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1 - wondering what experiences pt have w this new insulin levemir? in comparison to lantus? regarding weight? (Comment this)

2 - Just started using insulin and My Doc started me with Levemir. What is the normal dose? I was started om 10 units, now at 15 units. (Comment this)

3 - I'm using Levemir for 20 days now . I tried Lantus , it didn't work for me . I' ve beem diabetic for 25 years , have a good HbA1c with NPH but lots of hypos . I am a little bit confused about the "no eating " before exercise . Did it work ? Thanks , Reg (Comment this)

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5 - Iello,

I'm a 52y.o. single guy who has been type 1 since 1959. I've been on many different types of insulin over the years and am now on 3 doses of Actrapid , 56.6.56.from a pen, I also take levimir for overnight cover and my regular dose is 78 units.I know that these are high doses. at the present. I am not working as a couple of years or so ago I lost the lower part of my left leg and am useing a prothsesis. I shattered my foot one night whilst asleep against a wall adjacent to my bed. Anyway my comment is that since takeing this regime I get extremely tired, none of my healthcare professionals have an answer to this. I am also , and have been most of my adult life overweight, for a height of 6'2'' I'm around 18 1/2 stone. Is this an age thing ? or should I suggest some other type of treatment. I am also on quite a few other drugs for related problems etc.Perhaps there is an interaction between them as well? (Comment this)

6 - My Dr. is changing me from Lantus, 80 units daily to Levenir, 80 units daily. Does anyone out there have an opinion as to how these drugs compare and if the daily dose should be about the same?
Thanks
Phil (Comment this)

7 - I was prescribed Levemir with Byetta. I did use Lantus for six months or so, but it brought down my baseline, and seemed to raise my postprandial. I complained bitterly because my numbers after eating were quite high. I was put on Byetta, but still have the dawn phenomenon. I tried Levemir. Unfortunately it did not work well with Byetta.
My understanding is that Levemir acts for six or more hours. Lantus has a slower action, and lasts for about 11 hours. This has been my general appreciation of the two shots. I can't quite remember why, but there was a definite improvement of Levemir over NPH; hence, I was prescribed it. Hope this helps. (Comment this)

8 - I have been on Levemir for approx. 1 1/2 months now, at first I could not get a handle on the sugars levels, morning waking to 350+, kept increasing and up to 70 units a day, at the same time taking amaryl, actos, 1000mg gluco, daily. I have now got the sugars down, still a roller coaster but down, the eating habits have improved tremendously, exercise is now in the routine, mainly walks at lunch and started in the morning as well. Have lost weight but need to lose more, I am concerned with the ups and downs of the sugar levels, recently in the morning 92 was a nice surprise, then rises to 120, this morning however was 284, when I went to bed it was 240, this concerns me that morning is actually higher than bedtime. (Comment this)

9 - hi have been diabetic for 30years just changed from lantus 70 unites daily to Levemir ,as of yet cannot get my pre breakfast bg down ,am taking much more Levemir than lantus 95 unites Levemir copared to 70unites lantus ,any one else had the same kind of problems ?????? (Comment this)

10 - My doctor switched me from Protaphan to Levemir to help with my high morning levels. After I got the dosage right it worked wonders. I am Type 1, and do 2 injections of Levemir: At 8 am - 16 Units and when I go to bed (after 11pm) 11 Units. It works perfectly for me! I think the more you inject the longer it lasts and my feeling is it doesn't have the spike that Protaphan has. I don't have so many night-hypos as I used to either. But to answer Angela's question, I *am* using more Levemir than I was Protaphan, in about the same proportions as Angela. But I ask, is that important? The important thing, to me, is that my sugars are better balanced now, I couldn't care less if it means injecting more insulin. (Comment this)

11 - === off-topic comment ===
I recently received (and agree with) the following comment from a long-time reader:

It would have been so very helpful if we could have our diabetic history and current meds automated under our names each time so we could review quickly what medication each person is on, when they were diagnosed and what type Diabetes they have, when they started Byetta, etc., and eliminate the constant repetition of asking and answering. I understand from you that this is not possible in an automated way, so perhaps the blog contributors could be encouraged to voluntarily type under their comment each time as briefly as possible to assist us in responding in a more efficient manner? Thank you so much. (Comment this)

