# Side effects of analogue insulins?



## Catherine-louise (Oct 20, 2016)

Hello,
I don't post often but am a long time browser of this forum.

I'm a type 1 diabetic who has currently had an insulin pump for approx the last six years - pumping using NovoRapid for both background basal rates and also boluses.

I remember when I first went on an insulin pump, being in university and I remember thinking "gosh, my mind feels so foggy..." But just putting it down to the stress of studying at Uni.

Since then however the brain fog has only amplified along with a myriad of other symptoms. I am pretty much exhausted all of the time, despite getting a minimum of 8 hours sleep a night (the fatigue gets worse after meals). I temporarily go light headed and lose vision whenever I stand (my heart has been checked and I've been given the all clear). Heart palpitations/tachycardia. And I cannot go for more than an hour or so without eating. I can eat a big bowl of porridge with a chopped banana and bolus, but feel weak and shaky within an hour or so (despite my glucose levels being far from low, it almost feels like a hypo).

I have had blood test after blood test which has tested for vitamin deficiency, iron levels, thyroid and all have come back normal. I even cut out all wheat, gluten and dairy, increased my fluid intake, increased my salt intake (as advised by my GP) but still these symptoms seem to persist.

I am now at a stage where I am wondering if it is NovoRapid that maybe causing these symptoms. I am interested in maybe trying out a switch to a porcine or bovine (animal) insulin rather than an analogue insulin. Have any of you experienced similar problems with analogue insulins? I am really trying not to get my hopes up about an insulin switch solving all of my symptoms but even a slight relief from some of these debilitating symptoms would be wonderful.

Apologies for such a negative post. I look forward to hearing from some of you.
Cate


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## Radders (Oct 20, 2016)

Hi Cate, that sounds awful. Before you went on the pump what kind of insulin did you use? Might be worth trying a different insulin if the docs have ruled out everything else.
Hopefully someone who knows something more will be along soon...


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## Catherine-louise (Oct 20, 2016)

Thankyou for such a speedy response

I was diagnosed in 2002 and was put on Humamix, and then in 2003 I was switched to Humalog. I don't remember having any side effects, despite these also being analogue insulins.

I was then switched to a combo of Lantus/Glargine background and NovoRapid with mealtimes (these were injections).

And then I was placed on an insulin pump (which I adore and am very grateful for). So now I just use NovoRapid background and bolus (in the pump).

I seem to be ravenous all the time. I even wake in the small hours feeling like I need to eat, even though my blood is always usually above range. It's bizarre.
Cate


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## Pumper_Sue (Oct 20, 2016)

Have your cortisol levels been checked?
I use bovine neutral in my pump without a problem and many use porcine in pumps.


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## Catherine-louise (Oct 20, 2016)

I'm not sure if my cortisol levels have been checked. Would that be in with the routine bloods that GPs/consultants usually do? It's definitely food for thought and something to mention at my next appointment so Thankyou.

I did have a 24 hour urine sample taken last year, that came back normal also. 

That's really great to hear I could still use animal insulin in my pump. Do you mind me asking what made you choose an animal insulin or analogue? Had you previously been on an analogue type? Did you notice a big difference, or was there a big change in blood sugar levels? Was the transition okay? (Sorry for the twenty questions!)

Cate


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## AlisonM (Oct 20, 2016)

Have your thyroid levels been checked?


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## Catherine-louise (Oct 20, 2016)

Edit: the 24 hour urine sample was for to check for catacholomines (which was clear), and I've just checked and my cortisol levels have been tested a few months back. I haven't heard anything back so I assume they were normal. 
I am so stumped. 
-C


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## Catherine-louise (Oct 20, 2016)

Thyroid has been checked numerous times. GP tells me this is also normal. Are standard NHS thyroid tests accurate? I asked my GP for a more in depth one but she tells me that the TSH test is the standard.


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## Pumper_Sue (Oct 20, 2016)

Catherine-louise said:


> I'm not sure if my cortisol levels have been checked. Would that be in with the routine bloods that GPs/consultants usually do? It's definitely food for thought and something to mention at my next appointment so Thankyou.
> 
> I did have a 24 hour urine sample taken last year, that came back normal also.
> 
> ...


Hi Cate,
I tried synthetic insulin when it first came out back in the 1980's I have no hypo warning with it at all and refuse point blank to use it again. I've been on insulin for almost 52 year  My A1c is normally around  6.4% You just have to make sure you adjust your basal at least 2 hours before it's needed and bolus 30 mins before you eat.


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## Catherine-louise (Oct 20, 2016)

You have to adjust your basal two hours before its needed? 
So can you not set it to tick over automatically via the pump for example, I am automatically given 0.7 units of NovoRapid every hour? Does it not work like this with animal insulin?
-C


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## Catherine-louise (Oct 20, 2016)

Pumper_Sue said:


> Hi Cate,
> I tried synthetic insulin when it first came out back in the 1980's I have no hypo warning with it at all and refuse point blank to use it again. I've been on insulin for almost 52 year  My A1c is normally around  6.4% You just have to make sure you adjust your basal at least 2 hours before it's needed and bolus 30 mins before you eat.


