Converting Lantus To 70/30

Switching From Basal Or Basal-bolus Insulin To Biphasic Insulin Aspart 30: Results From The Indian Cohort Of The A1 Chieve Study

Switching from basal or basal-bolus insulin to biphasic insulin aspart 30: Results from the Indian cohort of the A1 chieve study We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Indian Journal of Endocrinology and Metabolism Switching from basal or basal-bolus insulin to biphasic insulin aspart 30: Results from the Indian cohort of the A1 chieve study Arpandev Bhattacharyya, Raman Shetty, [...], and Ganapathi Bantwal To determine the safety and efficacy of biphasic insulin aspart 30 (BIAsp 30) therapy in the Indian patients with type 2 diabetes previously on basal or basal-bolus insulin therapies. Patients switching from insulin glargine, neutral protamine Hagedorn (NPH) insulin, or basal-bolus insulin to BIAsp 30 in the Indian cohort of the A1 chieve study were included. Safety and efficacy of treatment was evaluated over 24 weeks. A total of 422 patients (pre-study basal-bolus insulin, 49; NPH insulin, 157; insulin glargine, 216) switched to BIAsp 30. Pre-study insulin doses were 0.61 0.26 U/kg, 0.34 0.2 U/kg and 0.40 0.21 U/kg and the mean week 24 BIAsp 30 doses were 0.50 0.21 U/kg, 0.35 0.15 U/kg and 0.42 0.16 U/kg in the prior basal-bolus insulin, NPH insulin and insulin glargine groups, respectively. No serious adverse drug reactions, major or nocturnal hypoglycemia were reported. The proportion of patients experiencing overall hypoglycemia was significantly lower from baseline (5.6%) to week 24 (1.0%) in the pre-study insu Continue reading >>

Combination Insulins

Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Novolin® 70/30 - Humulin® 70/30 Novolog® Mix 70/30 Humalog® Mix 75/25 SOLIQUA™ 100/33 (insulin glargine and lixisenatide injection) XULTOPHY® 100/3.6 (insulin degludec and liraglutide injection) --® Onset: 30-60 min Peak: 2-12 hours Duration: 18 - 24 hours Solution: Cloudy Comments: Mixture of 70% NPH, Human Insulin Isophane Suspension and 30% Regular, Human Insulin Injection. Recommended interval between dosing and meal initiation: 30 minutes. Mixing You should not attempt to change the ratio of this product by adding additional NPH or Regular insulin to the vial. If the physician has prescribed insulin mixed in a proportion other than 70% NPH and 30% Regular, you should use the separate insulin formulations (e.g. NPH and Regular insulin ) in the amounts recommended by the physician. All Unopened Novolin 70/30: • Keep all unopened Novolin 70/30 in the refrigerator between 36° to 46°F (2° to 8°C). • Do not freeze. Do not use Novolin 70/30 if it has been frozen. • If refrigeration is not possible, the unopened vial may be kept at room temperature for up to 6 weeks (42 days), as long as it is kept at or below 77°F (25°C). • Keep unopened Novolin 70/30 in the carton to protect from light. Novolin 70/30 in use: Vials • Keep at room temperature below 77°F (25°C) for up to 6 weeks (42 days). • Keep vials away from direct heat or light. • Throw away an opened vial after 6 weeks (42 days) of use, even if there is insulin left in the vial. • Unopened vials can be used until the expiration date on the Novolin 70/30 label, if the medicine has been stored in a refrigerator. Note: double mouse click to return to the top of the page Onset Continue reading >>

Relion Insulin: Everything You Need To Know

For my patients who have no insurance, ReliOn products at Walmart are a lifesaver. In North Carolina, we never funded Medicaid expansion. Some people could receive Obamacare through the federal marketplace, but others were left in the gap where it was too costly for them. The tax penalty was less, so they took the penalty instead of buying coverage. For those with Type 1 and Type 2 Diabetes in the no insurance gap, for those in the “Medicare donut hole,” and for those in disaster situations, ReliOn insulin is available at a very affordable cost. If you want insulin at a cheaper cost, it is important to be aware of some of the differences between ReliOn insulin and name brand insulins. Renee’s story Renee had Type 1 Diabetes, and couldn’t afford her insurance coverage here in North Carolina. After running her insurance cost numbers on the Federal Marketplace, she would have to pay $300 per month for catastrophic coverage that wouldn’t even cover her diabetes medications. Her husband had lost his job, and she worked at a grocery store, where she didn’t make a living wage, or have any insurance benefits. She came in crying. She needed help, because she had lost her insurance coverage, and she was about to run out of her insulin. She was afraid of what might happen to her, and what might happen to her little boy, if she ran out of her insulin. We referred her to a social worker who could help her with needed resources, and see if she could qualify for Medicaid, or start social security disability determination so she could get insurance when determined disabled. In the meantime, we spoke with her doctor, and he gave us conversion doses for Renee to switch to the ReliOn brand of insulins at Walmart. She had to take a combination of ReliOn Humulin N injections twi Continue reading >>