12 - I am currently at the tail end of a levemir study that my doctor asked me to participate in. I have come to the conclusion that I want to go back on my lantus. For the study I am required to inject in to my thigh rather than my stomach, which I have always used for my previous insulins. I have discovered these things while on Levemir.
1. I bruise very easily in my thighs and have stayed bruised for the last 3 months that I have been on the study.
2. I was taking 45 units of Lantus at night, but when changing over to Levemir, I'm now up to 77 units at night and still do not have my glucose as well controlled as I did with 45 units of Lantus.
3. My fast acting insulin is humalog. Pre-study my humalog units were right at 10 units a meal, they they are up to 20 units. That is without changing my diet or the things I am eating.
4. I do not like the Levemir injection pens. I take 77 units a night. The pens only dispense 60 units at a maximum, so I have to take two shots for the one dose.
5. It took me forever, almost the whole length of the study to get my glucose numbers back to where I consider them controlled.
These are just my observations and certainly aren't scientific in any way. I just thought I would share them in case anyone else felt like they were losing control right after starting a Levemir regimine. (Comment this)

13 - Geneva - these are really good things to know. I am seeing my endo next week and am going to ask to be switched to Levemir from Lantus. The weight gain is a real concern for me. After 4 months on Lantus I have managed to see better waking BG#s but have put on some lbs. I am also on Novorapid for meals and noticed I need more fastacting on Lantus than NPH. From your comments I will assume I may need even more fastacting on Levemir. All good things to be aware of. (Not a lot of Type I's are commenting on multiple daily injection therapy - more of a two shot per day regimen. Why is that...?) (Comment this)

14 - I have been a Type 1 diabetic since I was 12 yrs old, I am now 32. I have been using Novulin N, 30 units before every meal and now the doctors have put me on Levemir, 20 units at night and 10 units of Novulin N before each meal. I am about to start this program but wanted to hear from others just what I should expect. Thanks for any info. (Comment this)

15 - Just started on Levemir also. Have used UltraLente for the past 20 years and they have just discontinnued it so I needed something new. (Comment this)

16 - My daughter was diagnosed in Sept. of 2004. She started with Lantus and was switched to Levemir at her last check 2 months ago. She really likes the Levemir because the Lantus was pretty uncomfortable for her to inject due to its acidity level. Her BG#s have been high, but I don't account that to her meds as much as I do her lack of checking number often enough and watching her serving sizes. She's 12 years old and is very preteen. I am finding that having a diabetic teenager has its own set of challenges. She takes Novolog before each meal, units are based on a sliding scale. I wil ask her endo about splitting her Levemir. She currently takes 48 units before bedtime. (Comment this)

17 - I have been a Type 2 diabetic since 2001 and am on glucophage 2000 mg/day and amaryl 4 mg twice daily. My physician recently temporairly added Levemir when my A1C measured 8.4. I enjoy the convenience of the pen format but was concerned when I gradually had to increase to 28 units daily. Now I plan to watch my diet more closely, increase daily walks and hopefully eventually get to the point of requiring less or no insulin backup. The only complaint that I have had is minor itching at the site of the injection. It is a good feeling to have my blood glucose in the normal range now.
 (Comment this)

18 - HI All - New guy John here in Canada - where Lantus and Levimir are much "newer" products and we have no blogs on them as yet. I am Type 1 for 30 years due to pancreatic rupture and live on a 4 cans per day diet of Ensure Plus only and pancreatic enzyme tablets. I have full blown neuropathy of both feet treated with MS Contin and live a sedentary lifestyle on a Disability Pension. My Present 48 NPH plus Fast-acting 3 to 4 times / day has my BGs completely uncontrolled for 4 months now and I see my Doc on 5/15/06 to be scripted either Lantus or Levemir. I have tried to understand both of these Blogs but your product names are SO different that I have great problems understanding. MY PROBLEM IS: I must decide between Lantus or Levemir and would like to hear from people speaking generally as to their opinions on which is the better one - not considering cost or delivery method. Could some of you SKSs please openly, ( or privately to whatzizname[at]hotmail.com )let me know your personal opinions on which would be the better one to start on when I switch. TYIA, John. (Comment this)

19 - Started on Levemir a week ago at 6 units and have now increased to 18. Blood numbers have increased as the dose went up. I have also found it causes great problems trying to sleep.

