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Lantus to Levemir

1abRat

Well-Known Member
Messages
248
Type of diabetes
Type 1
Treatment type
Insulin
So, after more than 10 years on Lantus I've decided to cross over and try out Levemir.

I've grown weary of the amount of time it takes for Lantus adjustments to show, especially because my Endometriosis has gotten worse and more unpredictable and I also want to try and split my dose so that there's a bit of overlap in the morning when my liver gets a bit too enthusiastic. I also suspect that my Lantus is not 100% predictable at times and since I've lost almost 2 stone since January and reduced my dose, the Lantus no longer lasts 24 hrs.

I'm currently on 20 IU of Lantus so am planning on spitting this 9PM and 7AM with the Levmir 10/10.

The DSN (who was extremely unhelpful and seemed deeply offended that I'd made some sort of decision about my own care) said that I should do an 8/8 split initially and see how that goes for three days and then adjust if needed.

Her actual words were that I should reduce my dose by 10% and she got very angry when I observed than an 8/8 spilt would be a 20% reduction...sigh. I've decided to try 9/9 for a day but suspect I'll end up on more than 10/10 because most people seem to need more Levemir.

Anyway, I was wondering what the consensus on here was and what peoples experiences of changing over was? Especially on the day of the changeover. One concern I have is whether you ended up with Lantus still circulating making you hypo on the first day or was it OK?

I'd better get ready for lots of basal testing!

Thanks in advance guys!
 
Probably best if you don't change until 24 hours after your last Lantus, so you have the least amount still circulating. I needed more Levemir than Lantus but it's a good idea to start at 80% dose and titrate up as needed.
 

It's some time ago now, but when I briefly switched from lantus to levemir my DSN said that patients usually need a higher dose on levemir than they would on lantus.
 
My doc doesn't like levemir. Said I would need much more and very unpredictable.
 
Thanks very much folks!

@tim2000s I realised half way through that I'd read that thread before - very helpful and interesting that you found that you needed less Levemir than Lantus overnight!

Perhaps I'll start on a dose of 8 IU at night and then 9 IU in the morning rather than 9/9 to reduce the likelihood of night hypo.

At least if it turns out I need less than 9 in the day I'll be watching the Libre like a hawk and can snack accordingly!

@robert72 I was definitely going to leave it 24hrs but wonder if longer would be better? Probably not though...most likely leaving it longer is a terrible idea haha! The trouble with this stuff is it can be so variable from one person to the next can't it?

Not going to take the plunge until after the Bank Holiday as I've a lot going on that week so won't have the necessary time required, it all feels slightly daunting!
 
Kristin251 said:
My doc doesn't like levemir. Said I would need much more and very unpredictable.
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That's an interesting statement from them. In many people's experience Lantus is horribly unpredictable, and indeed, if you look through the research literature, the absorption variability of Lantus is much similar to NPH than Levemir, which, in the studies undertaken, proved to be much less variable. I'm fairly sure the research was independent too, and not sponsored by Novo. The details can be found in the early part of this post: http://crick-tech-munch.blogspot.co.uk/2015/11/lantus-lethal-or-lifesaver-doc-gbdoc.html?m=1

Still, who worries about little things like research!
 
I went from Lantus to Levemir after only a few weeks.
They thought I was having a minor allergic reaction to it as it was like a bee sting when I injected.
After being on Levemir. (as I'm newly diagnosed they're still playing with my doses) I'm now on 16 before bed and 10 in the morning.
The only downside I can see is that it doesn't last the full 24 hours so the dose must be split. Hence inject morning and night.
I feel so much better. They say that Lantus is more acidic so can sting when it is injected.
I would definitely suggest it if you aren't getting along with Lantus. Didn't really feel much on the day of switchover. But that may have been because I haven't been on any insulin for a long period of time.
Hope this helps
Emma


Sent from my iPhone using DCUK Forum mobile app
 
Thanks Emma!

Yes, I also get the "bee sting" effect! I consider the raised pH of Levemir to be an added bonus!

