Lantus to Levemir: in need of encouragement

[Leeannea]

Hi. I’ve had Levemir sitting in my fridge for a week that I look at every time I open the door. But I’m too scared to use it. I live in Australia and lantus is by far the more commonly prescribed long acting insulin here. My local chemist has “ almost no one “ on it. From reading the forum I get the impression that it is often prescribed in the UK, so I thought I’d turn to you all for encouragement.
I’m on MDI with 7 units of lantus in the am and 1.5 in the evening ( plus novorapid). I want to change to Levemir for 2 reasons. The first is that I’m very insulin sensitive and I’m terrified of injecting the 7 units intramuscularly. The second reason is that at night my big goes up from midnight to 3am then steadily down, often to mild hypos on waking. I think that Levemir might give me better control. My endocrinologist agrees.
My plan, that I m too afraid to execute, in case it has a literal meaning, is to take 4 units of Levemir the first morning and 2 units at night and go from there, correcting as necessary. Should I do 2 days before I change the dose of Levemir or do you think one day is enough?
I read Scott C’s thread on his change from lantus to Levemir but I’d be grateful for anyone’s opinion as I am just plain scarred.
Many thanks
Leeanne

 

[Fairygodmother]

When I changed from Lantus to Levemir I let the Levemir bed in for three days before I adjusted the doses. Like you plan, I corrected when I needed to. I also kept a rigorous chart of my results. This will be much easier if you have a libre or a cgm. The libre will show you the trends and the daily graph.
It took a while and lots of attention, together with the courage to adjust, but it was certainly worth it!
Can you get, or do you have a Novopen Echo for the Levemir so that you can make smaller adjustments to the doses?

 

[kitedoc]

Hi @Leeannea,
Fellow Aussie here.
Intramuscular Lantus might be one of your worries but regarding Lantus vs Levemir I invite you to look ar diabettech.com Lantus: Lethal or Lifesaver? which might help you to see Levemir's relative benefit compared to Lantus.
I reckon injection into a blood vessel is rare, but it can happen and people on this site and others have reported the sudden hypo onset when they have accidentally hit a blood vessel when injecting Lantus ( i remember @Rab and @alphabeta posting in past threads).
And it worries me that prescribers are not warning people of this potential problem with Lantus ( compared to absence of rosk with injection Levemir or Tresiba).
I hope this helps to encourage you to consider trying out your prescribed Levemir.
Best Wishes

 

[Leeannea]

When I changed from Lantus to Levemir I let the Levemir bed in for three days before I adjusted the doses. Like you plan, I corrected when I needed to. I also kept a rigorous chart of my results. This will be much easier if you have a libre or a cgm. The libre will show you the trends and the daily graph.
It took a while and lots of attention, together with the courage to adjust, but it was certainly worth it!
Can you get, or do you have a Novopen Echo for the Levemir so that you can make smaller adjustments to the doses?

Thanks so much for replying. I have a Guardian 3 cgm. I also have a half unit echo pen. I m just lacking courage but I m definitely heartened by your experience. Thanks !

 

[Leeannea]

Hi @Leeannea,
Fellow Aussie here.
Intramuscular Lantus might be one of your worries but regarding Lantus vs Levemir I invite you to look ar diabettech.com Lantus: Lethal or Lifesaver? which might help you to see Levemir's relative benefit compared to Lantus.
I reckon injection into a blood vessel is rare, but it can happen and people on this site and others have reported the sudden hypo onset when they have accidentally hit a blood vessel when injecting Lantus ( i remember @Rab and @alphabeta posting in past threads).
And it worries me that prescribers are not warning people of this potential problem with Lantus ( compared to absence of rosk with injection Levemir or Tresiba).
I hope this helps to encourage you to consider trying out your prescribed Levemir.
Best Wishes

Thanks for your help. And especially the link. I was hoping you’d comment as I remembered you had spoken about lantus before. Cheers

 

[urbanracer]

Hi @Leeannea,
Fellow Aussie here.
Intramuscular Lantus might be one of your worries but regarding Lantus vs Levemir I invite you to look ar diabettech.com Lantus: Lethal or Lifesaver? which might help you to see Levemir's relative benefit compared to Lantus.
I reckon injection into a blood vessel is rare, but it can happen and people on this site and others have reported the sudden hypo onset when they have accidentally hit a blood vessel when injecting Lantus ( i remember @Rab and @alphabeta posting in past threads).
And it worries me that prescribers are not warning people of this potential problem with Lantus ( compared to absence of rosk with injection Levemir or Tresiba).
I hope this helps to encourage you to consider trying out your prescribed Levemir.
Best Wishes

I did this change last year and am glad that I did. After initially starting on the same daily units, I waited several days before upping the dose, just to be sure that my body had adjusted to it.

I had to increase the dose for a second time a couple of weeks later, and from what I've read it seems common to need a higher dose with Levemir than with Lantus. For me it means my daily total is now 4u higher than with Lantus.

Good luck with the changeover, I'm sure it'll be fine.

 

[Leeannea]

I did this change last year and am glad that I did. After initially starting on the same daily units, I waited several days before upping the dose, just to be sure that my body had adjusted to it.

I had to increase the dose for a second time a couple of weeks later, and from what I've read it seems common to need a higher dose with Levemir than with Lantus. For me it means my daily total is now 4u higher than with Lantus.

Good luck with the changeover, I'm sure it'll be fine.

Thanks so much for replying. I’m certainly starting to feel more confident. Cheers.

 

[Deleted Account]

@Leeannea I went from Lantus to an insulin pump (to manage things like the night time rollercoaster).
I mention this because I was warned that although the peak of Lantus lasts less than 24 hours, you may find some residual Lantus affecting your BG for up to 4 days.
This is definitely not a reason to go for the Levemir. Just another reason for letting it "bed in" for a week before adjusting your doses.