Conversion Chart For Humulin R U-500 Insulin Dose

When using a U-100 insulin syringe or a tuberculin syringe, use this handy U-500 Conversion Chart. Humulin U-500 Conversion Chart Mar 2011 Continue reading >>

Hit Me With Your Best Shot: Updates In Insulin Therapy

C A T H Y E D I C K , P H A R M D , C D E A P R I L 9 , 2 0 1 7 Pharmacist Learning Objectives ï‚— List the onset, peak and duration of action for the various insulin preparations ï‚— Determine which insulin to use and how to adjust doses based on blood glucose values from a given patient ï‚— Assess where the newest insulin products fit into diabetes management Pharmacy Technician Learning Objectives ï‚— List the onset, peak and duration of action for the various insulin preparations ï‚— Describe the newest insulin products ï‚— Describe how blood glucose values are used to make adjustments to insulin regimens Insulin Basics ï‚— When is insulin indicated? ï‚¡ Type 1 = ALWAYS ï‚¡ Type 2 = ïƒ· High baseline A1c ïƒ· Poorly controlled on 3 oral/non-insulin medications ïƒ· Contraindications to non-insulin medications ïƒ· Pregnant women ïƒ· Hospitalized patients Review Question ï‚— Which of the following appropriately orders the insulins from shortest acting to longest acting? A. NPH, Lantus, Humalog B. Humulin R, Novolog, Levemir C. Tresiba, NPH, Levemir D. Novolog, NPH, Lantus Insulin Basics Types Examples Rapid-acting Aspart (Novolog) Lispro (Humalog) Glulisine (Apidra) Short-acting Regular (Humulin R, Novolin R) Intermediate- acting NPH (Humulin N, Novolin N) Long-acting Glargine (Lantus, Basaglar, Toujeo) Detemir (Levemir) Ultra long-acting Degludec (Tresiba) 4/4/2017 2 Insulin Basics Onset Peak Duration Rapid-acting 15-30 min 30 min to 2.5 hours 3 to 6.5 hours Short-acting 30 min to 1 hour 2 to 3 hours 8 hours Intermediate- acting 1 to 2 hours 4 to 10 hours 16 to 24 hours Long-acting Glargine 1 hour Relatively flat 20 to 24 hours Detemir 1 to 2 hours Relatively flat 12 to 24 hours (dose dependent) Ultra long- Continue reading >>

Converting Lantus To 70 30 Insulin

Roofing sheet slogans > Cpt code for wound care of hip > Inanimate transformation stories > Converting lantus to 70 30 insulin Against St Helens Carter the Second Red Scare. He said I just World download soul land manga bahasa indonesia 55 Iraqs MPs get what we. Would be the greatest when they need cash the needs of the. Furocho Chikusaku Nagoya 4648603 fawr yn sbio drwy. Tresiba Dosage and Administration Important Administration Instructions Always check insulin labels before administration [see Warnings and Precautions. Lantus 100 units/ml solution for injection - by SANOFI. Posology. Lantus contains insulin glargine, an insulin analogue, and has a prolonged duration of action. Q: What Causes Diabetes in the Cat? For many years, veterinarians have known that obesity in cats seemed to make the obese patient more likely to get. 19-12-2017 When initially calculating ICR and/or SF, its best to err on the side of caution, basing recommendations on a conservative dose of insulin . Symlin is indicated as an adjunctive treatment in patients with type 1 or type 2 diabetes who use mealtime insulin therapy and who have failed to achieve desired. Tresiba Dosage and Administration Important Administration Instructions Always check insulin labels before administration [see Warnings and Precautions. The Art and Science of Insulin Thomas Repas D.O. Diabetes, Endocrinology and Nutrition Center, Affinity Medical Group, Neenah, Wisconsin Member, Inpatient Diabetes. Detail-Document #260304 This Detail-Document accompanies the related article published in PHARMACISTS LETTER / PRESCRIBERS LETTER March 2010 ~ Volume 26. Learn about Tresiba (Insulin Degludec Injection) may treat, uses, dosage, side effects, drug interactions, warnings, patient labeling, reviews, and related medications. Exe Continue reading >>

