

Insulin Basics | Diabetesnet.com

Insulin Basics | Diabetesnet.com

Thu, 11/18/2010 - 15:14 -- Richard Morris Store insulin you are not using in a refrigerator. It is a protein dissolved in water, sort of like a soup stock, so keep it cold to prevent it from spoiling. Keep it between 36º and 46º F. If it gets colder it will freeze. If the insulin freezes, when it thaws it will separate and clump and will no longer be usable. If it gets warmer it will be ok for awhile but will eventually spoil. If it starts to spoil, bacteria growing in it breaks down the insulin. It won't hurt you to use this. However, its not as effective so your blood sugar will be higher than you expect even though you took the right amount of insulin at the right time. It is ok to keep a bottle of insulin you are using at room temperature for up to 28 days (room temperature is 59º to 86º F). The preservative in insulin keeps it from spoiling this long. Insulin at room temperature injected into the skin is more comfortable for many people. Also, it may be easier to get rid of air bubbles in the syringe when it is at room temperature. If you live in a hot climate and your room temperature is above 80º, keep your insulin in the refrigerator. Insulin in a pen can only be kept at room temperature for 2 weeks before it begins to spoil. Check with your pharmacist, the package insert or the manufacturer's websites. Insulin used past 28 days at room temperature or past the expiration date on the box may still be good. However, using it may cause control problems and is not recommended. Lantus, Humalog and Novolog seem to spoil faster than Regular and NPH. If you can't afford to buy insulin and insurance does not cover it, you may be able to get it free. Check the website www.helpingpatients.org or call 202-835-3400. The doctor who prescribes your insulin can help you g Continue reading >>

Prepare Your Patients For An Insulin Change For 2017

Prepare Your Patients For An Insulin Change For 2017

Mo st insurance plans will be dropping Lantus from formularies. Guest Post by David Kliff, Diabetic Investor Sometimes I’m amazed at how oblivious some people in this wacky world can be. Actually, I should say it really doesn’t amaze me given this is the wacky world of diabetes, which is full of clueless opinions. I mention this after some conversations on the nature of the insulin market. Yes, people are beginning to wake up to the fact (yes, those damn pesky facts again), that insulins have become a commodity. This is particularly true with long-acting insulins, of which there are now 5, one being a biosimilar. Lilly has the biosimilar, Basaglar, which is winning the war that counts: formulary position. Lantus, the current leader, isn’t just losing the war, it’s losing by a mile. Starting next year, when formulary changes go into full effect, Basaglar will become the long-acting insulin of choice. Not because it’s any better than Lantus — it isn’t. It’s the same as Lantus, only cheaper — which is exactly the point. Still, many seem to believe there will be pushback from physicians. Why would they switch any patient from Lantus to Basaglar, especially when Lantus works so well? First, as much as I hate to state the obvious, it really won’t be left up to the physician. It will be the payor and formulary position that wins, not the opinion of the physician. Think about the discussion a physician would have with a Lantus-using patient after these formulary changes take place. “Mr./Ms. Patient, you know I would like to keep you on Lantus. It’s been a great drug that has worked very well for you. Now I could keep you on Lantus, but there is a slight problem: your insurance company no longer covers Lantus. You can stay on Lantus, but I must warn you t Continue reading >>

Humalog Vs. Novolog: Important Differences And More

Humalog Vs. Novolog: Important Differences And More

Humalog and Novolog are two diabetes medications. Humalog is the brand-name version of insulin lispro, and Novolog is the brand-name version of insulin aspart. These drugs both help control blood glucose (sugar) in people with type 1 and type 2 diabetes. Humalog and Novolog are both rapid acting. That means they work more quickly than other types of insulin. There are important distinctions between Humalog and Novolog, however, and the drugs are not directly interchangeable. Check out this comparison so you can work with your doctor to choose a drug that’s right for you. Insulin is injected under your skin fat. It’s the most common type of treatment for type 1 diabetes because it works quickly. It’s also the only type of diabetes medication that’s absorbed into the bloodstream. Humalog and Novolog are both equivalent to the insulin made in your body. Unlike oral diabetes drugs, insulin provides fast relief for changes in your blood sugar. The type of insulin your doctor prescribes depends on how often and how much your blood sugar fluctuates each day. The table below provides quick facts at a glance. Brand name Humalog Novolog What is the generic drug? insulin lispro insulin aspart Is a generic version available? no no What does it treat? type 1 and type 2 diabetes type 1 and type 2 diabetes What form does it come in? solution for injection solution for injection What strengths does it come in? • 3-mL cartridges • 3-mL prefilled KwikPen • 3-mL vials • 10-mL vials • 3-mL FlexPen • 3-mL FlexTouch • 3-mL PenFill cartridges • 10-mL vials What is the typical length of treatment? long-term long-term How do I store it? Refrigerate at 36° to 46°F (2° to 8°C). Do not freeze the drug. Refrigerate at 36° to 46°F (2° to 8°C). Do not freeze the drug. Continue reading >>

