Soon insulin in Thailand??

[glegolo]

Good morning gents,

 

I m 68 years of age, and I am a so called diabetic 2 guy. Got it round 2013..... Ever since then I have it under control with Metformin 500 mg 4 pills a day plus excercise.....  From time to time when I am sloppy with the exercise immy the sugarlevel raises upwards.....

 

I like to ask you guys or ladies that have experience from buying Insulin in Thailand the following:

a - do they have insulin here, the kind we have in west???

b - Can you plse help me and tell me what the cost is to buy insulin in Thailand??

 

Thank you so much for your input...

 

glegolo

[tutsiwarrior]

I get Novo Mixtard 30 cartridges from my local clinic, thb400+ for 5 x 3ml, gotta buy the Novopen applicator and needles extra...they also got the prepackaged disposable Flexpens, 5 X 3ml to a box, more expensive and needles extra...

 

2000mg of metformin daily puts a big load on your liver and kidneys and I believe that the max recommended daily dose is less than that...

 

 

 

[glegolo]

34 minutes ago, tutsiwarrior said:

I get Novo Mixtard 30 cartridges from my local clinic, thb400+ for 5 x 3ml, gotta buy the Novopen applicator and needles extra...they also got the prepackaged disposable Flexpens, 5 X 3ml to a box, more expensive and needles extra...

 

2000mg of metformin daily puts a big load on your liver and kidneys and I believe that the max recommended daily dose is less than that...

 

 

 

Thank you great...... I have little trouble to see what the daily cost is in your case.... Can you help me plse????? It would be great to know what is waiting me in a possible near future costwise, with this insulin and parts to it...

 

Metformin in Sweden my homecountry, is being considerated as taking doses OVER 2.500 mg per day is NOT to recommend... So 2000 mg should be OK.. But I am not a doctor and I dare not dispute what you say..... But the doctor who gave it to me in Sweden is a specialist in the diabetes area of health, so I must trust the guy.....

 

glegolo

Edited May 20, 2019 by glegolo

[ThaiBunny]

36 minutes ago, tutsiwarrior said:

2000mg of metformin daily puts a big load on your liver and kidneys and I believe that the max recommended daily dose is less than that...

I take 2000mg of metformin daily but in the extended release (XR) form. I suspect taking it in standard format in one hit would indeed overload those organs as well as giving you diarrhoea. I've been told by my (non-Thai) diabetes specialist that 2000mg is the maximum effective daily dose; anything greater has no impact.  I'd be very loath to drop metformin as there's increasing (but not conclusive) evidence that it prolongs life and helps prevent dementia in both diabetics and non-diabetes adults (google it - plenty of articles)

[glegolo]

8 minutes ago, ThaiBunny said:

I take 2000mg of metformin daily but in the extended release (XR) form. I suspect taking it in standard format in one hit would indeed overload those organs as well as giving you diarrhoea. I've been told by my (non-Thai) diabetes specialist that 2000mg is the maximum effective daily dose; anything greater has no impact.  I'd be very loath to drop metformin as there's increasing (but not conclusive) evidence that it prolongs life and helps prevent dementia in both diabetics and non-diabetes adults (google it - plenty of articles)

thanks for your input. I myself takes 1 pill morning, lunch, dinner and bedtime, so no 4 at one time...

 

glegolo

[Saltire]

I am not recommending anything as everyone is different, but I was in a similar position as the OP 2 years ago, on Metformin. Looking to the future I wanted to avoid the need for insulin.

 

I came off Metformin 1 year ago (and dumped the statins as well) after embarking on a low carb high fat (ketogenic) diet. My blood sugar is now normal as long as I continue to abstain from the high carb foods (bread, rice, pasta, sugar etc). I believe my diabetes is now in remission as long as I continue this lifestyle change. An added benefit is I am down 20Kg so far.

 

Check out www.diabetes.co.uk and www.dietdoctor.com

 

Just an alternative for you. Good luck.

[tutsiwarrior]

if you don't use insulin daily then it's hard to calculate the daily expense for diabetes meds...if metformin alone then easy enough...if like me you test yer BG daily and inject some insulin to settle things down when the reading is too high (like throwing some spuds into a curry the night before that would normally not have any) then it's hard to say...I usually hit 30 units before bed as a minimum and then more in the morning depending on my fasting BG reading...the additional fructose from sweet/ripe fresh fruit in season can also play hell with the BG...