It would seems to me that as the dose went up the numbers should come down but it did not.

There must be something better then this stuff. I had far better control on 4mg of ameryl. (Comment this)

20 - I think that you will find that you will always use more Levemir than Lantus. And, for most people it will require more injections. If you read the PI most of the studies show equal efficacy to Lantus, but more insulin is needed to get there. An average of 137% more insulin than Lantus. Plus, from what I read there is a higher peak at higher doses. For a type 1 or a person who requires very little basal insulin to gain control, you might be able to get by on 1 shot a day. However, for a type 2 or a person who needs more insulin to get control (insulin resistant) the studies indicate you will need possibly more than 100 units of detemir to gain control. that would be two shots from the flexpen since it only doses 60 units at a time. Most patients in the studies required BID dosing.

I'll stick with my Lantus thank you very much. And, before your doctor tries to switch you from Lantus to Levemir/Detemir ask him how much money he is being paid to do so. Rumor has it, it is $1000 per patient to switch from Lantus. (Comment this)

21 - I began using Levemir 3 weeks ago. I am very sensitive to insulin and may need to split my basal dose, my MD isn't comfortable splitting Lantus.

So far I have not seen much difference and have only had to increase my dose slightly since beginning.

Shari

 (Comment this)

22 - I switched from Lantus to Levemir May 1 at same dosage, 7-8 units depending on bedtime BG. Happy to report good waking BGs with no more dawn effect. I have noticed few overnight lows and can tell if I wake up with a splitting headache and rebound BG#s. But I think I need more fastacting at meals now as oppposed to both the NPH and Lantus since pre-lunch and dinner can be higher than before. Trial and error but getting better and cheaper not to mention the convenience of the pen needle delivery method. Lantus is only available by the vial and needle. (Comment this)

23 - My doctor switched me from Lantus to Levemir in March, same amount. Happy to report that my sugars have leveled out and I am having less trouble with my morning highs. I was concerned at first as I had gained quiet a bit of weight on Lantus, but since being on Levemir I have actually lost 2 lbs. Although it doesn't sound like much, its nice to feel good and not to be putting on the weight. (Comment this)

24 - I switched from Humalog/Humalin combo
to Levemir almost a year ago. I tried the
Levemir at bedtime, but have found much
better results by splitting it into 2 shots 7am and 6pm. I still take the fast
acting at every meal, and on the whole
am pleased with the results. The decision for me,when presented with a choice between Lantas and Levemir was not having
to go back to a vial and needle. We can
only get the Levemir in pen form here in
Canada.
I have been having weight problems and the doctor has mentioned a combo of Metformin and Levemir. Does anyone have
info on that? I have been diabetic 38 yrs
this year. (Comment this)

25 - Levemir is a true nightmare and I hate it!!!!!!

I have been using Ultra Lente and Humulog for years and have been able to control it so well. They discountinued (God knows why!!!!) Ultra lente, and my new doctor gave me, without any explanation or help, this Levemir. I am trying to adjust it on my own, since he did not take the time, except telling me to try it and adjust it on my own. I'M SO MAD!

First, my Humulog does not seem to work anymore, and I've increased the dosage. I have been checking myself, with the blood sugar, about 9 times per day... so imagine how much this entire thing will end up costing me! I'M SO MAD!!!!! I could control it so well before... and this stupid insulin is allowed to be used. How could that be? How could they give me insulin without being help with the doctor? And, this insulin only comes in pen, which is very expensive... so, let's do the calculation, 9 blood sugar check per day, raising of Humulog dosage and a pen... this is without counting the seringues (for the Humulog... I used the vial because it is not as expensive as the pen - $30 versus $50), and the other stuff, such as the doctor's visit, etc.