Ps well done on such a great a1c!


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## Pumper_Sue (Oct 20, 2016)

Catherine-louise said:


> You have to adjust your basal two hours before its needed?
> So can you not set it to tick over automatically via the pump for example, I am automatically given 0.7 units of NovoRapid every hour? Does it not work like this with animal insulin?
> -C


Well if you have a basal pattern that is the same over a 24 hour period then yes fine but mine isn't flat.


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## Catherine-louise (Oct 20, 2016)

Oh I see, okay Thankyou. That's really helpful. 
-C


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## trophywench (Oct 20, 2016)

I'm gobsmacked also that your insulin profile is flat - I dunno if I've ever heard of anyone at all on a pump where that's the case?

When was your last basal testing done?


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## Catherine-louise (Oct 21, 2016)

Well, my basals were all over the place last year, I had lots of different basals. So when I told my diabetic nurse how I was feeling, she suggested starting me back on a flat basal rate and seeing how I went from there. Making adjustments accordingly. 
Cate


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## Lilian (Oct 21, 2016)

Catherine-louise said:


> Thyroid has been checked numerous times. GP tells me this is also normal. Are standard NHS thyroid tests accurate? I asked my GP for a more in depth one but she tells me that the TSH test is the standard.


What a load of rubbish.    Firstly you should get a opy of your result.   Normal just means you are within the range, optimal means you are a better place in the range for you.   Are you optimall?     There are other tests which should be done.   Antibodies, to find out if you have Hashimoto's.   This is an auto immune condition the same as type 1 diabetes and if you have one auto immune condition you can well have another.    The other tests are free T4 and free T3.    They rarely do free T3 but they should.   However a TSH is worthless without the Free T4.     This is going to be long sorry but my experience shows why just doing a TSH and it being normal does not mean you do not have hypothyroidism.      My TSH was right in the middle of the range and I was told I was normal and all my aches and pains, tiredness, IBS symptoms and many more were because I was depressed.     I went and had a private test done and it was found that my T4 was the lowest number in the range and the free T3 was below range.   T3 is the active hormone.  T4 is a storage hormone that converts to T3.   Your vitamin D and B12 (I think there are others too) should also be checked as if you are lacking in them it can stop the conversion.

Another experience which is really frightening.    The endocrinologist wanted a thyroid blood test done and my doctor did also.   I had two forms.    I decided that it would be better to do it all at once.   So they took two lots of blood.    When I went to see the endocrinologist he said I need more medication.   I asked for a printout of my results (as I always do) and the nurse printed them out for me.   She asked if I also wanted a copy of the results for the doctor.    I said yes.    Looked at one and presumed the other was the same.    When I went to see doctor he could not understand why the consultant wanted to increase the medication when according to the tests I was over medicated and needed to reduce it.    This puzzled me so when I got home I compared the two results.   It was dated the same day, same blood, and they should have had the same results but no, one said I was very high the other very low.   More scary is the fact that I told the consultant and my GP about this.   As I had not heard anything (whether I am having more or less) I phoned the lab and spoke to the HEAD lab technicial.    It took me 10 minutes for her to understand what I was talking about.   She kept telling me they must have been done on two different machines.   I said yes, I understand that, but both machines, even if different numbers should both show high or both show low.    She finally got it, although didn't give any indication that she was concerned.   She also had not heard from the consultant or the doctor about this.
She asked if I would like to be teststed again but did not see the sarcasm when I asked on which machine will it be tested on.    So neither consultant or doctor cared about the discrepancy, especially when it would affect my medication.   The lab technician gave a shoulder shrug over the phone (that is what she sounded like).    So how many people have been misdiagnosed, or given wrong mediction beforehand and how many after.  Maybe it is still happening.    I do not trust the TSH anyway.    It is NOT a thyroid hormone test, TSH is a pituitary hormone.


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## Catherine-louise (Oct 21, 2016)

Oh Gosh, this scares me. It really does. And a quick Google search reveals so many similar stories. 

I am beginning to have so little faith in our NHS Doctors. I didn't want to mention to my GP that I had read so many similar stories on the net about people being misdiagnosed. Silly I know, so I told her a 'friend' had been misdiagnosed because of the THS test and to ask for a more in depth thyroid panel to be done and she just shrugged and said 'no, there are no other thyroid tests, the TSH is the standard'. And I got the impression she was a little frustrated at me questioning this so I refrained from pursuing it any further. 

How can I get a more in depth test done? I have emailed my nurse and ask her to ask my consultant if I can have a more in depth thyroid screen done, but haven't heard anything back. Are these tests only available privately and if so how much do they cost and where can I get this test done? 

I am simply despairing at these symptoms now. After six years, I just want my life back. Thankyou for all of your suggestions on this thread, it is much appreciated. I don't even know where to begin to try and 'fix' whatever it is that seems to be broken. I'm clueless.