 

 

[glegolo]

27 minutes ago, Saltire said:

I am not recommending anything as everyone is different, but I was in a similar position as the OP 2 years ago, on Metformin. Looking to the future I wanted to avoid the need for insulin.

 

I came off Metformin 1 year ago (and dumped the statins as well) after embarking on a low carb high fat (ketogenic) diet. My blood sugar is now normal as long as I continue to abstain from the high carb foods (bread, rice, pasta, sugar etc). I believe my diabetes is now in remission as long as I continue this lifestyle change. An added benefit is I am down 20Kg so far.

 

Check out www.diabetes.co.uk and www.dietdoctor.com

 

Just an alternative for you. Good luck.

Great to know that you as well doing this. I did it for 3 years and it was great, but I was way too weak in the long run, missing out on bread especially..... But thanks for your input, I am seriously considering LCHF-diet again......

 

glegolo

Edited May 20, 2019 by glegolo

[glegolo]

22 minutes ago, tutsiwarrior said:

if you don't use insulin daily then it's hard to calculate the daily expense for diabetes meds...if metformin alone then easy enough...if like me you test yer BG daily and inject some insulin to settle things down when the reading is too high (like throwing some spuds into a curry the night before that would normally not have any) then it's hard to say...I usually hit 30 units before bed as a minimum and then more in the morning depending on my fasting BG reading...the additional fructose from sweet/ripe fresh fruit in season can also play hell with the BG...

 

 

I understand that it is hard to give an exact figure, but plse just give a number for what you are spending your self, so I am at least are in the ballpark.. Are we talking about 10th of thousands per month or 3-4000 baht monthly I havent got a clue, so all help is good help for me ...

 

glegolo

[tutsiwarrior]

21 minutes ago, glegolo said:

I understand that it is hard to give an exact figure, but plse just give a number for what you are spending your self, so I am at least are in the ballpark.. Are we talking about 10th of thousands per month or 3-4000 baht monthly I havent got a clue, so all help is good help for me ...

 

glegolo

 

I use about 1 box of mixtard 30 novopen cartridges (5 x 3ml, 100 units per ml) and a box of the local Siamformet (850mg x 100) metformin every 6 weeks and a box of needles every 2 - 3mos but those are my personal requirements and your - mileage - may - vary...need to go and price things out, I get my stuff from an outpatient clinic attached to the local district hospital so I pay a premium...if yer in a big town with lots of big pharmacies you may be able to find them fer cheaper...

 

the biggest diabetes related expense is for the Accucheck BG meter test strips, 25 for thb495...don't even last a month...

 

 

 

[glegolo]

37 minutes ago, tutsiwarrior said:

 

I use about 1 box of mixtard 30 novopen cartridges (5 x 3ml, 100 units per ml) and a box of the local Siamformet (850mg x 100) metformin every 6 weeks and a box of needles every 2 - 3mos but those are my personal requirements and your - mileage - may - vary...need to go and price things out, I get my stuff from an outpatient clinic attached to the local district hospital so I pay a premium...if yer in a big town with lots of big pharmacies you may be able to find them fer cheaper...

 

the biggest diabetes related expense is for the Accucheck BG meter test strips, 25 for thb495...don't even last a month...

 

 

 

Thanks will be waiting for your reply than..

thanks again

 

glegolo

[ignis]

Like many things depends where you shop......... I have 850Mg Metformin, 2 x a day...  mixtard 30/70 Insulin, the dosage I appear to have to reduce all the time or I go far to low..  was on 38 units evening and 45 units mornings in 2014, the last 2 months I am using 26 units at night and 36 units in the morning, even so woke up Saturday early morning wet with sweat and shaking came down and took a reading  43 !! far to low, Did not take any Insulin at all that day and Sunday morning was 114.. Sunday 26/36 dosage this morning was 103, so guess must take even less.. next Diabetic Dr Appointment 26th June.

 

Accu Chek 'Performa' BG meter test strips cost me 550 baht for 50..  so a big saving on what 'tutsiwarrior' pays [Notice in Boots they cost 498 baht for 25 strips]

 

I also have 5 other types of Pills every day + all the above ........ Total Bill.. All Med's + seeing older Dr [Professor of Diabetic] 2,200 - 2,300 baht every 100 days..  ALL bought at the Hospital as they appear same or cheaper than a cheap Pharmacy [it is a long way and a pain getting to the Hospital 'Red Cross' must leave at 4:30 am and never get back before 16:00 but it is only every 100 days]

 

P.S as a matter of interest always been on 500mg Metformin for over 30 years.. was changed to only 2 a day 850mg this year....  Metformin 500mg used to cost 168 baht per 500 tablets.. 

