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Lantus vs levemir?

Discussion in 'Insulins' started by AliciaM, Aug 19, 2013.

  1. AliciaM

    AliciaM Approved members

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    So I was prescribed lantus and was told to take it at night. But it's not lasting the whole day so I've split it 50/50 4u at 11 am 4u at 11 pm which seems to be working well. Would I be better off asking for levemir though? I asked about it initially and she had said they usually prescribe lantus not levemir (she didn't give me a reason why). I liked the novo echo pen because it has more precise dosing .5 increments instead of 1u increments. I always go high the days I practice so I'm not sure if that should be a basal change for that day or if I should bolus before practice?

    This would be so much easier on a pump to have diff basals for activities :rolleyes: lol
     
  2. obtainedmist

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    From what I've read here, it seems that Levemir has a shorter duration than Lantus.
     
  3. C6H12O6

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    You are right, Levemir does have a shorter duration than Lantus, that is why it is the norm to dose Levemir every 12 hours.

    I think they recommend lantus bc the rx it as once daily. They perceive that as less of a burden than 2 shots of levemir.

    The Aventis reusable pens are really the worst of all the pens on the market in fact many people use the various Eli lilly pens for apidra and lantus. I actually like the disposable lantus and apidra pens.

    The novopen junior is my favourite of all the pens
     
  4. C6H12O6

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    My pump basal ads up to 24 units so I take 24 units of Levemir twice a day when off the pump or reconnect 12 hours after going off. I think if you find that lantus is not lasting all day you are not supposed to just split the original dose 50/50. I think it is more complex than that.


    If they prescribed 4 units for you that was designed to meet your basal needs for 24 hours. It is the same as if your basal rate was 0.166 units per hour on a pump. By splitting the dose it is like you care cutting your basal rate in half to 0.083 units per hour

    Just make sure you check with your endo before making changes especially since you just had your first appointment

    Your endo should have someone on call 24 hours, and you can call during the day and speak to a CDE :cwds:
     
  5. C6H12O6

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    Btw the best place to post this question is in the parents of children with type 1 section. Most discussions take place there :)
     
  6. AliciaM

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    oops thanks i'll do that next time!! I will maybe call my endos office tomorrow and ask about that! Thanks :)
     
  7. cdninct

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    I think I am missing something here. If your pump total daily basal dose is 24u, are you saying that you take two shots, each of 24u, each day when on Levemir? I am not sure how this would work. If your basal was the same every hour, your pump would be giving you 1u/hr. If you take a 24u shot of Levemir, for each of the 12 hours it is working, it is giving you 2u/hr (obviously, I am simplifying everything here, but I hope you get my drift). I'm not saying that it does not work for you, but I am saying that it does not work in theory, nor does it work in practice for my son--his pump total basal was 3.8u earlier this summer, and when we went on Levemir, we successfully split the dose into 2u in the am and ~1.75u in the pm.

    I am also not sure that I understand your reasoning about splitting Lantus requiring double the dose. You are not cutting your dose in half by splitting the shot in two (except maybe for the first 12 hours...). Two doses of a 24-hour medication that overlap by 12 hours should still leave the same amount of insulin in the system as one dose that is double as large does.

    I apologize if I am misinterpreting what you are saying, but I just can't wrap my head around what I am reading. I am concerned that, based on what you have told her, the OP might try to double her dosage when I strongly believe
    that that would be a serious error.

    I totally agree with your "talk to the endo" advice, though!
     
  8. Joa

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    The Levemir (Insulin Detemir) molekules are less biological activ than other insulins are. So Levemir molecules are quite higher concentraded in the insulin solution of Detemir than in other insulin solutions.
    Anyway many (most) users need more Levemir units when changing the insulin to Levemir. The factor is often round about 1.5x sometimes up to 2 times. There are studies about that.
     
  9. C6H12O6

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    My basal is 1 unit per hour all day long (there are reasons behind this, and I know I am not making the best use of the pump but it relates to diabulimia and hang ups about insulin ). I also use temp rates for exercise and other issues.

    Anyways, I told my endo I was taking 24 units of Levemir twice a day based on my basal rate being 1 unit an hour. I told her I was not sure if that was right since my family doc had to write the script and just asked me how much to write the script for.

    My endo said 24 units twice a day at 11am and 11pm is fine. And she said that will be fine until I get my animas pump. She is anticipating me getting my animas pump soon.
     
  10. C6H12O6

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    I have a family member who takes 10 units of Levemir twice a day and will be switching to a pump soon. I was told they are going to start him on 0.41 units per hour to start and then base the new basal rates on the bgs. (He will have to test frequently when he starts on the pump.)

    They have never suggested doing a different am and pm dose of levemir. And the endo at one point said he might be able to get away with just one shot of 10 units levemir in the am.
     
  11. C6H12O6

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    I am seriously concerned her endo will fire her is she admits to making those types of changes without consulting anyone.

    That is pretty much the norm with adult endos in Canada, if you are not "compliant" there is no point in going.

    You can have your family doc order your blood work, and not take up the endos time. It kind of makes sense too. If you are doing well than more power to you. Just utilize your family doctor not an endo.

    my endo is not so heavy handed, she just says "I feel like you come here and I do nothing for you." Honestly she is right the appointments are a pointless ritual.
     
  12. AliciaM

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    My endo isn't the one who Rx'd the insulin my GP was. I've been really busy because I just moved but I will call and ask about whether or not I should split. But it's been working better than the all at once dose so I don't really see the problem?...
     
  13. cdninct

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    Interesting. I guess it is one of those YDMV moments. Perhaps K's very low basal needs (in general and compared to bolus needs) contribute to his 1:1 ratio with Levemir.

    I still think that Lantus broken into 2 doses would not have to be doubled, though.
     

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