Interactive Dosing Calculator

Interactive Dosing Calculator

Lantus® is a long-acting insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Lantus® should be administered once a day at the same time every day. Limitations of Use: Lantus® is not recommended for the treatment of diabetic ketoacidosis. Contraindications Lantus® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or one of its excipients. Warnings and Precautions Insulin pens, needles, or syringes must never be shared between patients. Do NOT reuse needles. Monitor blood glucose in all patients treated with insulin. Modify insulin regimen cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. Do not dilute or mix Lantus® with any other insulin or solution. If mixed or diluted, the solution may become cloudy, and the onset of action/time to peak effect may be altered in an unpredictable manner. Do not administer Lantus® via an insulin pump or intravenously because severe hypoglycemia can occur. Hypoglycemia is the most common adverse reaction of insulin therapy, including Lantus®, and may be life-threatening. Medication errors, such as accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. Patients should be instructed to always verify the insulin label before each injection. Severe life-threatening, generalized allergy, including anaphylaxis, can occur. Discontinue Lantus®, treat and monitor until symptoms resolve. A reduction in the Lantus® dose may be re Continue reading >>

I Accidently Gave Myself 24 Units Of Novolog Instead Of Lantus. Can I Eat My Way Thru It?

I Accidently Gave Myself 24 Units Of Novolog Instead Of Lantus. Can I Eat My Way Thru It?

I accidently gave myself 24 units of novolog instead of lantus. can i eat my way thru it? mixed up my insulins. can i make it by eating and testing for the next 4 hours? i recently spent two days in the hospital doing this. it wont be out of your system in 4 hours like you may think. best thing is to go to the ER. BELIEVE ME! I agree take a glucagon with you and go to the ER! Better to be safe there!!! thank you for the advice. i was too far from an ER. i am OK now, although not feeling terrific. One time I took 40 units of Humalog instead of Lantus. It took me ten minutes to convince myself I really did that and by the time I drove 3 blocks to the ER I had to be pulled out of my truck by the EMTs on the ERs doorstep. I agree with everyone else. You might be able to eat your way through it but rather safe than sorry. Go now! I bet a lot of us have done that taken our fast acting instead of our Lantus. I know I have! I took 17 Units of Novolog just before bedtime. (like about 9:30 PM). I immediately ate/drank 80 carbs, then I checked my blood sugars every hour and ate anouther 15 carbs each time, until I was certain I would be okay before going to sleep about 3:00 AM. So yes, it is possible to eat your way out of a mistake like this. Glad you did okay. It might be a good thing for insulin manufacturers to put fast-acting insulin in a vials with RED labels. THis would help us not make that kind of mistake. On the one year anniversary of my T1 diagnosis, I was rushing and accidentally took 10 units of Novolog instead of 10 units of Levemir. I realized it as soon as I pulled the needle out and thus began an awful evening of calling poison control, eating more Junior Mints than anyone person should every eat, and dealing with a lovely rebound high. I agree, Levemir and Novo Continue reading >>

Novolog Mix 70-30 Flexpen Insulin Pen

Novolog Mix 70-30 Flexpen Insulin Pen

Insulin aspart protamine/ insulin aspart is used along with a proper diet and exercise program to control high blood sugar in people with diabetes . This product is a combination of two man-made insulins: intermediate-acting insulin aspart protamine and rapid-acting insulin aspart. This combination starts working faster and lasts for a longer time than regular insulin. Insulin is a natural substance that allows the body to properly use sugar from the diet. It replaces the insulin that your body no longer produces, thereby lowering your blood sugar . Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke . How to use Novolog Mix 70-30 Flexpen Insulin Pen Read the patient information leaflet provided by your pharmacist before you start using this medication and each time you get a refill. If you have any questions, consult your doctor or pharmacist. Follow all package directions for proper use/injection/storage of the particular type of device/ insulin you are using. Your health care professional will teach you how to properly inject this medication. If any of the information is unclear, consult your doctor or pharmacist. Do not inject cold insulin because this can be painful. The insulin container you are currently using can be kept at room temperature. Wash your hands before measuring and injecting insulin . Check the product visually for particles, thickening, or clumps before rolling and turning the container. If any are present, discard that container. To avoid damaging the insulin, do not shake the container. Gently roll and turn it between your palms at least 10 times. If using a cartridge or pen, turn it upsid Continue reading >>

Lantus And Levemir: What’s The Difference?

