Shayla

I run a mailing support list for parents of children in the UK and also
spend a lot of time on US parents lists.  Lots of people do really well on
this insulin and love it.  Other dont find it works so well for them.  Some
people find some problems are solved by taking it in two doses 12 hours
apart.  I think that you just have to try it give it enough time.
Everyone's different.

My daughter Sasha aged 9 used it and we had poor results.  Peaking a couple
of hours after administration and lows later and hypos in the evening and
night (she took it in the mornings)  One of the main problems was that we
started in the summer months and she is extremely active and on summer
evenings she would be playing out, skateboarding, cycling climbing trees
until dark and once given you cant reduce the insulin. With Lantus its "IN
AND ON UNTIL IT'S GONE"  if you have variable basal needs it can be tricky.
We went back to split dose of Insulatard which meant that on an active day I
could then reduce the evening Insulatard. I do not think you could mess
about reducing doses of Lantus like this as we found that any alterations in
dose took about 3 days to have full effect.

However, despite my comments I still think for a lot of people it works very
well.  There are plenty of people using it that didn't have our problems.
So get an Owen Mumford pen and give it a go. Just dont think it does all it
says on the tin!

Jackie
Mum of Sasha D for nearly 5 years.

Shayla Walmsley wrote in message ...

    Insulatard is an extremely difficult insulin to use well.   It is too
peaky.   It comes on strong at 4-6 hours for many folks, and for many other
folks, it loses background power somewhere around 12 hours.

That means you can have mystery lows without warning,  especially at 3 am!
It also means liver dumps and mystery highs ( sometimes over 16 mmol/L)  if
you have no other insulin active when your last  Insulatard shot loses its
background power  (i.e. abililty to maintain a minimum insulin concentration
of 8-12 microunits/Liter in your blood).

Both the mystery lows and the mystery highs are YMMV affairs.   It depends
on how fast your particular fat layer releases the Insulatard.

If you read the personal accounts of folks who find the insulin pump totally
necessary for any kind of decent control, you will be struck by how many of
those folks were on Insulatard  (aka NPH in other countries),   and how
erratic the Insulatard (NPH) absorption patterns were.   Slow today,  fast
tomorrow,  who knows what the day after.

The more modern insulins,  Ultratard and Lantus avoid a lot of those
problems.   They are less peaky and longer lasting.   You can have troubles
but they are usually solved more easily then similar problems with
Insulatard,  e.g.  I "beat" NPH  (the US version of Insulatard) but I had to
split my daily dose into 4/day to do so.

Lantus is a lot easier to use than Ultratard.   Ultratard is more powerful.
I get much better performance with 3 shots/day of Ultratard than many do
with 1 shot/day of Lantus.    If you are willing to put up with the
difficulties in injection, and more frequent shots,  Ultratard is the better
insulin.   Very few of your DSN's patients are willing to do that so she is
"pushing" Lantus.

Insulin Levemir is claimed to have  much more uniformly activity than
Ultralente or Lantus.   It's not available yet but they claim it's on its
way.

Regards
 Old Al

I'd agree with all jackie and oldal said. I use Lantus and apart from a pen
that belongs in the bin the insulin is ok. I still don't think it works the
full 24 hours for me, but with the time of day i inject it i seem to have
that covered ok, certainly much better than my old insulatard routine.
Combined with novorapid it's given me a degree of control i could only have
dreamed of in the past.
Patrick