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Lantus vs. Levimir

Discussion in 'Insulins' started by tuckerk, Jul 26, 2007.

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  1. tuckerk

    tuckerk Approved members

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    Hi,

    I was so thrilled to discover this website. It is good to know that there are other parents who have the same questions. I am an Family Nurse Practitioner. This has been the hardest thing I have ever had to do. My daughter was diagnosed 4/2007 and like many other families, Caitlin's blood sugar has been all oer the place. We were started on Lanuts and Novolog pre-meal bolus. But recently, her endo changed us from Lantus to Levemir. Her morning BS are high (250-399). This is even if she did not have a bedtime snack. Help!!!!:confused:
     
  2. Amy C.

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    First of all welcome. You will get a variety of opinions and will need to consider what will work for you.

    It is my understanding that Levimir is given in two shots a day. I don't think it lasts for more than 12 hours. If your daughter is high in the morning, she needs more of the night time insulin.

    Is she in range at bedtime and what is the BG in the middle of the night?
     
    Last edited: Jul 26, 2007
  3. tuckerk

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    Thanks!

    Cailtin has an endo appt. next week. I will definitely put that on the list.
     
  4. tuckerk

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    Hi,

    Her blood sugar is normally anywhere from 150-250. Since she has been on Levemir is bedtime is sometimes over 250. I have had to strat recently giving her insulin with the bedtime snack (if she is hungry)
     
  5. Amy C.

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    It is hard to make a recommendation (which is all anyone can do) unless there is more data.

    How long after dinner is bedtime? If the bedtime reading is within 3 hours of dinner, the high reading may be caused by not enough insulin at dinner, so you may have two problems.

    When do you give the Levimir shot?

    Is your bottle less than 28 days old? Old insulin may not be as effective.

    Is she high at other times during the day?

    Do you know how to adjust the insulin dose now?

    Almost always, high sugars without any lows, are due to not enough insulin.
     
  6. tuckerk

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    Thanks for the response!!

    Usually bedtime is 9:30 or 10:00. Dinner time is 5:30 or 6:00 pm.
    Example : Dinnertime BS-221 (gave 1.5 units of Novolog bolus), Bedtime BS-147 (did not have a snack at bedtime), Blood sugar this morning was 321!!!!!

    I talked to her endo this morning and he wants to start NPH at bedtime. I think that the Levemir dose is not enough. I asked about d/c levemir and resuming Lantus (seemed to work much better). He did not seem to think that this would make a difference. :confused:
     
  7. willdee3

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    Lantus Vs Levimir

    Hello! Finally know enough to answer this question! Did you know that the levimir is only an 18 hour med but Lantus is a 24 hour? My 4yr old grandaughter is on her second year as a T1 and had an appt with the Endo in August. Her A1C was 7.4. He changed her to Levimir at night and this has been like going back to square 1!

    She would be 49 at 2:00 AM and 321 at wake up. My dil has had to call and call. Sometimes wait 4 days to talk to anyone about this. They split it up to 2 shots. One unit in the morning and 2 at night. With all the highs during the day had to do MORE insulin in the day! Finally got to talk to someone who called the doctor and changed it back to Lantus in the AM. Have had a few lows in the 90's and some high's in the 200s but this is the 4th day and she is feeling better.

    I hope that you can get this straightened out. I will be praying that your doctor will get it right this time. This is a 365/24 job that you are on and it can really get to you . Hope that what I said will help you a little!
     
  8. tuckerk

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    Hey!

    Had to change endos. He tried to convince me that Lantus and Levemir were exactly the same. Wanted me to start NPH and I refused. We resumed the Lantus and within 2 days or so numbers were dramatically improved.

    Our endo now is in Birmingham, AL (about a 2 hour drive from home), but it is worth it. I have a doctor that respecs my opinion and we together come with a care plabn for Caitlin.
     
  9. willdee3

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    Better!

    So glad to hear that Caitlin is feeling better. Do whatever you can to make everything better. The Doctor in Birmingham is THE one. He is so good with the T1 diabetes and he cares about our babies!

    Good luck and God bless you and your family.
     
  10. jendean

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    Welcome!

    You know what, the hospital I work at recently went all Novolog, and therefore when anyone comes in on humalog, they get a substitute, as well as with Levimir for Lantus.
    A lot of my patients who just do Levemir and pills tell me that Levemir seems different, and complain that thier numbers are goofy.
    So, yes, you are right to suspect the Levemir.
    The two are meant to act alike, but They have a different chemical make up, so they will not be precicely the same, and while most people notice no difference, some notice a great difference.