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## Catherine-louise (Oct 21, 2016)

I've had a look at the last two blood tests I've had done. TSH levels were 1.2 and then a few months later 1.5. Can anyone help me interpret these or are they pretty much useless pieces of info without the other lab results from T3, T4 etc?


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## Lilian (Oct 21, 2016)

If you join www.tpauk.com or thyroid.uk you will be able to find out from them the place where to get a private blood test.   They both have discounts on them.   I am not sure whether you have to be a paid up member of thyroid.uk to get that information.    tpauk information is free.    Do NOT go to British Thyroid Association/Foundation.    They are the ones encouraging the doctors not to do any more tests other than the TSH and if you do not get on with levothyroxine then it is all in your mind.    Just as doctors have been told that human insulin (synthetic) is just as good as animal insulin and they do not even offer animal insulin and completely discourage it.    I remember years ago Diabetes UK (I think it was called the Diabetes Society then) tried to fight to keep animal insulin available.   The succeeded in getting people who were already using it to be able to carry on using it, but any newly diagnosed diabetic was put on human insulin regardless.   This is a bit like the thyroid situation.     Have you also had your B12 tested as that can cause similar symptoms as well.   However there again the rule is an injection every three months whether you need them closer together or not.  So there seems to be a pattern here.    They are trying to save money on people with chronic conditions, not by being up front and honest about it, but trying to convince everyone that there is no need for extra or difference (more expensive) medication, and tell patients who complain of symptoms that it is all in their head and will offer anti depressants out like sweeties.   I think the pharmaceutical companies have a hand in this too.    By keeping patients sick they are keeping customers.   They do not want to cure as that loses a customer, same as they want to keep them alive - but just.     If they keep someone who has many symptoms without the correct medication then the doctor prescribes so many more tablets to counter act each and every symptom.    So instead of one pill which might cost £10 you get 12 pills for the symptoms costing only £1 each.    Doctors think they are saving money because they are prescribing such cheap medicine and not prescribing the dear one.    One word of advice, keep copies of all your test results.   

Yes the tests are a bit expensive and it is better to get the full test plus B12 whilst you have the blood because it also costs to get it drawn at a private hospital.    NHS wont do it for a private doctor.   Also you have to give a practitioners name on the forms, both tpauk.com and thyroid.uk allow you to put their name as your practitioner, but the results go back to them and they have to forward them on to you.    Just like this forum they are knowledgeable about their own subject (thyroid).    Although you can be a free member of  Thyroid.uk they make a charge to be a full member and I do not know whether you have to be a full member to get the discount on tests.    tpauk.com do not charge anything at all to be a member and all members get the same discounts etc.

I too am wary of the medical profession.     Sorry it is a long one again.


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## Catherine-louise (Oct 22, 2016)

Wow, that's really helpful. Thankyou. So it definitely isn't available on the NHS? I'm unsure whether I would be able to afford private testing at the moment. 
Cate


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## Lilian (Oct 22, 2016)

Catherine-louise said:


> I've had a look at the last two blood tests I've had done. TSH levels were 1.2 and then a few months later 1.5. Can anyone help me interpret these or are they pretty much useless pieces of info without the other lab results from T3, T4 etc?


First of all you should also get the reference range with them because say 2 in a range of 1 - 500 would be rather low but 2 in the range of 1 - 4 is not too bad.      I think it depends a lot on your symptoms.   People usually feel better when the figure is about 1 and if your T4 is in the upper quarter in its range then it could be something else, but without the Free (not total) T4 and preferable Free T3 as well you are not getting the full picture.     They will sometimes do antibodies if they are asked but a lot of doctors feel there is no point because they treat both the same anyway.

With TSH the higher it is the more hypothyroid you are, with T4 the higher it is the less hypo you are (same with T3)   Ideally both T4 and T3 should be in the upper quarter of their range and your TSH 1 or below within range.  Although the top of the range is about 5 or 5.5 or even 6 on some machines, a lot of doctors will leave it to 10 before they will treat on first diagnosis.


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## Lilian (Oct 22, 2016)

Catherine-louise said:


> Wow, that's really helpful. Thankyou. So it definitely isn't available on the NHS? I'm unsure whether I would be able to afford private testing at the moment.
> Cate


Well yes you can get them tested on NHS but mostly it is when you have a problem and an endocrinologist asks for them.  They do not do it for doctors.    However there is a bit of a post code lottery here.   You will find they are more likely to do it if you live in parts of Yorkshire and parts of the Lake District.    Actually Thyroid UK and tpauk.com have a list of doctors (private AND NHS) who are more knowledgeable and have been known to take T3 into account and even prescribed it.   Where I live in Essex there is no chance of them testing T3.    I have been taking T3 now for 16 years, first from a private doctor and then I buy it myself from America.   

After 12 years of doctors and consultants raging at me that I must stop, but never doing a T3 test, they finally did a T3 test and found I did need it and I had it prescribed.    Just recently the pharmaceutical company has put the pills up from about £30 a packet to hundreds of pounds a packet.    As the NHS cannot afford this they are now stopping prescribing it.   But how can you tell a patient who has been made well on it (like I have) that they are going to take it away and make them ill again.   Not very ethical.    So they come up with every reason they can think of why you do not need it and one of the ways is that they do not do the test.   

