Q: How effective is the new insulin Lantus and is it safe to change over to this from Human mixtard for a person who has been a type 2 diabetic since nearly 25 years and is not achieving a good blood sugar control? Can you tell me all about this new insulin and is it a good idea to start this now? The person is 55 years old and is on 18 units Human mixtard before breakfast, Pioz after lunch and 12 units before dinner. Please suggest the best combination to achieve good sugar?

A:Lantus is the brand name of insulin. Its duration of action is 24 hours. Mixtard is also a brand name that contains two types of insulin: short acting for immediate need and long acting (isophane) for long periods. Hence Mixtard is also called biphasic i.e. two phases. The duration of action of Mixtard is also 24 hours though many a times it is given twice a day. I doubt that a patient whose blood sugar is not controlled by Mixtard will benefit from Lantus. It may be better to titrate the dose of Mixtard and also review the specific preparation (i.e. 30/70, 50/50 etc). There is no point in spending a huge sum of money without corresponding benefit. While taking medicines for life, one needs to look the cost of the same medicine sold under various brand names by different companies, particularly when the manufacturers enjoy similar reputation. You can look at the cost difference between Wosulin Biphasic and Mixtard - both exactly same medicine. Similarly you may wish to compare the cost of two brands of pioglitazone - Pioz with Opam.