WHAT ELSE WORKS BETTER????????????????? Please, email me on this one. Thanks (Comment this)

26 - Andree:
I suspect the problem is not the Levemir, but your physician. Go back, and explain your frustration, and ask for a referral to an experienced diabetes team with a diabetes nurse educator, dietitian, and endocrinologist.

Best wishes. (Comment this)

27 - Levemir and Byetta:
Anyone using this combo? It gave me terrible stomach pain and vivid vivid nightmares. Endo says nightmares are a function of low sugar, and the stomach pain is the Byetta. I am scared to try again. Wondering if the timing of these shots could be better spaced. (Comment this)

28 - One of the big things to watch is that Lantus or Levemir is a basal insulin so if you wake up in the morning and your blood sugars are between 90-110 you have the basal insulin set correctly. If your Post Prandial insulin rises and is high your doctor needs to adjust your Meal time insulin (Humalog, Novolog, Apidra). One of the biggest issues with Doctors is they ask a basal insulin to cover meals and they are not designed to do so. (Comment this)

29 - Also something to remember is Levemir is a peaking insulin. It is very dose dependent and most people have to use a ton of it just to get the same efficacy as mild doses of Lantus or NPH. The drawback to this is it usually does not last 24hrs and most of the time needs to be dosed twice a day. The other downfall is it is usually about 8% more expensive than Lantus and you have to use 60% more insulin to get the same efficacy. I have had major problems tweaking this insulin and have now stopped and went back to Lantus. My phsician told me that Lantus is a better product and that it really is the best basal insulin to use. (Comment this)

30 - My son has just started using Levemir, he is 11yrs old and was diagnosed at the age of 3. up untill now he has been on Nova mix. Just recently he has been put on to 4 injections a day, Novamix before breakfast, novarapid before dinner & Evening meal and 9 units of Levemir at 8pm. His sugar levels have been really good the levermir is a flat working insulin and has no peaks therefore reducing the chances of hypo's in the night, we were also told to keep one injection site especially for the levemir to avoid it mixing with any of the other insulin and to keep to the same hour every night. I also was told that levemir lasts in the system for approx 12hrs. (Comment this)

31 - I'm a 44 yo type 2, diagnosed at 30. I take 50 units of Levamir p.m. and 20 units a.m. My endo changed my insulin from Lantus, which was working, to Levemir which did not and my a.m. sugars increased from ~120s to 200+. He has now switched me back to Lantus. I'll put up with the sting at the injection sites. Good Luck. (Comment this)

32 - I'm a 35yr old guy who has been diabetic for 25 yrs. Just changed from Lantus to Levemir 20 days ago due to severe problems with unpredictibility of the Lantus. I found with the same food and exercise I could go from being high to low from one day to next that was beyond any of the Docs to explain!
At the moment still slowly gaining control but I seem to have the oposite experience to everyone here. I have always been a low doser, 14 units of Lantus (once a day at 18:00) and have reduced to 12 units with the Levemir (one dose a day at 22:00). I have also found that I have become very senesitive to the Humalog and now use approx. half the dose for meals that I used previously. Originally 6 - 8 - 10 and now 3 - 4 - 3.
Has anyone else out there had a similar experience? By the way my blood sugars are now extremely stable!! :-)
Anyway my recommendation is to try this new insulin if you find the Lantus too unpredictible like I did. (Comment this)

33 - I left the oral meds (glucovance & actos) due to paying over $300 per month for pills and saw my A1C's starting to rise again. My doc started me on Lantus down at 10 units - blood sugars went nuts, I adjusted up to my one month visit where I was at 37 units at night. That was okay, but I had pain for 20 minutes every night at the injection site. I went walking twice a day - 1/2 mile to a mile each time. I just switched to Levimir since the doc wanted to keep me on once a day for cost concerns. I've not increased my weight during this last month, but I'm sure not losing any either, and I've definitely cut out more carbs.

I'm a little concerned at what I'm reading here, sounds like I'm going to spend more money to escape some pain? We'll see what happens in the next few weeks.