If they do not do the test there is no way of knowing whether that is what you need or not.    But then when I showed me GP the results of the private test that my T3 was below range, she said that they do not take any notice of T3.   Well that is like telling a diabetic that they take no notice of insulin.    I had some terrible symptoms and I think I was on the border of myxodema coma and was slowly dying.    So I have been buying my own medicines for 16 years so far.    I have to buy it from abroad as it a prescription medicine and they wont give me a prescription, unless I get a private prescription, but as I can get it without the prescription, and it is dear enough anyway than pay extra to a private doctor, I just order it myself.   Fortunately it is cheaper from abroad than the NHS are being charged from the UK company.   Although after 12 years it was prescribed it was nowhere near enough so I still had to supplement it.   But it has kept me well with all the major symptoms gone and I would rather give up a holiday to be well all year round and anyway I could not enjoy a holiday whilst I had the symptoms.     

I was recently referred back to endocrinologist because GP wants him to say whether she can carry on prescribing T3 but he is one that does not want me to have it.    He tells my doctor I am over medicated because TSH is very low, but the T4 is still in the lower half of the range and he has not done a T3.     The T4 should indicate I am not over medicated and I have no hyper symptoms, but they want to stop prescribing the T3 and they have to justify it somehow.    If they say I am over medicated so will stop the T3 I shall ask why not stop the levothyroxine instead and see what they say to that.    

.


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## Catherine-louise (Oct 22, 2016)

Oh wow, that is shocking. So awful. I don't even know where to begin with getting this checked out then. I really need to find a Doctor who is on side (needle in a haystack springs to mind). 

(According to my blood results the normal TSH range is between 0.30-6.00). So would that suggest 1.2-1.5 as being at the lower end of the scale?

Thankyou for your help. You're obviously very informed on this.


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## Catherine-louise (Oct 22, 2016)

I wonder if my diabetes consultant might be inclined to check these levels? I think she also specialises endocrinology. I am really hoping I can get her on side.


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## mikeyB (Oct 22, 2016)

Catherine-louise said:


> I've had a look at the last two blood tests I've had done. TSH levels were 1.2 and then a few months later 1.5. Can anyone help me interpret these or are they pretty much useless pieces of info without the other lab results from T3, T4 etc?


The first thing to say is your TSH measurements are perfectly normal. In answer to your second question, No it is not a useless piece of information, and you have no worries about your thyroid, which has absolutely nothing to do with your originally reported symptoms. How this discussion became obsessed with the thyroid I have no idea, but you can forget all about it. Please don't spend any money on private tests, you would be wasting your money.

In answer to your perfectly reasonable question right at the start of this thread, your symptoms started as soon as you went on the pump. So before you go delving into the depths of body biochemistry, any reasonable person would associate your symptoms with that change. Analogue insulins are all slightly different. It seems likely that you are reacting to that insulin because your symptoms seem to be worse after eating, that is, after a bolus. So if your symptoms worsen after a bolus, it is odds on that it is the insulin causing the problems, and a change of insulin, possibly  to an animal insulin, might make all your symptoms disappear. Discuss this with your diabetes nurse or GP. Don't worry about having any other condition that doctors can't find, it strikes me as being blindingly obvious that should be the first thing to do, so please sort this out with your doctor, and let us know how you get on.

All the best


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## Catherine-louise (Oct 22, 2016)

Thankyou, I've emailed my diabetes nurse re; switching to animal insulin, so fingers crossed. 
Cate


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## mikeyB (Oct 22, 2016)

I'm just up out of bed correcting an unexpected hypo

Sorry if I sounded a little stern, Cate, but I thought you might be getting worried about stuff unnecessarily. If your symptoms persist after the change, just shoot me


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## Catherine-louise (Oct 22, 2016)

No it makes absolute sense. I do find myself getting overwhelmed and mentally going down all sorts of avenues; thyroid, food sensitivities, vitamin deficiencies etc, the list is endless! 

A trial insulin switch would absolutely make sense as the first place to begin. 

Thankyou 
-C


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## Lilian (Oct 22, 2016)

Catherine-louise said:


> Wow, that's really helpful. Thankyou. So it definitely isn't available on the NHS? I'm unsure whether I would be able to afford private testing at the moment.
> Cate


Get the list of doctors from  tpauk.com and see if any are near you on the NHS, or within the distance you are prepared to travel.    You cannot be referred to that particular doctor but to the hospital but there are ways of making sure you do see that doctor, although it might take a longer time.   The forum members will tell you how to do it.


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## Lilian (Oct 22, 2016)

Of course Mike is right (trust a man to bring logic into it).   First things first.


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## Catherine-louise (Oct 22, 2016)

Thanks Lillian. You've definitely given me a lot of food for thought! 
Cate


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## CosmicHedgehog (Oct 22, 2016)

Catherine-louise said:


> Hello,
> I don't post often but am a long time browser of this forum.
> 
> I'm a type 1 diabetic who has currently had an insulin pump for approx the last six years - pumping using NovoRapid for both background basal rates and also boluses.
> ...


