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During my outpatient clinic last week, I was queried about the “untethered regimen” in which the person with diabetes uses both Lantus and the insulin pump. I have heard Dr. Steven Edelman (an adult endocrinologist and person with type 1 diabetes) talk about this regimen in person and in a diabetes conference.
What is it? The “untethered regimen” is such that Lantus is given as an injection to provide approximately 75 percent of basal insulin with the remainder (25 percent) given by the pump. The pump continues to provide bolus insulin for correction and carbohydrates. Generally, most diabetes healthcare providers recommend either insulin pump therapy OR multiple daily injections with Lantus once (or occasionally twice daily) or Levemir (twice daily or occasionally once daily) along with rapid acting insulin for boluses to avoid confusion. Most feel that it is hard enough using one regimen rather than making one’s insulin regimen even more complicated by ...
Isn’t it funny when a mistake leads you to discover something beneficial? I had this happen to me last week and thought I’d share, so other can benefit from my “mistake”. (Note: My doctor has given me the green light to make these changes to my dosing without his consultation. Please check with your doctor before changing the timing or dosing of your insulin.)
Typically I give myself two injections of Lantus daily: one at bedtime (usually around 10:00 p.m.) and another with breakfast (between 6:30 and 7:00 a.m.) One morning, I realized I forgot my morning Lantus dose and ended up giving it to myself at 10:30 a.m. Later that day, I noticed the Dexcom didn’t show the gradual rise of my blood sugar in the late afternoon to early evening period that I was getting used to seeing. Maybe the timing of the Lantus dose had something to do with it?
I decided to test the theory and try giving the second daily do...
In 2009, there was much ado about the possible correlation between glargine and cancer in people with type 2 diabetes. Several studies published in Diabetologia indicated a relationship between different types of cancer and glargine. Therefore, investigators developed prospective studies to prove whether or not there was a causal relationship. The latest evidence- based literature has not demonstrated a causal link between glargine and cancer. This lack of relationships with specific cancers has clearly reduced anxiety regarding the potential effect of glargine on cancer. However, there have been concerns focusing on breast cancer, particularly with longer exposure to insulin. Keep in mind that there is a clear association between diabetes and the incidence of cancer that is not completely understood. Some sources include insulin resistance and obesity, age and smoking. Because glargine is the most commonly prescribed formulation of insulin, its safety is extremely important to ...
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