How do people feel about going to a Gen Pract. vs. a specialist? Is it worth the extra money for the specialist? My current insurance has a rider on my diabetes, so I'm on my own here.

Thanks to all - God Bless!
Kathy (Comment this)

34 - We were just switched from Lente to Levemir yesterday because of the discontinuation of Lente. . . .very frustrating! My son has done VERY well for many years using Lente on a one-shot-a-day program. A1c's in the 6 - 6.6's.

Now Levemir, and the Dr. did not explain how to adjust his Humalog usage to allow for the change. We are used to having a Humalog base at breakfast and supper . . . with scale as necessary. Do we still use a 'base' system or go to strictly units to carbs ratio???

Anybody out here who can explain?? Thanks. (Comment this)

35 - P.S. You can contact me at xrosie@bellsouth.net (Comment this)

36 - Hi, I am a type 2 diabetic and just was switched from lantus over to levemir. I was switched because the lantus was burning my leg so bad....and the doctor said this is because it is very acidic...does anyone else have this problem. i was also complaining about gaining LOTS of weight when I started the lantus, and the doc said that this was normal. I am now on levemir, taking a slightly higher dose, 34 of lantus to 45 of levemir. My morning sugars are good, and i check in the evening and that is good too. I inject in my tummy, leg or arm, it doesn't matter. I am unsure why the previous poster said that levemir can only be in the leg, I do it all over. I go back to the doctor soon, so i am curious to see what the a1c is. I do know this does not burn like the lantus and also the doctor said I may lose weight with this insulin. I hope to lose the weight that lantus caused me to put on. Hope the other people are having the great success I am, I am glad that levemir is here. (Comment this)

37 - I Hate Levimur! Been using it for 2 months with little result.I would go to bed with an 11 reading and wake up with a higher reading. I got up to 74 units twice a day and gave up.Thought I would try the natural way, bad choice sugars are up to 17.I am on Metformin highest dose for 4 years with no success.Type 2 since 2000.Frustrated to no end. My endo is over worked and hard to get a hold of.Does anyone know if Byetta is avalible in Canada? (Comment this)

38 - I work at a doctor's office and the rep for Levemir stated that it lasts about 18 hrs., so you should adjust your dosage accordingly instead of assuming it works for 24 hours. Please have your doctors check on this. Also, with either Lantus or Levemir, you will need to have additional "bolus" coverage for meals. It is a basal insulin. It will not cover what you take in for your food. Please check with your doctors on this. Also, diabetes educators in your area are a great help. (Comment this)

39 - Levemir vs: Lantus...I was injecting a basal dose of 33 units of Lantus twice daily for several years and gradually gained weight,mostly in my gut,the whole time. My Dr. changed me to Levemir at the same dose, which I found not equivilent to Lantus, so I have gradually been increasing my Levemir and now seem to be settling down at 55 units twice daily. It's pretty obvious that Lantus and Levemir are NOT equal.
Thankfully, the weight gain seems to have stopped.
Phil in Atlanta (Comment this)

40 - Question:

Does anyone know the onset range of Levemir?? I feel like it would help me to know WHEN it begins entering the bloodstream so that we can gauge the actual '16 - 18 hour' predicated 'life' of this insulin. There just is not any real info it seems to be found about this stuff . . . the even the actual website is nothing but propaganda, nothing useful to a consumer.
Thanks for any info. xrosie@bellsouth.net (Comment this)

41 - Does anyone supplement a fast acting insulin with Levimur? The Levimur by itself is not doing the job and the doctor is thinking of adding something else. (Comment this)

42 - I work at a dr's office and yes we supplement Lantus and Levemir with meal-time bolus. These two are to cover the basal rate. (Comment this)

43 - My son is 17 and takes 50 units of Lantus 0800, 40 units of NPH at 0800 & 1900, Humalog sliding scale, and Actos 45 mg 0800. His Dr is thinking about switching him to Levimur instead of Lantus. Do you think he will continue with the NPH twice a day as well? Do you think it is better to take the Levimur twice a day? (Comment this)

44 - I have been using Levemir for 2 months, but feel I need to split my dose. How is the dose usually split? 50%/50%? I recall my endo stating the split wouldn't be equally split every 12 hours. What time of day do you take the split.

