Lets say your insulin pump breaks, what’s your ‘go to’ backup basal for manual injection?
If you are on MI, feel free to post your preferred basal.
Who picks what basal you use? Do you tell the Doc what you feel comfortable with or do they simply assign you on?
I run Omnipod 5 on my cell phone. I have two OP5 controllers as backups. So if my phone dies I would just use one of those along with my backup Dexcom receiver to dumb pump until I bought a new phone.
My CDE and endo told me how much to use the first month of insulin. After that it’s all been me without any input whatsoever.
My back up is a box of Lantus SoloStar pens in the fridge, 10 bags of syringes and of course the vials of Novalog.
My endo is not only willing to prescribe the Lantus, he is in agreement that it is a better choice for temporary use than Tresiba. It is easier to go back to the pump.
I also used Lantus to boost my basal when I was receiving a steroid during chemo.
Somewhere in the bowels of FuD there is my experience with Chemo/steroids and managing BG.
Here it is. It does get off topic on various tangents that are sort of related.
My first choice is Levemir, but they don’t make it anymore. I still have some, so I would use what’s left.
My second choice would be Lantus.
I have a back-up pump; it’s the same model as my primary pump. If I need to go MDI for whatever reason, I would choose Tresiba for its time-flexibility. A box of 5 Degludec (biosimilar Tresiba) pens in the fridge with a 1/27 expiration date would fill that need. If I usually take a once daily dose in the evening and I forget, I found that if I take the missed dose the next morning, my BG control remains good.
My preferred local hospital, however has Lantus only, on its formulary. I have no experience with Lantus but I worry that it may not last me a full 24 hours. For MDI readers who use Lantus, does it last you a full day? Anyone taking 2x/day of Lantus?
For those of you who are long-term pumpers, have you rehearsed going on MDI?
I’ve got some old expired Lantus that I am saving for an unplanned or emergency pump break if needed. In case I find myself planning ahead for a pump break someday I’ve got a prescription for Lantus vials that I could kick into gear. I tried some of the old expired Lantus a few years ago and it still seemed to work well. Dosage will be a guessing game though.
I thought I had an old box of Lantus in the fridge, but turns out I don’t. I guess I should get it refilled, in the highly unlikely event that all at the same time my phone dies, my PDM dies, and Insulet can’t courier me a new PDM same day or early the next. And if the world’s in that bad a state, I suspect having long-acting insulin would be the least of my concerns.
@Terry, last time I was on MDI, a decade ago, I took Lantus twice a day. I liked it, but I gather some of the newer long-actings work much better at keeping BG stable.
Lantus would be great on Neptune, where a day lasts only 16 hours!
On Earth, it’s not the greatest.
It does not last 24 hours, despite what they tell you. For me it lasts around 16-18 hours.
And since it does not last 12 hours, if you do 2x daily, you will have some overlap.
I have been using Lantus for 1.5 years and I LOVE it! I take 2 doses, 12 hours apart (9am and 9pm), slightly more in the morning (8u in the morning and 7u at night). It’s nice because if I have a heavy exercise day or heavy eating day, I can easily adjust one or both doses up or down.
When I used Tresiba, I didn’t like that it lasted so long because I couldn’t fine tune it as much.
My pump break started in August 2024 and there’s no end in sight. So much easier for me than using a pump (which I did for 25 years).
To answer OP’s question, I think they started me on Lantus and then I asked to try Tresiba. Then I went back to Lantus. (She also let me pick whatever fast-acting I wanted.) Doctors should be willing to let you switch.
I am on a tandem mobi right now, and I have my old tslim x2 as a backup.
I did a pump vacation for a few months at the end of last year, specifically because I hadn’t done MDI for about 20 years or so, and I think it’s a good skill to have in today’s world of uncertainty and supply chain issues. Now, I have a box of Tresiba pens and novolog pens in the refrigerator as a backup as well. I tried lantus first, but I can’t use it. I had lows every night (serious lows, like 40s). Tresiba works better for me.
