On my last visit my endo mentioned a new basal insulin which is in approval at the FDA and which may be out in a few months. He thought this would be good for me and would help to keep me more stable. It stays in your system longer without lows and fluctuations apparently... I tend to get that when my lantus runs out during the afternoon. I think this is it Degludec, I forgot to write the name in my phone. He said you can go for a day without basal if you miss a dose with no worries of DKA. Has anyone else heard of this?
What do you think?
Novo-Nordisk will market degludec under the brand name "Tresiba". They will market the 70/30 degludec/Novolog under the brand name "Ryzodeg".
I believe that was the name he mentioned.
The research branch of my endos did a study with degludec. Their assessment was very positive - especially in the T2 group. It seems that this is the first basal insulin that will cover more than 24 hours equally with one shot. Lantus, Levemir and even NPH insulin will state in their package insert that they are active for 24 hours. The problem is that their activity is not distributed equally over this time span. NPH will degrade rapidly after 12 hours with a spike at the 5 hour mark. Levemir will fade out after 14 hours (the duration depends on the dosage) and it will not spike much. Lantus has the potential to cover 24 hours smoothly but for many it will only last for 22 hours. These influences of the basal insulin can result in strange I:C ratios or changing insulin sensitivity factors (ISF) over the day. Hopefully degludec will improve this situation.
That sounds hopeful..I think my basal runs out a lot more quickly than that sometimes and I think my liver and pancreas are still at work which may explain some of the fluctuations too.
Yes, They ( Co.'s & the Big Phrama) forse the Future in making $ is to sell to the Type 2's of the World ( there are at least 10x more of them , than Type 1's and Growing at the rate of over 8% a yr..
Cautiously Optimistic would be the Word..
Myself? I would Like to see the INSULIN PATCH come out- Just Like Anyother Transdermal Patch that will provide a Certain Amount of Basal Insulin ( Novalog) every Hour and be Alot Cheaper than Needing a Insulin Pump..( Costing over $8,000 now ) that very few can Get..
But, then again, It would Severely Hurt the sales of Insulin Pumps and All other Long Lasting Insulins ( that are not That Long Lasting, nor Consistant)
If one only needs 0.25 -1 Units of Fast Acting per Hour via a Pump? Why not Just use a Insulin Patch? and then they only have to either use a Insulin Pen for Bolusing for Meals/Snacks ? Thus Eliminating the need for the Far More Expensive Insulin Pumps and most other Insulins for most of us Type 1's and Many Type 2's as well..
Solo is working on such a Patch, but For some reason, it's Not Been Released yet, or will it be? Will Big Pharma buy it out and it's Patent and Keep it off the market?
I suspect it will and come up with some Excuse to cover their Rears about it not working..
And the New Insulin Pens and The Very Small Needles that go with it? Can't even Feel them.. For Type 2's? That only need from 1-2 injections per 24 hrs of Levimire Insulin?
Priceless ! Of course, Dr.'s Don't want Type 2's to Use Insulin Right Away.. It won't force most that are Obeise, to Control their Diets and Exercise 1st..
But most Don't and just run High BG's for the 1st 2-5 yrs in the Meantime..
Why does Santa have 3 Gardens? So he can Ho, Ho, Ho!
Environmental conditions and genetic factors will influence the blood supply of the skin and its layering. Thus it will be highly unreliable to absorb insulin through the skin. Insulin is far too complex to be absorbed that way. If insulin could get in then viruses and bacteria can also. The two shots of Lantus per day are no big deal in my opinion. To have an easy but unreliable delivery method like patches or inhalation is far more troublesome.
What do you think about the patch I linked to? I agree the two shots of lantus aren't a big deal at all, but unfortunately it just doesn't stay in the system reliably and evenly and you can't shut it off like a pump when you exercise etc. that is something I would like to be able to do, reduce my basal when necessary.
I think that this development is a blind alley. Reliability is not the only concern but dosing and quality management too. If you can not make sure how much insulin has been absorbed how should you make conclusions about future adjustments of your basal rate? How to handle different absorbtion profiles of different parts of the skin? A part under drag force will have a different amount of blood supply and will absorb differently. Will multiple patches be needed to adjust the dosage? How many patches to remove for sports? How many hours before the activity? Will the absorbtion rate change with sweating? Can the removed patch be reapplied again? In case a patch does not stick anymore is it safe to reapply a new one or will this cause an overdose? Lantus binds to fatty tissue, Levemir binds to albumin, Degludec is forming a complex multihexamer structure and blocks itself - these are reliable methods that will make sure that their performance can be measured experimentally and is reproducible for their user. Their blocking method starts to work after the injection. This is what makes the characteristic profile of these basal insulins. I do not have this high level of confidence in any patch applied human insulin.
That's interesting Holger, are you a scientist? you sound like one... I think you could be right about all of these issues... I thought it was interesting that at their website they mentioned that only 20% of insulin is required to be absorbed by any means, I think they meant injections and pumps as well as this patch... I was surprised by that... I may participate in trials for this though when they do that if possible.. so I will let everyone know if it works or not if I do, but I won't be throwing out my pens any time soon!
There is a patch in the works which is aimed at type 2 for basal but which they say will be good for type 1 also.. it uses ultrasound to get the insulin in. I'm not sure if this is more effective than previous attempts with patches. They are starting trials soon I think. I will look at the Solo patch, I don't think I have heard of that one yet.
Are you talking about the pens that are already out? I do have very fine needles but sometimes it still hurts quite a bit. I don't think I will ever be able to use a pump due to sensitivities/pain and I have concerns about malfunctions.
You might have also heard of the V-go
I think it is like Omnipod in that there is an infusion set to stick under your skin, and it sticks to your skin w/o tubing.
But it is a 24 hour pre-filled, preset basal rate, and on-demand bolus. The article indicates it is designed for T2, so I think the assumption is the T2 is still providing insulin to deal w/fluctuations and can handle the fixed basal from the pump.
The V-Go is for the continuous subcutaneous delivery of insulin in preset basal rates and with on-demand bolus dosing for adult patients requiring insulin. V-Go devices will be available in a preset basal rate to deliver 20, 30, or 40 Units of insulin in one 24-hour period (0.83 U/hr, 1.25 U/hr or 1.67 U/hr, respectively) and on-demand bolus dosing in 2 Unit increments (up to 36 Units per one 24-hour time period). The V-Go offers a simple way to deliver basal-bolus therapy.