    I dont have any idea why the hospital went levemir, but some patients bring in thier own Lantus because they dont like to use Levemir. The reverse would be true if we went all Lantus, people would bring in their Levemir.

    Welcome and thanks for joining!:cwds:
     
  11. Nancy in VA

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    Wow - I would never let the hospital change the drugs because we were admitted. They aren't the same and reactions and lag times are different. I'm quite surprised with something so delicate to manage that they would make that kind of wholesale change.
     
  12. mom2kenny

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    My son is 13 and on levemir, he started out on lantus. The lantus only lasted 16 hr for him so that is why we switched to levemir (plus the levemir pen is much easier than the lantus pen)He takes his levemir at 9 pm>evey child is different, but if it were kenny I would up the levemir.(Only my opinion) Does you child take it in the morning or night? It can also be split into 2 doses(1/2 morning and 1/2 pm) which may be something you may want to ask the endo.I have heard a lot of negatives about NPH but we have never been on it.
     
  13. twodoor2

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    I'm sort of in a dillema right now. Elizabeth is on Lantus, and it works remarkably well for her, but I know that Lantus is created with e-coli and I'm not sure of the long term effects. Levemir is created with yeast, and is not acidic, but I'm not sure how well she would react to it (I heard it has an abnormal peak with small children). So far, I don't know what to do, and I'm a bit distressed about it. I really don't want to use variable basals with the pump because she enjoys being untethered.
     
  14. somanybakers

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    This thread is really interesting to me. My son decided to take a "pump holiday" after 2 3/4 years on it. We are using pens now. We are playing with Lantus and Levimir to decide which one is right for us. One week on one and one week on the other (endo recomended this).

    I am finding that levimir is only lasting about 10 hours for him. After that his numbers sky rocket. Lantus seems to last the full 24 hours. However, Lantus hurts, like a burning, and he does not like it. I prefer good numbers.

    We will pick up a "port" from the endo tomorrow, so we will insert that like a pump site and inject the pens into it and not his skin. I hope that it works well.

    the post that talked about e-coli and the acidity of Lantus seems to make sense of the fact that he says it burns.
     
  15. Tabithas_storm

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    My daughter was on an insulin pump, and when we went to the hospital the last time (Long story) she was taken off the pump per my request. Her endo started her on Levemir and Novolog. She was already on Novolog with the pump, so it wasn't a big change there. Since starting the levemir, her sugars have stayed in teh 100-140 range. A drastic improvement from the pump. The first 2 weeks, we had a couple of lows, we reduced the Levemir by 2 units and she has been fine since.
    As for the high BG in the morning, it is possible that she is crashing and rebounding. A good way to check is by randomly checking for ketones. If she isn't getting enough insulin, she may show some.
    It sounds as if you have gotten things straightened out with the new endo, and that is wonderful. Stay persistant, and don't let any doctor walk on you or your daughter. You have ultimate control over her care, and sometimes you just have to make them listen to you. We have been fortunate with our endo, and haven't had any problems.
     
  16. twodoor2

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    How old is your daughter, and did her insulin needs increase, decrease, or stay about the same from going from the pump to Levemir?

    Thanks!
     
  17. Ryans-Rock

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    Just thougt i'd jump in here on the Levemir. My son takes 14 units of levemir at bedtime. His bg's are usually around 100 at bedtime and his waking number is usually in the 90's. We love the levemir. Hopefully you can get it figured out. Maybe with 2 shots instead of just 1. 1 int the morning and 1 at night. I know each child is different. But the levemir sure keeps my son stable at night. I would also suggest maybe do a overnight basil test.
     
  18. Tabithas_storm

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    My daughter is 13. We did have a growth spurt over the last year. She went from 4'8" to 5'5". She hasn't really had much changes due to hormones and adolescence, but I am sure that is coming.

    We are still having great results with the Levamir and she has been on it for 3 months now. We did at first have to play with it, we called the doctor every other day to adjust it up and down. (By the way, LOVE our Endo!) We never have tried Lantus. When she was on shots when she was initially diagnosed, they had her on NPH and Novolog. She was still honeymooning at that point, and she would fluctuate greatly. But I am just thankful that we are on a great trend of steady sugars now. Hopefully when we go back, her A1C will be back to a healthy range.
     

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