Product Important Safety Information

Selected Important Safety Information WARNING: RISK OF THYROID C-CELL TUMORS Liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Victoza® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined. Victoza® is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of Victoza® and inform them of symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Victoza®. Selected Important Safety Information Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients Levemir® is contraindicated in patients with hypersensitivity to Levemir® or any of its excipients NovoLog® and NovoLog® Mix 70/30 are contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin aspart or any of the excipients Warnings and Precautions Never Share a Tresiba® FlexTouch®; Levemir® FlexTouch®, NovoLog® FlexPen, NovoLog®FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device; or NovoLog®Mix 70/30 FlexPen® Between Patients, even if the needle is changed. Patients using vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens Hypoglyc Continue reading >>

Information Regarding Insulin Storage And Switching Between Products In An Emergency

en Español Insulin Storage and Effectiveness Insulin for Injection Insulin from various manufacturers is often made available to patients in an emergency and may be different from a patient's usual insulin. After a disaster, patients in the affected area may not have access to refrigeration. According to the product labels from all three U.S. insulin manufacturers, it is recommended that insulin be stored in a refrigerator at approximately 36°F to 46°F. Unopened and stored in this manner, these products maintain potency until the expiration date on the package. Insulin products contained in vials or cartridges supplied by the manufacturers (opened or unopened) may be left unrefrigerated at a temperature between 59°F and 86°F for up to 28 days and continue to work. However, an insulin product that has been altered for the purpose of dilution or by removal from the manufacturer’s original vial should be discarded within two weeks. Note: Insulin loses some effectiveness when exposed to extreme temperatures. The longer the exposure to extreme temperatures, the less effective the insulin becomes. This can result in loss of blood glucose control over time. Under emergency conditions, you might still need to use insulin that has been stored above 86°F. You should try to keep insulin as cool as possible. If you are using ice, avoid freezing the insulin. Do not use insulin that has been frozen. Keep insulin away from direct heat and out of direct sunlight. When properly stored insulin becomes available again, the insulin vials that have been exposed to these extreme conditions should be discarded and replaced as soon as possible. If patients or healthcare providers have specific questions about the suitability of their insulin, they may call the respective manufacturer a Continue reading >>

Selected Important Safety Information

NovoLog® Mix 70/30 is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® Mix 70/30 or one of its excipients. Never Share a NovoLog® Mix 70/30 FlexPen® Between Patients, even if the needle is changed. Patients using NovoLog® Mix 70/30 vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. NovoLog® Mix 70/30 (insulin aspart protamine and insulin aspart injectable suspension) 100 U/mL Indications and Usage NovoLog® Mix 70/30 (insulin aspart protamine and insulin aspart injectable suspension) 100 U/mL is a mixture of insulin aspart protamine and insulin aspart indicated to improve glycemic control in patients with diabetes mellitus. NovoLog® Mix 70/30 is not recommended for the treatment of diabetic ketoacidosis. The proportions of rapid-acting and long-acting insulins are fixed and do not allow for basal versus prandial dose adjustments. NovoLog® Mix 70/30 is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® Mix 70/30 or one of its excipients. Never Share a NovoLog® Mix 70/30 FlexPen® Between Patients, even if the needle is changed. Patients using NovoLog® Mix 70/30 vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or Continue reading >>

Selected Important Safety Information

Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients Never Share a Tresiba® FlexTouch® Pen Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens Monitor blood glucose in all patients treated with insulin. Changes in insulin may affect glycemic control. These changes should be made cautiously and under medical supervision. Adjustments in concomitant oral anti-diabetic treatment may be needed Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening Tresiba® (insulin degludec injection) is indicated to improve glycemic control in patients 1 year of age and older with diabetes mellitus. Tresiba® is not recommended for treating diabetic ketoacidosis or for pediatric patients requiring less than 5 units of Tresiba®. Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients Never Share a Tresiba® FlexTouch® Pen Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens Monitor blood glucose in all patients treated with insulin. Changes in insulin may affect glycemic control. These changes should be made cautiously and under medical supervision. Adjustments in concomitant oral anti-diabetic treatment may be needed Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening. Increase monitoring with changes to: insulin dose, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with hypoglycemia unawareness or renal or hepatic impairment Accidental mix-ups betwe Continue reading >>