 

glegolo - it is all about where you shop to what you pay, but NO Insulin is Not expensive depending on what type you will use.

[glegolo]

22 minutes ago, ignis said:

Like many things depends where you shop......... I have 850Mg Metformin, 2 x a day...  mixtard 30/70 Insulin, the dosage I appear to have to reduce all the time or I go far to low..  was on 38 units evening and 45 units mornings in 2014, the last 2 months I am using 26 units at night and 36 units in the morning, even so woke up Saturday early morning wet with sweat and shaking came down and took a reading  43 !! far to low, Did not take any Insulin at all that day and Sunday morning was 114.. Sunday 26/36 dosage this morning was 103, so guess must take even less.. next Diabetic Dr Appointment 26th June.

 

Accu Chek 'Performa' BG meter test strips cost me 550 baht for 50..  so a big saving on what 'tutsiwarrior' pays [Notice in Boots they cost 498 baht for 25 strips]

 

I also have 5 other types of Pills every day + all the above ........ Total Bill.. All Med's + seeing older Dr [Professor of Diabetic] 2,200 - 2,300 baht every 100 days..  ALL bought at the Hospital as they appear same or cheaper than a cheap Pharmacy [it is a long way and a pain getting to the Hospital 'Red Cross' must leave at 4:30 am and never get back before 16:00 but it is only every 100 days]

 

P.S as a matter of interest always been on 500mg Metformin for over 30 years.. was changed to only 2 a day 850mg this year....  Metformin 500mg used to cost 168 baht per 500 tablets.. 

 

glegolo - it is all about where you shop to what you pay, but NO Insulin is Not expensive depending on what type you will use.

This was really a great deal of work you put in for me, and I am very grateful for that.... And I must say that it seems to be MUCH less expensive than what I was expecting reading little bit about it in the past, I thought it must be a diseaster just like the new bloodthinning medicin (Lixiana) that I eat on a daily basis.... (28 days = 3,500 baht)..

 

So I am very grateful for your input and detailed information, will save all this info, BUT I will of course hope that it never will come to insulin.. It is like science to learn all that I guess.

 

thanks Sir,

glegolo

Edited May 20, 2019 by glegolo

[Sheryl]

Short, medium and long acting insulins are available here though oit necessarily the exact brands/formulations as in the West.

 

Prefilled injectable pens are quite costly, ranging from say 200 -700 baht per dose. If you can learn to handle syringes and use vials (requires drawing up  the correct dose and injecting yourself and learning how to avoid contaminating the needle) this is vastly cheaper.

 

Considerable instruction is needed first from your doctor on dosage and type of insulin. Mixing up rapid with  long acting insulin, and any dosage errors, can have very serious consequences. Hence the preference for the prefilled injectable pens if you can afford them.

 

For your home country doctors' reference, the types of insulin sold here in multidose vials are:

 

Humulin N 

Insugen-N

Gensulin-N

The above are all isophane insulin,  Intermediate acting ("normal").

 

Humulin R  (same but rapid acting)

Insugen-R

Gensulin-R

The above are all rapid acting insulins

 

Humulin 70/30 

Insugen 30/70

Gensulin M30 (30/70)

The abve are all mixtures of 70% intermediate acting ("normal") insulin and 30% rapid acting insulin

 

GnesulinM50 is a 50/50 mix of gensulin-N and gensulin-R

 

Expensive imported options:

Lantus (Insulin glargine) - long acting. Comes  in both prefilled pens but also in mutli dose vial. Imported and expensive.

 

Humalog (Insulin lispro). Fast acting. Comes  in both prefilled pens  (Humalog KwikPen)but also in mutli dose vial. Imported and expensive.

 

Expensive imported pre-filled pens only:

Glaritus (Insulin glargine)  long acting

Humalog mix 75/25 Kwikpen (mix of rapid and intermediate acting)

Humalog Mox 50-50 Kwikpen (mix of rapid and intermediate acting)

Novomix30 penfill / Novomix30 flexpen I/Novomix rapid (insulin aspartame, fast acting)

 

It is by no means inevitable that a type 2 diabetic ultimately needs insulin, in fact most will not. There are oral medications in addition to metformin that can be added, and of course diet and exercise are of utmost importance

 

 

 

[glegolo]

Sheryl my utmost gratitude for that information. I save it here in my computer and I do hope that I never will need it......