 

[Leeannea]

@Leeannea I went from Lantus to an insulin pump (to manage things like the night time rollercoaster).
I mention this because I was warned that although the peak of Lantus lasts less than 24 hours, you may find some residual Lantus affecting your BG for up to 4 days.
This is definitely not a reason to go for the Levemir. Just another reason for letting it "bed in" for a week before adjusting your doses.

That’s a good thought and I will definitely take this into consideration. Thanks for your help.

 

[alphabeta]

Hello, thanks for the mention @kitedoc
I did have some horrible times with Lantus but till this day it remains a mystery as to what happened. One day I can't hold 10 units without going hypo the other I am at 16 units (currently). Literally, only the season has changed.
In my case however, Lantus once was spoiled by heat and it caused massive hypos as if it is short acting within an hour although I reduced my dose to the half. Also, thigh injections are no option for me because no matter what I do, I end up screwing up and hitting a vessel and going hypo.
That's my experience but now I can say that I am trouble-free from all that. Good luck.

 

[mentat]

Another reason to feel good about Levemir... Lantus forms a sticky ball when you inject it in your body and stays there. This is how it achieves its slow release, but putting physical pressure on the ball changes insulin release. Levemir does not have this problem.

I have much better results on Levemir than Lantus. Levemir is shorter-acting than Lantus and for me at least, I can reduce my Levemir after a day of exercise so I don't go low overnight.

I'm in Aus as well (Sydney). Endos here rarely prescribe Apidra and Levemir, even though I think they're hands-down better if you know what you're doing. Although Fiasp is on the PBS now which will work better than Apidra for some people.

 

[Justin04]

Hi @Leeannea. Also in Aus. Until 2013 I was on Humalog NPH. The hypos were few but very savage when they hit. Saw a different endo by total accident at an appointment (I travel 3 hrs to see an endo), and he asked why I was still on ‘90’s technology. He politely told me to get with the program and prescribed Levemir. I asked why not Lantus and he said from his findings Levemir worked much better for people that had an active lifestyle. A few weeks after starting they split my single dose to 40/60 and it’s the best control I had in 15 years. I’ve now gone to a pump but from all the info I found/heard, Levemir is the pick of the bunch. In saying that I’ve never used any others either. I’ve heard good things about Tresiba but I guess everything works different on each individual.

 

[etmsreec]

For me, Levemir was much better than Lantus, and Tresiba was much better than Levemir.
I had some trouble in sorting out the split in my doses on Levemir. Levemir is one of the shorter acting basal insulins, so splitting the dose is quite common, from what I understand.
Tresiba, if you're able to get it, is a much longer acting insulin, so doesn't need to be split, and will be in the body for upwards of 26 hours. This does have the side effect of not being able to adjust basal doses for weekends or rest days, as one might with Levemir. Whether on Levemir or Tresiba, it's best to leave about three days between adjustments to basal rates, so that they bed in properly.
Lantus, just to give full information, made me very drowsy. I could fall asleep just sitting down to take my shoes off. Once I had swapped off Lantus and onto Levemir, I got my life back again.

 

[Leeannea]

Thanks so much everyone for your replies. I still haven’t swapped, although every night I think “tomorrow is the day”. Hopefully soon it will be.

 

[VivD]

I didn't know it could do that. I have both lantus and novarapid and I am feeling drowsy a lot of the time. I'm only taking 12ml at the moment - on a pretty strict keto diet. I use the novorapid if I go a bit high. think I will drop the lantus and rely on novarapid and see if it makes a difference.

 

[Lynne211]

Hi @Leeannea,
Fellow Aussie here.
Intramuscular Lantus might be one of your worries but regarding Lantus vs Levemir I invite you to look ar diabettech.com Lantus: Lethal or Lifesaver? which might help you to see Levemir's relative benefit compared to Lantus.
I reckon injection into a blood vessel is rare, but it can happen and people on this site and others have reported the sudden hypo onset when they have accidentally hit a blood vessel when injecting Lantus ( i remember @Rab and @alphabeta posting in past threads).
And it worries me that prescribers are not warning people of this potential problem with Lantus ( compared to absence of rosk with injection Levemir or Tresiba).
I hope this helps to encourage you to consider trying out your prescribed Levemir.
Best Wishes

why post something like this, these are incorrect statements, the poster already mentioned she's scared and very insulin sensitive, as am I, she's working with her health care team...so posting nonsense like this is not beneficial!

 

[Fairygodmother]

why post something like this, these are incorrect statements, the poster already mentioned she's scared and very insulin sensitive, as am I, she's working with her health care team...so posting nonsense like this is not beneficial!

Levemir doses are smaller than Lantus, it works best when split. Some people also split Lantus to eradicate the drop off before 24 hours and the dip approx 5 - 6 hours after injecting. A high dose of any insulin directly into the bloodstream will cause problems as it will be absorbed much more quickly. As I understand it Lantus is designed to create slow dissolving crystals when it combines with fat molecules so it’s going to be more problematic if it’s injected into a vein.

 

[Leeannea]

Hi. I thought I’d share the news that today is The Day! It only took a month! I had my first injection of Levemir this morning. I’ll give it a bit of time then share the outcome in case it helps anyone else changing from lantus Cheers and thanks again for the support of those who replied to my original post.

 

[22nw22]

I was on there. I was fine and corrected when I need to. Not on Levemir anymore as they switched me to Tresiba

 

[Leeannea]

Hi again. As an update, unfortunately twice daily levemir wasn’t for me. It only lasted 9 hours, so it ran out in the early hours of the morning leading to exacerbated dawn phenomenon and foot on the floor. Then around 4pm I had take more novorapid Oh well, worth a try. Cheers. Leeanne