I am weighing the pump option, but not quite there yet. 5-6 injections a day is getting old.

Shari (Comment this)

45 - I've been a type 1 for 8 yrs now and have been on lantus the last 5. Switched to Levemir 3 months ago and things are great. MUCH more PREDICTABLE results especially fasting in the morning. I am on more units of Levemir but haven't gained any weight so I'm fine with that. For type 1's this could be a twoce a day insulin but that is the case with lantus as well both are dose dependent. Type 2's will be fine on this once a day. If you look at the Package Insert both are "up to 24 hours duration of action" and levemir has a neutral PH whereas lantus does not meaning no burning with levemir. (Comment this)

46 - I moved to Levemir from Lantus in October last year aftr 2 years on Lantus and I want to say short and sharp:

- both insulins worked for me
- but I have a constant fight with my WEIGHT and with Lantus I had to snack at night and was GAINING WEIGHT
- I can say use Levemir if you want help keeping your WEIGHT DOWN, it actually does help me, and I don't need to snack anymore
- it does not STING like Lantus
- I use a higher dose than with Lantus, but SO WHAT? both will bring down your numbers if you use them right and I've never gone to low on Levemir
- the Levemir pen is FANTASTIC, no more syringes for me ever again
- My only concern was would it last as long as the Lantus because I also read some comments tht it didn't. I went to the diabetes meeting in Washington last week and there was a paper which shows levemir and lantus WORK EXACTLY THE SAME AMOUNT OF TIME at exactly the same doses - my experience says it too but of course it might be different in every person.
- My doc said one day I might need RAPID insulin too but that is just the natural progress of diabetes, not my fault

PS (OT) I also traded my metformin three times a day for once a day Glucotrol XL and that seems to work just as well as the other ones if you are looking to cut back on the number of pills like I always am

[i]Timbo, Halifax, Canada. Glucotrol XL and Levemir (both once a day) plus a bunch of other stuff which has nothing to do with diabetes... [/i] (Comment this)

47 - Sorry I just read the comment from someone who wanted information that was not biased like on the drug company websites. I use Medline, which is a government site, where you can search for clinical papers. Just go to

www.ncbi.nlm.nih.gov/entrez/

and type like 'levemir review' or 'lantus review' and you will get papers where doctors review it against other therapies like this:

REVIEW ARTICLE
Insulin detemir: a new basal insulin analogue
Handrean Soran1* and Naveed Younis2

Diabetes, Obesity and Metabolism
Volume 8 Page 26 - January 2006
doi:10.1111/j.1463-1326.2005.00487.x

The availability of new basal insulin detemir offers several advantages over the use of NPH insulin, including lower risk of nocturnal and 24-h hypoglycaemia, lower and more predictable FBG, less weight gain and less within-participant variability. Disappointingly, there is no solid evidence to suggest better glycaemic control, compared with NPH insulin. Further studies to clarify this point and to assess cost-effectiveness, quality-of-life effect of insulin detemir and comparison between insulin detemir and glargine are needed.

Look at them all and make up your own mind! (Comment this)

48 - Maria, You are very confused about the differences bwtn Lantus and Levemir, and no one is being paid to switch patients. Levemir may require a higher dose in some patients however, even at the higher doses, it has less weight gain and hypoglycemia associated with it versus Lantus or NPH. Do an online search to find more information from recent posters just presented at the ADA. If it were me, I would want to take Levemir, not Lantus. Lantus couldn't even show that they had any advantage over NPH (Comment this)

49 - To everybody considering starting Levemir:

I'm quite surprised at some of the recent comments touting Levemir over Lantus. Some are based on clinical trials, but some are clearly personal experiences.

And some sound very suspicious that they were written by sales reps who are paid to pitch their product, and who are sometimes extremely unscrupulous: see Novo Nordisk Short on Ethics? at DiabetesMine.com (Comment this)

50 - Hi

I use Levemer and it's in a glass bottle. What is a pen please? (Comment this)