# Question re insulin types??



## Ndel (Mar 1, 2012)

I am trying to get my HBA1C on track so over the next year or so i can try to get pregnant.

However, i had my clinic appointment this morning, and after being told a few months ago by the diabetic nurse that they might change me to lanuts from levemir at my hospital appointment this morning (as they said lantus lasts 22 hours and levemir only lasts 12,news to me), the doctor then told me that he was NOT changing me from levemir to lantus as there was no point as "they" (the experts) are not sure if its safe to use either levemir or lantus when pregnant.

is this true? first i have heard of it. He said whem im TTC that he will change me to insultard. Anyone had this said to them before?? or am i behind on things??

This is a new doctor as my old one who i have had since diagnosed 20 years ago has retired. So im just a bit weary.

Going to ring my diabetic nurse when shes back in on monday and ask her as she seems to know more than any of the doctors.

Thanks
Noelle


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## Natalie123 (Mar 1, 2012)

Never heard this before Noelle! Hopefully one of the pregnant ladies / mums will be around soon. Make sure you get a second opinion from your nurse.


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## RuthieG (Mar 1, 2012)

*Lantus*

Hi

I am now 18 weeks pregnant and before conceiving was quite happily injecting novarapid along with Lantus. I have very recently gone onto a pump but prior to that I had no problem with Lantus and certainly nobody mentioned that there was any issue with it being any risk to he pregnancy or the baby. I don't have any experience of levemir sorry.

So far I have found the pregnancy/diabetes balance a bit hard work but not too bad really and am counting down the days to my 20 week scan to check up on the baby.

It is really important for your own piece of mind to get as good control before you conceive because of all the worrying things there are to think about once you conceive, so to know you had done the best you could beforehand will give one less thing to be worrying about or feeling guilty about!

All the best

Ruthie


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## trophywench (Mar 2, 2012)

Neither Levemir nor Lantus are licensed for use in pregnancy.  They can hardly do clinical trials on pregnant women, can they?

Some hopsitals know that both the L's actually work OK, and loads of ladies get left on the insulin they are on, NP.  Other hopsitals will let you stay on them if you feel your control is good and now ain't the time to change, but may want you to sign a disclaimer to say you can't sue em if the insulin causes problems.  I've known ladies do that too.

Other hospitals simply won't risk it under their care because (it seems to me) they are more scared of being sued than anything else (IMHO)

Levemir is supposed to be taken in 2 jabs by the way and if you haven't got great control on one jab, that could be a fairly large part of the problem - the less of it you take when compared per kg of body weight, the faster it will run out but it's generally reckoned the max is around 16 hours.

I've had the nurse at my GPs surgery tell me is does last 24 hours but no consultant or proper DSN I have ever spoken to, agrees with that assertion, and Nursie Nightshade has been entirely wrong about quite a bit of other stuff too along the years.  I generally say Yes and mean No ....

Finally a girl on my other forum had to change from Lantus to Insulatard for her first pregancy - he's 3 now and she's currently 30-odd weeks along with baby no. 2 - conceived and still cooking happily on 2 jabs of daily Levemir that she changed to, after she gave birth to no. 1 son .....


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## Emmal31 (Mar 2, 2012)

First I have heard of it I have used lantus since being diagnosed 4 years ago and wasn't told anything about it not being safe to use during pregnancy.I had my little one just over 2 years ago now. Sounds like a good idea to ring your diabetic nurse, I would be interested to know what she says.


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## Monkey (Mar 2, 2012)

Yup, what trophywench said - I'm sure I was told that there are no clinical trials regarding use of lantus (and I presume levemir) in pregnancy, but there are clinical trials on relatively few drugs in pregnancy anyway! 

FWIW, I used lantus throughout my pregnancy. In fact, I actually took it twice daily for better background cover and it worked a dream.

My consultant did wonder if there was some link between high birthweight and lantus, but that was purely a musing and nothing remotely scientific.


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## trophywench (Mar 2, 2012)

Just a musing from me - people often see a different team for their pregs - I don't mean just the obs and the midwife etc - I mean some centres reportedly have a 'Diabetes Obs/Midwife' and they generally seem  better 'tuned in' than the chaps/ladies who see you and eg all the elderly T2's.

I definitely think you need to speak to your DSN, too!


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## Ndel (Mar 3, 2012)

thanks everybody for all your replies. Its great to get so much help on here. Will contact my DSN on monday. 

Thanks again

Noelle


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## allana (Mar 3, 2012)

Hi,

I have a little girl who is 19 months and I'm currently 17 weeks pregnant. I took levimir thoughout my 1st pregnancy and my little girl is fine.

Try not to worry xx


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## Babysaurus (Mar 3, 2012)

I took both, and am now on a pump (so Humalog only) and have never heard this either. 
I also agree with what Trophywench said (so won't type out much the same thing for you to read again!)


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## Ellie Jones (Mar 4, 2012)

Levimer is actually a 24 hour injection...

But a lot of people split it for one of 2 reasons, either because it's tailing off too quickly so stops being effective enough or because they have different needs between two periods of the day...

Actually no insulin has been licensed for use during pregnancy...  The original animal insulin there wasn't a license involved, and with the introduction of a license ethic's won't allow a clinical trial to be carried out...

But there are many drugs that fall into this group, Metformin is another that isn't licensed to be used in pregnancy.  

My hospital still won't use metformin during pregnancy...  When I got caught with my youngest my medic's weren't amused at all that I wouldn't follow their advise of having a medical termination


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## trophywench (Mar 4, 2012)

Ellie, depends on Insulin to body weight ratio.

Please see

http://www.diabetes-support.org.uk/info/?page_id=428

I usually up the screen resolution to 400%  LOL

But anyway, the greater the amount of Levemir to body weight the longer it lasts.   ie take TDD of it and divide by weight in kg, you then know how many units per kg you take and which line to follow, when the 'dots' stop, it's over and done with.

For instance I was on 18 - 20u of Lev, my weight was approx 60 kg giving a ratio of 0.33r units per kg - so it died completely after 20 hours.


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