I don't have any answers. But i am following this thread with interest. It could have almost been me writing the same thing you did. I feel exactly like what you have described. I'm also pumping with novo rapid and have been on a pump for six years. As i said i cant really help, but i sympathise massively with you. Hope we can both find some answers xx


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## Catherine-louise (Oct 23, 2016)

Will keep you informed. I am going to telephone my nurse tomorrow.
Cate


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## Pumper_Sue (Oct 23, 2016)

Catherine-louise said:


> Will keep you informed. I am going to telephone my nurse tomorrow.
> Cate


You will be told it isn't available or it's going to be discontinued and or it doesn't work in pumps


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## mikeyB (Oct 23, 2016)

Yes, that is the standard line, but  Wockhardt UK will supply it, and are apparently committed to do so for the foreseeable future. And you could stick any insulin into a pump, as you know Sue.


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## trophywench (Oct 23, 2016)

....... or - you could just swap it to Humalog or Apidra both of which are freely available on the NHS and would cause no major problems getting them and of course every one has a different recipe and totally different ingredients so if you don't react well to one it doesn't necessarily mean you'll react badly to them all.

After all - after being on Porcine insulin for 15 years it stopped working on me!  They used to just swap you to Bovine or vice versa cos it was reasonably common for it to happen apparently, but anyway they'd invented the new ones by then so they swapped me straight over.  I personally (or rather my own body doesn't, I personally am quite willing LOL) don't get on at ALL well with any Humulin products or Lantus - and look at how many thousands of folk do perfectly OK with either !

I'm just thinking - we all know very well if you do actually need Animal insulin - you definitely do have to jump through hoops - so before doing it, it's probably fairer to your own body/brain and everyone else involved in your care to show them that you definitely DO ?


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## Northerner (Oct 23, 2016)

Catherine-louise said:


> Will keep you informed. I am going to telephone my nurse tomorrow.
> Cate


Good luck Cate


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## grovesy (Oct 23, 2016)

Good luck!


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## Catherine-louise (Oct 23, 2016)

Pumper_Sue said:


> You will be told it isn't available or it's going to be discontinued and or it doesn't work in pumps



Oh no!  Any idea what I should be saying if I do get fed this line?


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## Catherine-louise (Oct 23, 2016)

trophywench said:


> ....... or - you could just swap it to Humalog or Apidra both of which are freely available on the NHS and would cause no major problems getting them and of course every one has a different recipe and totally different ingredients so if you don't react well to one it doesn't necessarily mean you'll react badly to them all.
> 
> After all - after being on Porcine insulin for 15 years it stopped working on me!  They used to just swap you to Bovine or vice versa cos it was reasonably common for it to happen apparently, but anyway they'd invented the new ones by then so they swapped me straight over.  I personally (or rather my own body doesn't, I personally am quite willing LOL) don't get on at ALL well with any Humulin products or Lantus - and look at how many thousands of folk do perfectly OK with either !
> 
> I'm just thinking - we all know very well if you do actually need Animal insulin - you definitely do have to jump through hoops - so before doing it, it's probably fairer to your own body/brain and everyone else involved in your care to show them that you definitely DO ?


You do have a point. And I don't recall having many symptoms when I was first diagnosed and was on Humalog. Although it was an awful long time ago. 

I am just so desperate to get my life back that I am almost afraid to try another analogue insulin for fear of wasting anymore time. It has been six years since I have felt well or had some form of life without these symptoms. 

Do I take the risk and go for another analogue or stick to wanting to try porcine? 

I'd love to hear from others who have successfully tried porcine insulin and noticed an improvement in their general wellbeing? 
Cate


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## Catherine-louise (Oct 23, 2016)

Pumper_Sue said:


> You will be told it isn't available or it's going to be discontinued and or it doesn't work in pumps


When I first mentioned possibly changing insulins a few months back, my nurse glossed over it and said that insulins don't usually offer any side effects other than hypoglycaemia. So I am expecting some form of resistance from my health care team. 
C.


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## Pumper_Sue (Oct 23, 2016)

Catherine-louise said:


> Oh no!  Any idea what I should be saying if I do get fed this line?


Tell her pumps were in use before synthetic insulin was invented. Also the government has said animal insulin must remain available in the UK.


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## grovesy (Oct 23, 2016)

It is still listed on Wockharts website!


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## Pumper_Sue (Oct 23, 2016)

grovesy said:


> It is still listed on Wockharts website!


I should ruddy well hope so as many thousands all over the world use it, me included


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## mikeyB (Oct 23, 2016)

Blind your diabetes nurse with science. Say that you are allergic to the E Coli traces in synthetic insulin. Or the yeast traces in Humalog. They are definitely different in their molecular form, so a switch to Humalog might work, but my hunch is that an animal insulin would be better, because your body is more likely to ignore it. Don't take no for an answer. Loads of people worldwide can't tolerate analog insulins. My mum hated the stuff, completely lost hypo awareness.


