[soho]

Hi amydunn

The problem with ALL the links you posted and all the quotes about the effectiveness of Lantus (glargine) you supplied is this:

They only used ONE type of insulin in those comparisons. If you were to use only ONE type of insulin I would agree that NPH is marginally better than Lantus. But I have never nor will I ever suggest that you use only ONE type of insulin for a diabetic dog. You will NEVER get the level of glucose control using only ONE type of insulin as you will get with the 2 types of insulin regimen I recommend.

http://www.lantus.com/images/hcp/charts/lrg_1.2.3_1.png

The above link tells you the onset of action and duration of 6 different types of insulin. For each type of insulin there is a graph. Axis y is insulin levels, axis x shows 4 points, Breakfast , lunch, supper and bedtime. The colored line in each graph shows the insulin level in the blood.

The first graph is the basal graph which uses Lantus, the line is flat and stays near the bottom of the graph at the top of the basal level of glucose but below the 3 peaks of breakfast , lunch and dinner. So if you took away the 3 peaks on that graph there would still be a low gray area that traveled from left to right on the graph. That is the basal level of glucose which is constantly being secreted by the liver. The dark blue line of the lantus rides nicely at the top of the basal level of glucose.

The next graph is the prandial graph which uses a rapid acting insulin such as Humalog or Novolog. There are 3 green lines that represent 3 different injections of rapid acting insulin. Each green line almost perfectly covers the 3 glucose peaks of breakfast, lunch and dinner.

So the Lantus perfectly takes care of the basal level of glucose and the rapid acting insulin almost perfectly takes care of the rises in glucose from meals. This is the regimen I suggest. My regimen COMBINES the long acting insulin of the basal graph with the rapid acting insulin of the prandial graph. In this regimen you would only inject the rapid acting insulin once if your dog ate only one meal, twice if your dog ate two meals and not at all if your dog didn’t eat that day.

I used Lantus as an example of an ultra long duration insulin. There is also Ultralente or Levemir. I used Novolog and Humalog as examples of a rapid acting insulin. There is also Apidra.

You suggest using ONLY NPH insulin. The graph of the NPH insulin shows the light blue line of the NPH not covering the basal glucose or the mealtime glucose AT ALL. This regimen is nowhere near as effective at covering the glucose of a dog with diabetes as the 2 insulin regimen I recommend.

I have tried my best to convey to you the superior effectiveness of the 2 insulin regimen I recommend over the use of NPH alone. Everyone is entitled to their own opinions and beliefs. I ask you to please respect my opinions and I will respect yours. I wish you and your dog the best.

Thank you.