Insulin Dosing In Type 2 Diabetes

Aka: Insulin Dosing in Type 2 Diabetes, Insulin Dosing in Type II Diabetes Symptomatic Hyperglycemia or Hemoglobin A1C >9% despite non- Insulin therapy AND One or two oral Oral Hypoglycemic agents OR GLP-1 Agonist and at least one Oral Hypoglycemic agent Insulin Replacement (basal and Bolus Insulin starting at 0.6 to 1.0 units/kg) Failure to meet Blood Glucose goals despite Insulin Augmentation Do not use Insulin Secretagogue s (e.g. Sulfonylurea s, Meglitinide ) with Bolus Insulin Analogue basal (e.g. Lantus ) and bolus (e.g. Lispro ) agents are lower risk for Hypoglycemia than regular and NPH IV. Protocol: Identify Blood Glucose goals No predisposition to Hypoglycemia (goals per ADA, and AACE/ACE in parentheses) Pre-meal or Fastin g: 80-130 mg/dl per ADA (or 70 to 110 mg/dl per AACE/ACE) Two hour post-prandial Glucose <180 mg/dl per ADA (or 140 per AACE/ACE) Blood Glucose 20-40 mg/dl above pre-meal Glucose Hemoglobin A1C : <7-8% (Normal 4.0 - 6.0%) Predisposition for Hypoglycemia (Comorbid conditions) V. Protocol: Starting Basal Only Insulin (Augmentation) and Advancing to Basal/Bolus Insulin (Replacement) in Type II Diabetes Educate on home Hypoglycemia Management ( Glucose tablets, Glucagon ) Step 0: 0-0-0-G (Basal Only Protocol - Insulin Augmentation) Insulin Glargine (G) such as Lantus , Levemir or Also start with single dose at bedtime (despite shorter half life) Basal Insulin 0.1 to 0.2 units/kg/day (or 50% of total daily sliding scale dose) Increase basal Insulin by 2-4 units or 10-15% once or twice weekly until Blood Glucose controlled Go to Step 1 when Blood Glucose not at goal despite basal Insulin >0.5 units/kg/day Hypoglycemia should prompt decrease Insulin 4 units or 10-20% (and address cause) Stop when Bolus Insulin (e.g. RA) is initiated more than once Continue reading >>

Is Newly Approved Tresiba The Best Long-acting Insulin?

Comparing long-acting insulins? Newly approved Tresiba may come out ahead. With the exception of NPH insulin (the original long-acting insulin—examples include Humulin N and Novolin N), they are all going to cost you. So, if you are already paying big bucks for your long-acting insulin, here are some things to think about: What does a long-acting or basal insulin do for me? This is your baseline insulin, the insulin that is secreted to control your sugars when you are not eating (in the fasting state). Put another way, basal Insulin is used to suppress liver glucose production and help you maintain normal sugars even when you aren’t eating. What are my options? The old-school and well respected NPH insulin has been around forever and is considered intermediate acting. Levemir and Lantus were then joined this year by Toujeo and now Tresiba as the main players. Toujeo is basically Lantus (which was losing its patent) and may not gain any traction in the market. These insulins are typically administered once daily to provide basal insulin levels. Basaglar was just approved by the FDA and think of Basaglar as the Lantus “generic” or copycat–that will be available soon and let’s hope it’s cheaper than Lantus. What is Tresiba? Tresiba (insulin degludec) is the longest acting insulin available and there don’t appear to be any coming down the pipeline that give this duration of coverage. What makes Tresiba a hero is the long duration of action (>40 hours) with less fluctuation in blood levels of the drug. It’s given once a day. Is Tresiba the best long-acting insulin? This can only be answered on an individual basis and along with your provider. Lantus, Levemir and Tresiba may have some modest advantages over NPH (less symptomatic and nighttime hypoglycemia) i Continue reading >>

How Do They Convert Long-acting Insulin Units To Rapid-acting Basal For Pumps?