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## Pumper_Sue (Oct 23, 2016)

When the flat refusal comes it normally means they know nothing about animal insulin and have no intention of getting off their articles to find out. 
When I met an Endo about 7 years ago it was due to an emergency admission for a Addison's crisis, I saw him a few weeks later in an outpatients clinic he said he had never prescribed it before or had any patients on it so would I kindly tell him about it. He then proceeded to write it all down so he could follow it up. Others throw their hands up in horror at such old fashioned treatment, because they know nothing about it this in their eyes equals non compliant on my part.


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## Catherine-louise (Oct 23, 2016)

Gosh, it's frightening how ignorant they seem to it all. I hope they are a little clued up on how animal insulin works in the pump otherwise I am way out of my depth to take it upon myself to use it without their guidance. 

I think I will definitely push for the animal insulin switch. Im a little worried that I may react badly to it, I've never used animal insulins before. How likely is an allergic reaction to porcine? Or is there a way I can start slowly and gauge any reaction to it in good time? (This may be me being overly cautious, just don't know what to expect). 
C.


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## Pumper_Sue (Oct 23, 2016)

Catherine-louise said:


> Gosh, it's frightening how ignorant they seem to it all. I hope they are a little clued up on how animal insulin works in the pump otherwise I am way out of my depth to take it upon myself to use it without their guidance.


It's very simple to use you just bolus 30 mins before you eat and set your basal at least 2 hours before it's needed as I explained to you before


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## Catherine-louise (Oct 23, 2016)

Ok brill. I can't wait to get the ball rolling now!


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## SB2015 (Oct 23, 2016)

Reading through this thread, it still seems that you need to do some fasting tests to find out what profile you need for your basal rate on yr pump.  I do not know anyone on a pump who does not have some changes in the rates through the 24 hours.  Until these are sorted it is very difficult to get anything else right.

Once you have an appropriate insulin to use in your pump, get the rates sorted.  Then focus on other ratios.  It takes a bit of work but it will be worth it.


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## Northerner (Oct 24, 2016)

Pumper_Sue said:


> It's very simple to use you just bolus 30 mins before you eat and set your *bolus* at least 2 hours before it's needed as I explained to you before



Presuming you meant 'basal' there, Sue?


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## Pumper_Sue (Oct 24, 2016)

Northerner said:


> Presuming you meant 'basal' there, Sue?


Oops yes, good spot have edited the post thank you.


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## Catherine-louise (Oct 24, 2016)

Morning All,
Just phoned and spoke to my diabetes nurse, she was surprisingly on board. She says she doesn't think switching over insulin will make much difference to the way I feel but that she will speak to my consultant, and if she is willing to allow me to try porcine, get a prescription sent over to my GP surgery. She said she realises that unless I've tried changing insulins to see if it makes a difference that I won't be able to put my mind at rest. She really sounded like she thought it wouldn't make much difference.

Still, just got to wait to hear back now! Fingers crossed!!


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## grovesy (Oct 24, 2016)

Good luck, hope it works if not at least you tried!


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## mikeyB (Oct 24, 2016)

Well done Cate. Fingers crossed


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## Pumper_Sue (Oct 24, 2016)

Catherine-louise said:


> Morning All,
> Just phoned and spoke to my diabetes nurse, she was surprisingly on board. She says she doesn't think switching over insulin will make much difference to the way I feel but that she will speak to my consultant, and if she is willing to allow me to try porcine, get a prescription sent over to my GP surgery. She said she realises that unless I've tried changing insulins to see if it makes a difference that I won't be able to put my mind at rest. She really sounded like she thought it wouldn't make much difference.
> 
> Still, just got to wait to hear back now! Fingers crossed!!


That does sound promising. Remember to change your insulin duration on the pump, you will need 6 hours at least some people need more.


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## Catherine-louise (Oct 24, 2016)

Pumper_Sue said:


> That does sound promising. Remember to change your insulin duration on the pump, you will need 6 hours at least some people need more.


Well I said to her 'how does it work? Will I have to make sure my basals are set two hours before they are due to kick in? With it being a little slower acting than NovoRapid?' And she said 'no, no, you use it pretty much the same way as NovoRapid...' Hmmm... Anyway, see what the consultant reports back with! I'm so hoping I can give it a try before the end of the week! 
C.


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## Pumper_Sue (Oct 24, 2016)

Catherine-louise said:


> Well I said to her 'how does it work? Will I have to make sure my basals are set two hours before they are due to kick in? With it being a little slower acting than NovoRapid?' And she said 'no, no, you use it pretty much the same way as NovoRapid...' Hmmm... Anyway, see what the consultant reports back with! I'm so hoping I can give it a try before the end of the week!
> C.


I can assure you the dsn is wrong, but who you choose to believe is entirely up to you


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## Northerner (Oct 24, 2016)

This is quite a handy wallchart of all available insulins:

https://www.diabetes.org.uk/Documents/Magazines/Insulinwallchart.pdf

Although I have to say, I use Novorapid and it takes 15mins-1hour to get working for me - I hardly ever inject just before eating! I suppose like anything to do with diabetes you use the guidelines at first, then adapt to your own experience


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## trophywench (Oct 24, 2016)

I've no idea what I was told to do with Novorapid, it's been that long.  But fine, do what you're told - and only change it if it doesn't work.