Lantus And Levemir: What’s The Difference?

Lantus and Levemir have a lot in common. Both are basal insulin formulas, which means that they last for a long time in the body and act as background insulin, with a slow feed that mimics the constant low output of insulin produced by a healthy pancreas. Both are insulin analogues, which means that their insulin molecules are analogous to human insulin, but engineered, or recombined, with slight differences that slow their absorption. Lantus is a clear formula made with glargine, a genetically modified form of human insulin, dissolved in a special solution. Levemir is also a clear formula, but it contains dissolved detemir, a different form of genetically modified insulin. Human insulin is made of two amino acid chains, called A and B, that have two disulfide bonds between them. In glargine, one amino acid has been switched out, and two extra amino acids have been added to one end of the B chain. The modifications make glargine soluble at an acidic pH, but much less soluble at the neutral pH that’s found in the body To make Lantus, first the glargine is produced by a vat of E. coli bacteria. Then it’s purified and added to a watery solution containing a little zinc and some glycerol; a dash of hydrochloric acid is also added to make it acidic, bringing its pH down to about 4. At that degree of acidity, glargine completely dissolves into the watery solution, which is why the vial is clear. After you inject it into your subcutaneous tissue, the acidic solution is neutralized by your body to a neutral pH. Because glargine is not soluble at a neutral pH, it precipitates out into a form that’s not soluble in subcutaneous fat, and there forms a relatively insoluble depot. From that pool, or depot, of precipitated glargine in the tissues, small amounts slowly move back Continue reading >>

What Is Novolog (insulin Aspart)?

What Is Novolog (insulin Aspart)?

Before you receive DARZALEX®, tell your healthcare provider about all of your medical conditions, including if you: have a history of breathing problems have had shingles (herpes zoster) are pregnant or plan to become pregnant. DARZALEX® may harm your unborn baby. Females who are able to become pregnant should use an effective method of birth control during treatment and for at least 3 months after your final dose of DARZALEX®. Talk to your healthcare provider about birth control methods that you can use during this time. are breastfeeding or plan to breastfeed. It is not known if DARZALEX® passes into your breast milk. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. DARZALEX® may be given alone or together with other medicines used to treat multiple myeloma. Your healthcare provider will decide the time between doses as well as how many treatments you will receive. Your healthcare provider will give you medicines before each dose of DARZALEX® and on the first day after each dose of DARZALEX® to help reduce the risk of infusion reactions. If you miss any appointments, call your healthcare provider as soon as possible to reschedule your appointment. Infusion reactions. Infusion reactions are common with DARZALEX® and can be severe. Your healthcare provider may temporarily stop your infusion or completely stop treatment with DARZALEX® if you have infusion reactions. Tell your healthcare provider right away if you get any of the following symptoms: shortness of breath or trouble breathing dizziness or lightheadedness (hypotension) cough wheezing throat tightness runny or stuffy nose headache itching nausea vomiting chills fever Changes in blood tests. DARZALEX Continue reading >>

Can Insulin Go Back In The Fridge?

Can Insulin Go Back In The Fridge?

After removing insulin glargine (Lantus) from the refrigerator for use, can it be refrigerated over and over again after having warmed to room temperature, or does this degrade it? Continue reading >>

You Get The Beer, And I'll Get The Lantus

You Get The Beer, And I'll Get The Lantus

The other day, Steph and I were divvying up the shopping that we had to do. I was running low on Lantus, and our refrigerator was also running low on beer, so it was pretty obvious that someone had to get the refills. She also suggested that she would pick up some takeout pizza for supper. And I went to the pharmacy and picked up the insulin. The concept of beer, pizza, and insulin all being part of a tight-control diabetes program might strike some people as unreasonable. But let me assure you that it can work. My tight-control program consists of Novolog given immediately after most meals plus Lantus as basal insulin. Since starting this program a bit over a year ago, I’ve averaged 110 mg/dl on my blood glucose levels, and had normal A1cs, most recently 5.9 You might ask: do I have any restrictions on what I eat? Yup, but they have nothing to do with diabetes. If I eat too much, I’ll gain weight, and like most other people, I have no need to gain any more weight. How can such a program work? 1) Zillions of blood glucose measurements. For example, I always check my BG before driving. To be sure, once in a while, I’ll do only two BGs a day, but if things are exceptional, I have no hesitation to check 6-10 times in a day. 2) Figuring out how much insulin is needed for my routine foods. For me,** 1** slice of pizza takes 4 units of Novolog; 1 bottle of beer is 3 units; 1 English muffin with peanut butter is 3 units. 3) Counting carbs and taking the Novolog after eating. I simply add up the number of units of insulin I’ll need as I go, from salad (no insulin coverage needed) to main course to dessert. Then I pop the total number of units right then and there, using an insulin pen. 4) Injecting through clothing. I discussed this a while back at my other blog, in an Continue reading >>

