Struggling with changing to Levemir from Lantus-anyone else?

[cageyytigers]

I have been on Levemir for 3 weeks after changing from Lantus. My sugars have been all over the place- mostly drifting high during day and night. I took 13 units of lantus- now up to 22 on Levemir- split dose- and still not happy. Any advice/insights? before I'm back to Lantus and its hypos.

 

[kitedoc]

Hi @cageyytigers, I have been on Levemir bit not Lantus. The problem when looking at some studies of dosing equivalents is that some studies are done on T2Ds where some endogenous insulin (from the person's own pancreas) may have confounded the results.results.
From blogs like diabetesdaily.com Switching from Lantus to Levemir Dec 26 2016 and forum.tudiabetes.org Levemir/Lantus dosing equivalents Oct 2014 the individual answers amounted to a dose ratio of Lantus to Levemir of between 1:1 and 1:1.4 or higher.
The question of once daily levemir vs twice daily was also raised and most on Levemir seemed to prefer the twice daily regime as being more flexible for reducing risk of night time hypos.
So one that very small sample: So you have a current ratio of 1:1.6 but that is not unheard of and it depends I guess on whether some further increase on Levemir is warranted before abandoning it. Everyone is different and if say, a little more am Levemir helps, without causing night-time hypos it may be worth a try, having, of course, discussed this first with your prescriber.
The other thing to consider is whether you still have some endogenous insulin supply which is confusing the issue.
Best Wishes.

 

[urbanracer]

I have been on Levemir for 3 weeks after changing from Lantus. My sugars have been all over the place- mostly drifting high during day and night. I took 13 units of lantus- now up to 22 on Levemir- split dose- and still not happy. Any advice/insights? before I'm back to Lantus and its hypos.

I am currently using Abasaglar (a biosimilar Lantus) but my next insulin script is for Levemir so I'll let you know how it goes. Will probably be making the change next weekend.

 

[cageyytigers]

Hi @cageyytigers, I have been on Levemir bit not Lantus. The problem when looking at some studies of dosing equivalents is that some studies are done on T2Ds where some endogenous insulin (from the person's own pancreas) may have confounded the results.results.
From blogs like diabetesdaily.com Switching from Lantus to Levemir Dec 26 2016 and forum.tudiabetes.org Levemir/Lantus dosing equivalents Oct 2014 the individual answers amounted to a dose ratio of Lantus to Levemir of between 1:1 and 1:1.4 or higher.
The question of once daily levemir vs twice daily was also raised and most on Levemir seemed to prefer the twice daily regime as being more flexible for reducing risk of night time hypos.
So one that very small sample: So you have a current ratio of 1:1.6 but that is not unheard of and it depends I guess on whether some further increase on Levemir is warranted before abandoning it. Everyone is different and if say, a little more am Levemir helps, without causing night-time hypos it may be worth a try, having, of course, discussed this first with your prescriber.
The other thing to consider is whether you still have some endogenous insulin supply which is confusing the issue.
Best Wishes.

Thank you so much for taking the time to help me.