 

Many thanks

glegolo

[ignis]

Lixiana imported here from Switzerland = very expensive...

 

Did you ask your Dr if there is a Thai version ?  My Dr will advise. also shows on his PC the price of every Medication even the prices of different Thai Brands, sold in there Pharmacy. 

 

Also if you have Not a regular Dr. go into a Thai Pharmacy and ask for the Pharmacist they will speak English, ask if there is a cheaper or a Thai version of Lixiana

 

When I was in Hospital in 2014 they put me on NovoMix 30/70, was expensive..... My Permanent older Dr [Professor of Diabetic] said there was no need for expensive Insulin unless I was wealthy, and for a fraction of the price have been on Mixtard 30/70 for past 4 years.

[glegolo]

1 hour ago, ignis said:

Lixiana imported here from Switzerland = very expensive...

 

Did you ask your Dr if there is a Thai version ?  My Dr will advise. also shows on his PC the price of every Medication even the prices of different Thai Brands, sold in there Pharmacy. 

 

Also if you have Not a regular Dr. go into a Thai Pharmacy and ask for the Pharmacist they will speak English, ask if there is a cheaper or a Thai version of Lixiana

 

When I was in Hospital in 2014 they put me on NovoMix 30/70, was expensive..... My Permanent older Dr [Professor of Diabetic] said there was no need for expensive Insulin unless I was wealthy, and for a fraction of the price have been on Mixtard 30/70 for past 4 years.

Thank you so much for your advice, and of course great advice. But unfortunately these NEW medicines like Lixiana, Xialto and Elequis they are so new so the patent is still in use, so there is no versions of these medicines , and I am also very sorry for that.....

 

But thanks for trying to help me...

glegolo

[Oxx]

If Metformin is proving insufficient, surely the next step is to add another drug to the mix - something like Januvia or Trajenta - rather than jumping to injecting yourself.

 

You really should be talking to a doctor, rather than trying to DIY.

[glegolo]

7 hours ago, Oxx said:

If Metformin is proving insufficient, surely the next step is to add another drug to the mix - something like Januvia or Trajenta - rather than jumping to injecting yourself.

 

You really should be talking to a doctor, rather than trying to DIY.

Yes I do fully agree with you, no question about that. My original thoughts were, which maybe can be noticed in my OP, that I would like to be prepared for what kind of cost it would be, IF and WHEN I must go over to insulin injections.

 

But as said, you are correct of course....

 

thanks for advice.

glegolo

Edited May 22, 2019 by glegolo

[robblok]

What i heard is that if you change your diet sufficiently to low carb and exercise a bit more you can at least stop it from getting worse there are even people who don't need medicine anymore after changing to low carb and more exercise. 

 

Not advising here to stop medicine and go low carb but if your worried about it getting worse why not try to change your diet and lifestyle ?

[glegolo]

28 minutes ago, robblok said:

What i heard is that if you change your diet sufficiently to low carb and exercise a bit more you can at least stop it from getting worse there are even people who don't need medicine anymore after changing to low carb and more exercise. 

 

Not advising here to stop medicine and go low carb but if your worried about it getting worse why not try to change your diet and lifestyle ?

I am all for it to what you are saying and suggesting as you may see earlier in this thread. I am today exercising (bicycling) about 40-50 kilometers 2 hours at least a day. I am "only" about 10 kilo overweight, so it could be much worse....

 

What I understand is that, when people are overly fat and they have never in their whole lives excerised before, they can successfully loose weight and can stop diabetes and the medicine... But it is a bit tricky for a guy like me, that have been exercising my whole life, and have never been overly fat, or obese....

 

I have been on LCHF before and it was great, lost kilo immi, and felt great, Negative side of it...   B O A R I N G...  I love my bread and my potatoes.... But guess that I ends up there in the end any how..

 

Thanks for your great input..

 

glegolo

Edited May 23, 2019 by glegolo

[robblok]

1 hour ago, glegolo said:

I am all for it to what you are saying and suggesting as you may see earlier in this thread. I am today exercising (bicycling) about 40-50 kilometers 2 hours at least a day. I am "only" about 10 kilo overweight, so it could be much worse....

 

What I understand is that, when people are overly fat and they have never in their whole lives excerised before, they can successfully loose weight and can stop diabetes and the medicine... But it is a bit tricky for a guy like me, that have been exercising my whole life, and have never been overly fat, or obese....