It’s been several years since I took a pump vacation. I’m overdue! It’s hard to make that change when things are working well. I’m thinking that a long-term pump user who switches to MDI for a few weeks per year gains currency, flexibility, and confidence during uncertain times. Your back-up plan seems solid, Brianna!
It’s been so long since I was on manual injection that I can’t even remember.
Thanks for talking through this. I think you all had me on a split Lantus dose last time I was on long term MI. But I wouldn’t have remembered that. I’m often using a split NPH dose from Walmart in an emergency. I think I have a backup Omnipod Classic pump and pods. I should locate it.
I’m not 100% what John is trying to communicate in another thread, but I think he’s saying that he’s kinda married to that pump (and mail order insulin). I’m surprised how many of you have backup pumps and don’t even really consider falling back on MI…if it can be avoided.
I asked because I was speaking with a woman who is kinda a lobbyist for one of the specific basal insulins that she preferred. I got kinda freaked out talking to her because she suggested they might not manufacture NPH forever. That made me a little panicky because it’s the only one I can get over the counter.
Some people are really married to their preferred basal insulin and some aren’t. Some people are really married to their pumps and some aren’t.
My old 670G is sitting somewhere in a book case. So I’d go back to that even though the buttons had gotten difficult. Medtronic reservoirs and infusion sets haven’t changed, so no problem there.
My go to is Lantus in the short run and I have an Omnipod controller for the backup on my telephone. I feel fairly well covered, and could make the jump on my own, if I had to do so.
I just got a basal script written for backup, but the pharmacy and doc don’t know the diff between bolus and basal insulin, so I had to delete the basal Rx. I going strictly Walmart OTC.
I seem to be like most of the above responders. I use Dash pods, so replacements (currently) aren’t hard to come by, though I’ve discussed with my Endo and he’s prescribed a box of Lantus in flexpen format like I used before pump-dom (I think I can get it replaced annually, if not then when it expires). The Lantus along with my Novolog pens would still serve for treatments, might have some high’s/low’s during the transition days, but nothing expected that would be extreme or life threatening. The issue for me will be when Insulet discontinues the Dash pods due to my use of Trio and/or Loop as an AID. I know the day is coming when either I or my caretakers will have to make a choice, the question is what options will exist at the time.
When my Dash/loop system went haywire a couple of months ago when I was off visiting my parents, I moved to Tresiba and Novolog. But I also used Lantus for MANY years AND I HAVE SO MUCH OF IT LEFT (*expired, but what does that even mean?). Does anyone need Lantus? I am your source. Seriously. At some point I am going to have to throw it away and that is going to cause severe agita - that stuff is liquid gold. Let me know. I even have coolers and ice packs that other medication arrives in!
@JessicaD First, thanks for thinking of others and offering your Lantus supply. Second, please don’t throw it away, depending on how old, please consider sending it to one of the organizations that collects medical supplies for other parts of the US/world in need, i.e. conflict zones, poverty zones, etc., where supplies are needed. Some of them take “technically” expired products. I’ve sent a few boxes of various supplies. I try to research them first and make sure they’re reputable. Insulin is difficult because it’s supposed to stay in a temp controlled environment, so its a little tougher to work with, but it can be life altering for those that get it.
My Endo here in Florida will not let her insulin pump patients leave the office without a prescription for basal insulin and explicit instructions geared to their needs on how to use it should the pump fail. Please consider a call to your endo to see if you can work out that dosage BEFORE you need it. That said, I am on the OmniPod 5, and I do not even remember when the last time was that I had a pump failure. It has been at least 15 years. That said, though, I am happy that I have the instructions on what to do should I need to go back to MDI for a while.
I also would suspect that some of us just go with whatever the insurance company will pay for in that particular year. For decades, I had Lantus as a back-up in case I needed it. Then insurance decided that they no longer would cover Lantus, but they would cover Basaglar. OK. Fine, since I never really have used it in all of these years. Then THIS year my insurance decided that they WOULD cover Lantus again, so the last time I threw out the expired insulin and bought new, I went back to Lantus. I am thankful that I have never had to use it!