I've been injecting Lantus for 14 years so whether allergy or just a side effect it hasn't progressed or done any damage to my injection sites. It has really done wonders for my dictionary of swear words though haha!
 
Just an update on my switch to Levemir.

I made the change last Sunday and went with 8 units at bed and 9 in the morning. Set my alarm to wake me every 2 hours in the night and boy was I glad. Sugars were ~15 mmol/L every time I woke despite corrections all night.

Bearing this in mind I did 10 units for my morning split.....high all day despite almost zero carbs and lots of corrections again AND I HATE BEING HIGH GRRRRRR!!!

Fast forward to a week later and a lot of sleepless nights and steadily increasing doses and my weekend of basal testing has revealed that (at the moment) I need 18 units at night and 21 units in the morning! This is going from 20 units of Lantus a day!

Apart from this I find Levemir to be a nicer basal for me. Overlapping it in the morning (I inject at 9pm and 7am) has reduced the severity of my "foot on the floor" so that instead of the Libre showing a vertical up arrow and an increase of ~4 mmol/L every half an hour it now trickles up gently and needs less Novorapid to correct.

I find it doesn't drop off a cliff so quickly when I'm exercising.

Dosage adjustments take effect quicker than with Lantus.

It doesn't sting when I inject so no more watering eyes and swearing before bed (this pleases my partner!)

In answer to my own initial question I did notice that I was higher on the second day despite having actually increased my Levemir dose so it seems that even though it was 24 hours after I'd last injected Lantus there was still some in my system that first day.

Thanks everyone for your advice before my changeover. It was reassuring to know that if anything unexpected happened I could come here for advice
 

That's quite a difference from using lantus @1abRat, regardless as long as your bg levels are much more stable and you feel much better in yourself that's all what matters, hope your good progress continues.
 
noblehead said:
That's quite a difference from using lantus @1abRat, regardless as long as your bg levels are much more stable and you feel much better in yourself that's all what matters, hope your good progress continues.
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Cheers!

I know, I can't believe it either but I'd done loads of work with the Lantus trying to get the basal rate just perfect and it was, apart from the morning foot on the floor so 20 IU was definitely right.

The Levemir is giving me the most amazing flat line profile overnight, even better than the Lantus which would always drift down by 1-2 mmol/L which was a necessary compromise as my daytime requirements were higher than night and I figured if I was going to have to split my Lantus I may as well give Levemir a go.

I'm 90% sure of my daytime Levemir and will be doing more daytime basal testing this week but have just changed Libre sensors so that'll need a couple of days to stabilise first.
 
1abRat said:
I'm 90% sure of my daytime Levemir and will be doing more daytime basal testing this week but have just changed Libre sensors so that'll need a couple of days to stabilise first.
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The joys of basal testing @1abRat

You done extremely well to nail the dose down in the space of a week, when I changed over to levemir I had a hell of a time trying to get the dosage right and ended up changing back to lantus, again well done.
 
noblehead said:
The joys of basal testing @1abRat

You done extremely well to nail the dose down in the space of a week, when I changed over to levemir I had a hell of a time trying to get the dosage right and ended up changing back to lantus, again well done.
Click to expand...

Well, we'll see what happens when the "lady hormones" decide to change everything again! Sigh!
 
Hi, I just wanted to say I was put on Levemir a few years ago now, when I went on a carb counting course at my hospital. Initially I was on 16 units at night, over the years (and being told 16 is to much for me and to reduce it by two) gradually reduced the dose came down and I am on 10 units before bed and that's it. I did once ask about splitting this amount, but DSN said I don't need to.
Good luck @1abRat
 
ive got an apointment and I want to talk about the lantus/ levimer thing. I'm on 15 units of lantus before bed but sleep for 12 hours a night due to ME. I always have to eat before bed becasue i drop alot in the night so I'm hopeing to find away around that
 

If you find that your night requirements differ to your daytime Lantus you can split your dose.

Make sure you do some basal testing. It might be that your Lantus dose just needs reducing and your bolus needs increasing during the day.
 
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