 

I have been on LCHF before and it was great, lost kilo immi, and felt great, Negative side of it...   B O A R I N G...  I love my bread and my potatoes.... But guess that I ends up there in the end any how..

 

Thanks for your great input..

 

glegolo

Yes but its too much carbs that often cause diabetic. I love my bread and potatoes too both are not bad in moderation. What is bad is huge amounts of processed carbs. However if you are like you now already forced to take medicine I would lower the amounts of carbs i take and it will help.

 

Don't talk to me about boaring because that is what exercise and diet often are. I like my exercise but not always. I just do it because its good. Food.. i know i get fat if I don't eat healthy if it were up to me (without gaining fat or bad health) id be eating pizza's all the time and kfc and mc Donalds. I am not doing that because i care about my weight and looks. But it is far more tasty (in general) then what i eat now. 

 

I am not going too low in my carbs (still lower then most) but I don't have your problems.

 

I was not criticising you at all just trying to help a bit. In the Netherlands if you are diabetic they always tell you to cut carbs and lose weight (both help). 

[eezergood]

2 hours ago, glegolo said:

I am all for it to what you are saying and suggesting as you may see earlier in this thread. I am today exercising (bicycling) about 40-50 kilometers 2 hours at least a day. I am "only" about 10 kilo overweight, so it could be much worse....

 

What I understand is that, when people are overly fat and they have never in their whole lives excerised before, they can successfully loose weight and can stop diabetes and the medicine... But it is a bit tricky for a guy like me, that have been exercising my whole life, and have never been overly fat, or obese....

 

I have been on LCHF before and it was great, lost kilo immi, and felt great, Negative side of it...   B O A R I N G...  I love my bread and my potatoes.... But guess that I ends up there in the end any how..

 

Thanks for your great input..

 

glegolo

cook & cool potatoes & the Glycemic load is significantly reduced ( I want to say 30%) this is yest again reduced if the procedure is repeated. Also many (compared to zero) low GI breads are available here, If you want to reduce your need for medicine I think you have dietary options without too much discomfort. 

[TerryLH]

Expensive imported options:

Lantus (Insulin glargine) - long acting. Comes  in both prefilled pens but also in mutli dose vial. Imported and expensive.

 

I used to be on Mixtard.  40++ units a day.

The middle of last year I was switched over to the Lantas Solostar Pen.  It works differently, so they had me start with 8 units in the AM.  

The pens have 300 units, so you can see how long they last me.  I pay 565 per pen.

I'm not the one paying for it, but I don't consider that expensive once you factor in the much smaller amount of insulin I need.

Terry

KKC

 

[glegolo]

2 hours ago, TerryLH said:

Expensive imported options:

Lantus (Insulin glargine) - long acting. Comes  in both prefilled pens but also in mutli dose vial. Imported and expensive.

 

I used to be on Mixtard.  40++ units a day.

The middle of last year I was switched over to the Lantas Solostar Pen.  It works differently, so they had me start with 8 units in the AM.  

The pens have 300 units, so you can see how long they last me.  I pay 565 per pen.

I'm not the one paying for it, but I don't consider that expensive once you factor in the much smaller amount of insulin I need.

Terry

KKC

 

Yeah this was really useful info when it comes to i.e. costs for insulin... 8 units a day, 1 pen equals 300 units and cost for a pen is 565 baht.... That gives you I guess; 37 days, lets say 1 month and the cost for that is only 565 baht.. Whoa that is great news..... I was really afraid that it could ends up in thousands of baht each and every month for the rest of my life....

 

Thank you so much for your information..

 

glegolo

Edited May 23, 2019 by glegolo

[moogradod]

On 5/24/2019 at 1:49 AM, TerryLH said:

Expensive imported options:

Lantus (Insulin glargine) - long acting. Comes  in both prefilled pens but also in mutli dose vial. Imported and expensive.

 

The middle of last year I was switched over to the Lantas Solostar Pen.  It works differently, so they had me start with 8 units in the AM.  

The pens have 300 units, so you can see how long they last me.  I pay 565 per pen.

May I ask where you can get a Lantus Solostar Pen for THB 565.-- ? I need tons of it and it would make a big difference on my budget. Currently I pay more than THB 1'000.-- per pen.

 

Thank you for any information. I am Pattaya based but would travel elsewhere to buy the pens at that price.