Compare Novolog Vs. Lantus

Compare Novolog Vs. Lantus

When used correctly, this medication will l lower blood sugar every time you use it and prevent the harmful, long-term effects of high sugar levels on your organs and blood vessels. You can easily change the dose of Novolog (insulin aspart) to fit your individual needs. Starting insulin early in the treatment of Type 2 diabetes can maintain your body's insulin-producing cells and slow down disease progression. Can use Novolog (insulin aspart) even if you have liver or kidney problems, unlike many other blood sugar-lowering medicines. Insulin is one of the most effective blood sugar-lowering medication and can lower your A1c (average blood sugar over time) by up to 2-3%. Lantus (insulin glargine) is a long-lasting insulin that provides consistent, all-day sugar control with just once or twice daily dosing. Dose can be easily adjusted to make a customized regimen that's tailored to your body's needs. Lantus (insulin glargine) can be used with liver or kidney problems. 177 reviews so far Have you used Novolog (insulin aspart)? Leave a review 584 reviews so far Have you used Lantus (insulin glargine)? Leave a review The Novolog (insulin aspart) FDA package insert doesn’t have numbers about how common side effects are. Continue reading >>

Lantus Dosing

Lantus Dosing

Well, I never thought I’d say this, but it’s a great week to be a person with Type 1 diabetes. With all of the bad news surrounding the Type 2 drug Avandia (rosiglitazone), it’s a relief to know I don’t have to worry about it. I recommended you read my colleague Tara’s blog entry (“Type 2 Drug Avandia Linked to Increased Risk of Heart Attacks”) for the full story. That’s one of the first times in my life I’ve referred to someone as a colleague. What can I say? It’s just not a word in my describe-a-friend/coworker vocabulary. While all of the controversy surrounds Avandia, I’m way over in Type 1 land contemplating whether or not to lower my daily dose of Lantus (insulin glargine). I’ve just started a brand new bottle of Lantus and I’ve been taking my normal 15 units in the morning and then eating a rather normal breakfast and lunch, but I’m still going low in the midmorning and early afternoon. This happened Monday after eating Brussels sprouts and whole-wheat pasta for lunch and only taking one unit of rapid-acting NovoLog (insulin aspart) to help out the Lantus. I’ve known for a while that my body is sensitive to insulin, but lately it’s been a little more sensitive than usual. I took 13 units of Lantus yesterday and my blood glucose was 86 mg/dl before lunch. I often wonder how much of an adjustment two units of Lantus is. While I’m very much locked in on an insulin-to-carbohydrate ratio with my NovoLog, it’s a bit tricky to judge how much the longer-lasting insulins affect your blood glucose. Is there a chart for your Lantus dose? I seem to remember something from when I was diagnosed. I wonder what Google will tell me to do. I realize that Lantus doesn’t have a true peak the way some of the other insulins do, but sometimes it su Continue reading >>

What Is The Difference Between Lantus Vs Novolog?

What Is The Difference Between Lantus Vs Novolog?

What is The Difference Between Lantus Vs Novolog? What is The Difference Between Lantus Vs Novolog? It is a long-acting insulin that is used to control blood sugar levels in adults with type 2 diabetes and in adults and children 6 years and older with type 1 diabetes. Lantus takes about 1 to 2 hours to begin working after injection. After injection, Lantus is released slowly and constantly into the bloodstream, and its effects last between 18 and 26 hours. The drug contains insulin glargine, zinc, metacresol, glycerin, and water. You may need to use this drug in combination with other insulin or oral diabetes drugs. It is a fast-acting synthetic insulin that controls blood sugar levels in patients with both type 1 and type 2 diabetes . Usually, NovoLog is taken in combination with other medications to control blood sugar levels for longer periods. NovoLog begins working within 15 minutes and lasts for up to 4 hours. After using NovoLog , also known as insulin aspart, you should eat a meal within the next 5 to 10 minutes. It should be injected under the skin or into a vein with an IV. Lantus should be injected under the skin and should not be injected into a vein or muscle. Your health-care provider will show you the best places to inject insulin aspart or insulin glargine. Rotate the area of injection to avoid injecting into the same place twice in a row. Similarities and differences between Lantus and NovoLog Both drugs are meant to be injected on a daily basis in order to control blood sugar levels. Lantus and NovoLog may cause fluid retention or low potassium . As well, they may also cause low blood sugar. Speak to your doctor if you experience any of these effects. Do not change your dose without instruction from your doctors. NovoLog is a fast-acting insulin that Continue reading >>

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