Except in this particular case - I would be guided by Sue, for the simple reason that since jabbing in plenty of time before eating absolutely WAS what we all had to do when we all used animal insulin - the rest of what she says does makes total sense!


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## Pumper_Sue (Oct 24, 2016)

Animal insulin takes 30 mins to start working and peaks a couple of hours later and all people using animal insulin start the basal change at least two hours before needed some go a bit more. if you try doing as your dsn says you will end up in big trouble


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## Catherine-louise (Oct 24, 2016)

She only said it in passing comment, so I'm expecting her to come back with different instructions once she has spoken properly to my consultant. I'll keep you informed. 

She also said 'I'm not sure they even make animal insulin anymore, but I will speak to your consultant and get back to you...' I'm intrigued to know just how many people in my health care catchment area actually use animal insulin, it doesn't sound like many, judging by my nurse's knowledge of it. 
Cate.


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## Northerner (Oct 24, 2016)

Northerner said:


> This is quite a handy wallchart of all available insulins:
> 
> https://www.diabetes.org.uk/Documents/Magazines/Insulinwallchart.pdf
> 
> Although I have to say, I use Novorapid and it takes 15mins-1hour to get working for me - I hardly ever inject just before eating! I suppose like anything to do with diabetes you use the guidelines at first, then adapt to your own experience


I've been informed that this is out of date and that some products listed are withdrawn or defunct. However, for those that are extant, and being prescribed, it still holds relevance


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## mikeyB (Oct 24, 2016)

Well, they do make animal insulin, and will do for years to come. You always get this kind of reaction with rare prescriptions, whatever they are. I think I'm the only person on the island taking Creon, so neither doctors or nurses are familiar with dosing, which I learned from the pancreatitis forum.


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## grovesy (Oct 24, 2016)

mikeyB said:


> Well, they do make animal insulin, and will do for years to come. You always get this kind of reaction with rare prescriptions, whatever they are. I think I'm the only person on the island taking Creon, so neither doctors or nurses are familiar with dosing, which I learned from the pancreatitis forum.


I looked on Wockharts website yesterday and they still have both bovine and porcine Insulin's listed!


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## Pumper_Sue (Oct 24, 2016)

> Well, they do make animal insulin, and will do for years to come. You always get this kind of reaction with rare prescriptions,


The prescription isn't that rare because the company would not be viable for half a dozen people


grovesy said:


> I looked on Wockharts website yesterday and they still have both bovine and porcine Insulin's listed!


Obviously they still make it as I use it and not washing up liquid in my pump


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## Radders (Oct 24, 2016)

Pumper_Sue said:


> Animal insulin takes 30 mins to start working and peaks a couple of hours later and all people using animal insulin start the basal change at least two hours before needed some go a bit more. if you try doing as your dsn says you will end up in big trouble


I thought changing the basal 2 hours before was standard for analogues?


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## Pumper_Sue (Oct 24, 2016)

Radders said:


> I thought changing the basal 2 hours before was standard for analogues?


I have no idea what is right or wrong I know many change 1hour before needed and many change at the 2 hour mark.


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## Peter1947 (Oct 24, 2016)

Northerner said:


> I've been informed that this is out of date and that some products listed are withdrawn or defunct. However, for those that are extant, and being prescribed, it still holds relevance



Yes its ten years out of date. Diabetes UK revised the chart in 2012. But even so the 2012 one is slipping out of date e.g no mention of Tresiba or Toujeu.

Here is the 2012 revision ...Please don't post the 2007 version again !
https://www.diabetes.org.uk/upload/Professionals/Publications/Wallcharts/WallchartInsulins.pdf


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## Catherine-louise (Oct 31, 2016)

Well today is change-over day!

Both my consultant and my nurse agreed to the switch over with no resistance whatsoever, which I was so grateful for. They faxed over a prescription to my local GP and I had the prescription by Friday (a total of 5 days since I'd asked to switch over, they were really efficient, which again I was so appreciative for).

So my nurse has emailed me over my new basal rates and told me to start this morning so that she is on hand at the other end of the telephone to advise. I am so grateful for her support. I told her I was worried I might have an adverse reaction to the new insulin, with it being so different to the one I've been on solidly for 6 years +. But she told me that if she thought I might react badly in some way, she wouldn't have agreed to the switch.

So here I am, sat waiting for it to kick in - I have no idea what I am expecting to feel, or to even happen. But I shall keep you informed! Thanks for all of your support and input over the last week,
Cate


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## grovesy (Oct 31, 2016)

Good luck and hope it goes well!


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## Northerner (Oct 31, 2016)

Good luck Cate, I hope that it works out really well for you


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## mikeyB (Oct 31, 2016)

Fingers crossed, Cate. I truly hope this does the trick for you


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## Pumper_Sue (Oct 31, 2016)

@Catherine-louise I hope you have remembered to change your insulin duration otherwise you will run into trouble with hypos.