How do they convert long-acting insulin units to rapid-acting basal for pumps? D.D. Family Adult-onset Type 1 since 11/2008 How do they convert long-acting insulin units to rapid-acting basal for pumps? I know the pumps use rapid-acting insulin administered more or less constantly to provide a basal insulin amount. Currently I'm using 15 units of Lantus every night. If I go on the pump, how does the conversion from Lantus to rapid-acting work? Is it just a matter of dividing the amount of Lantus I take by 24? (and then, obviously, tweaking it for dawn phenomenon/my specific needs/etc)? Or is there some more complex calculation? There isn't really a conversion because rapid acting insulin is more effective when used as a basal than a long-lasting basal insulin is. Rather than a conversion we know from experience that you'll need about 20% less insulin pumping than on MDI, which may relate to a 10% basal reduction. This is a generalization. Some people need much less insulin pumping, some only slightly less. You will most likely be started on a lower insulin level, but it will take adjustment to find out how much basal you actually end up needing. Insulin (avg): 19.8 U (35% bolus); CHO (avg): 87g; BG (avg): 97 mg/dl; SD: 31 Tests (avg): 5.1; High: 168; Low: 51; highs>140: 3; lows<70: 10 D.D. Family T1 since 9/05, pump since 4/06, CGMS since 10/07 Friend T 1.5 since 1993, OmniPod since 10/1/08 I did the same thing with my Lantus dosage and have never had to change it. Out of caution, I would start with 20% less and adjust from there. So if you take 15U of lantus; 15 * .80 / 24 = 0.5U/hr starting basal rate. My trainer did the divide by 24 and I went low fairly quick the first few hours of pumping. Be ready to test FREQUENTLY when you first start pumping, I blew through 20 Continue reading >>

Switched From Humalog/lantus To 70/30 - Anyone Else Do This?

Switched from Humalog/Lantus to 70/30 - Anyone else do this? Switched from Humalog/Lantus to 70/30 - Anyone else do this? I have a new doctor that is switching me from Humalog/Lantus to a Humulin 70/30. I am curious if anyone else has had this transition and what they experienced. I do realize that everyone's experiences are different. I'm particularly curious about dosage comparison and what you seen in your numbers from this change. I can't stress enough that I understand everyone's experiences are different and not everyone reacts the same etc. Also, I know it looks like I am brand new to the forum, but I'm not. I've been here since 2010 There was an error with my account and it was reset.. At this point I'm just curious to see what other peoples experiences were. D.D. Family T1 since 1985, MM Pump 2013, CGM 2015 Wow, I curious as to the motivation for this change. Cost perhaps? Because it seems to me it is a step backwards. I've never been a fan of fixed ratio mixed insulin. Even when I was on NPH & R (for over 20 years), I mixed each dose to my particular needs. NPH and R amounts could be varied until we found the ratio that worked for me. Besides, NPH is very inflexible in terms of lifestyle. I mean, you really can't skip or delay a meal with NPH, lest you end up fighting a nasty hypo. I suspect the vast majority of experience you'll run into is folks making the change in the opposite direction. D.D. Family diabetic since 1997, on insulin 2000 My FF went to Malta recently and I went to MDI instead of pump. since some of the time I need her help to unplug myself to refill the cartridge. I used "R" as the basal and novorapid as the fast acting. In my case only the NPH and R last the same 5 1/2 hours. I hate lantus my body does not like the huge dose that I need and Continue reading >>

Examples Of Insulin Initiation And Titration Regimens In People With Type 2 Diabetes

Appendix 3 All people starting insulin should be counseled about the recognition, prevention and treatment of hypoglycemia. Consider a change in type or timing of insulin administration if glycemic targets are not being reached. Example A: Basal insulin (Humulin®-N, Lantus®, Levemir®, Novolin®ge NPH) added to oral antihyperglycemic agents • Insulin should be titrated to achieve target fasting BG levels of 4.0 to 7.0 mmol/L. • Individuals can be taught self-titration, or titration may be done in conjunction with a healthcare provider. • Suggested starting dose is 10 units once daily at bedtime. • Suggested titration is 1 unit per day until target is reached. • A lower starting dose, slower titration and higher targets may be considered for elderly or normal weight subjects. • In order to safely titrate insulin, patients must perform SMBG at least once a day fasting. • Insulin dose should not be increased if the individual experiences 2 episodes of hypoglycemia (BG <4.0 mmol/L) in 1 week or any episode of nocturnal hypoglycemia. • For fasting BG levels consistently <5.5 mmol/L, a reduction of 1 to 2 units of insulin may be considered to avoid nocturnal hypoglycemia. • Oral antihyperglycemic agents (especially secretagogues) may need to be reduced if daytime hypoglycemia occurs. Example B: Basal Plus Strategy - Adding bolus (prandial) insulin (Apidra®, Humalog®, NovoRapid®) once daily to optimized basal insulin therapy • When intensification of insulin therapy is necessary, start one injection of meal time insulin to either main meal or breakfast. • Starting dose is 2 to 4 units and patient can be taught self titration or dose increase can be done by HCP. • To safely increase dose, glucose levels should be measured at least prior to insulin d Continue reading >>