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## Rosiecarmel (Oct 31, 2016)

Fingers crossed for you! I've not commented on this thread but have been reading it with interest. I hope it works out for you. Do let us know how you get on


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## Catherine-louise (Oct 31, 2016)

Pumper_Sue said:


> @Catherine-louise I hope you have remembered to change your insulin duration otherwise you will run into trouble with hypos.


Yes, I've been told by my nurse to change the duration to 5 hours, does that sound about right?
Cate


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## Pumper_Sue (Oct 31, 2016)

Catherine-louise said:


> Yes, I've been told by my nurse to change the duration to 5 hours, does that sound about right?
> Cate


No it's not right, it should be the minimum of 6 hours and possibly up to 8 hours for some people. Your nurse is working on the analogue insulin duration.


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## Catherine-louise (Oct 31, 2016)

Oh I wonder why she's said that then. 
Mine is Hypurin Porcine Neutral, is that the same as yours?

I will email her now and double check,
Cate


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## Pumper_Sue (Oct 31, 2016)

Catherine-louise said:


> Oh I wonder why she's said that then.
> Mine is Hypurin Porcine Neutral, is that the same as yours?
> 
> I will email her now and double check,
> Cate


https://www.diabetes.org.uk/Documents/Magazines/Insulinwallchart.pdf the information is freely available and your dsn should have checked if she didn't know.


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## Catherine-louise (Oct 31, 2016)

Ugh! I have been into town today with my Mum and walking around shops for an hour and a half and it has been one hypo after another, I feel absolutely ghastly and so exhausted and weepy :'( 
I don't know whether to decrease my afternoon basal rates or my carb ratios/boluses with lunch? 

Cate


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## grovesy (Oct 31, 2016)

Oh sorry to here this!


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## Catherine-louise (Oct 31, 2016)

I think I just really need to do some adjusting with the amount of insulin I need. 

The good news is that I don't feel like my sugars are adjusting up and down quite so rapidly. I feel like it isn't quite as 'harsh' as what NovoRapid was. 

Will keep you informed. Just a few teething problems, as to be expected on first day I suppose


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## mikeyB (Oct 31, 2016)

Catherine-louise said:


> Ugh! I have been into town today with my Mum and walking around shops for an hour and a half and it has been one hypo after another, I feel absolutely ghastly and so exhausted and weepy :'(
> I don't know whether to decrease my afternoon basal rates or my carb ratios/boluses with lunch?
> 
> Cate


Cate, that's horrible, but don't panic, that can happen to anybody starting on a new regime. The reason is clearly too much insulin, but it could be either the bolus or the basal rates. You'll have to talk to the nurse again. It would be wrong to use the same rates as you did with the other insulin because if the theory that your body was reacting against the other insulin is correct, it would not be working efficiently. My instinct would be to say reduce the basal, for sure, and it wouldn't do you any harm to reduce your bolus for your evening meal, say by 20% for now. I'm sure Sue will see your post and advise you with more certainty. You may have to go through the routine fasting establishment of your basal rates on the new insulin.

With all that going on, it would be a daft question to ask if your other symptoms are any better.


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## Pumper_Sue (Oct 31, 2016)

I would suggest you reduce all of your basals by at least 20% and if you didn't change your duration of insulin that certainly wont help. Animal insulin also kicks hard at the 6 hour mark as well so you need to factor that in.

You need to do a lot of basal testing as animal insulin is a completely different ball game to analogue insulin.


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## Catherine-louise (Oct 31, 2016)

Thankyou both of you for your support. It's so nice to have somewhere to come where other people know exactly what it feels like. 

I'm glad I've experienced a hypo (or many hypos!) on porcine insulin. I was intrigued to know if there would be any difference in hypo symptoms. The hypo symptoms didn't pack quite as much punch as the NovoRapid hypo symptoms. In fact I was walking in town and felt that familiar low blood sugar feeling and when I tested it was 3.3mmol. Normally on NovoRapid, I would feel hypo at anything under 5.0mmol. It's certainly quite fascinating, getting to grips with it all.

My pre-meal blood sugar before my evening meal was 8.8mmol. I was expecting a rebound high reading after my hypos this afternoon. That's what usually happened on Novorapide. But I was very pleasantly surprised this evening on Porcine 
Cate


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## mikeyB (Oct 31, 2016)

I'm so, so pleased that you can find it fascinating after the torture you've had all this time. It will be interesting for you to get it sorted. It's a bit like getting a vintage Bentley after driving round in a Lamborghini


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## Catherine-louise (Oct 31, 2016)

Haha that's a funny analogy! I like that! 
-C


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## Brendan Hyland (May 31, 2018)

Cath, how did you get on? Any new updates?


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## everydayupsanddowns (May 31, 2018)

Brendan Hyland said:


> Cath, how did you get on? Any new updates?



Unfortunately the poster hasn't been seen since 2017, and this thread is a year older than that


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