I was reading Dr Bernstein’s book DIABETES SOLUTIONS. He recommends Levimir over Lantus. I am curious what others are doing? Can Lantus be divided into two doses successfully?
I’ve read other’s posts about dividing Lantus successfully. I do it with Levemir. It all depends on what works best for you. Try them both if you have the opportunity to do so.
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When I was on Lantus, I had to divide it, since it seemed to last only about 20 hours for me—when I first started it with only one shot a day, I’d spike in the hours before my next shot. Splitting doses reduced that effect significantly. I also had my doses unevenly split so that my evening dose was larger, so I was sure to have plenty of insulin active in the morning, when I tend to need the most. That said, I’m now on Tresiba, which I think is far more stable than split-dosed Lantus (and seems to be the general consensus around here).
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Bernstein’s preference in the book is based largely on the old suspicion that Lantus may be associated with heightened risk for certain cancers. No study has confirmed this and millions of people continue to use Lantus without apparent problem.
A single dose works well for some people. Others get better results by splitting the dose in two. That applies to both insulins. There is wide individual variation. As @Christopher5 points out, the only way to determine which insulin and which protocol gives you the best results is to try them and see.
For what it’s worth, I use Levemir with a split dose, morning and evening. Trial and error showed that that’s what works best for me.
I’ve been on Lantus since I was first put on insulin about four years ago. I’ve never tried Levemir. Lantus works fine for me just once a day by taking it just after dinner. If it did run out an hour or so earlier, I wouldn’t notice it, as I would be taking my dinner bolus an hour or an hour and a half earlier, and I would have ended up calculating any extra need in with my dinner bolus. That was my thinking when I first started on the Lantus and was deciding upon a timing for it.
In a diabetes class I took the instructor said whether or not a person needs to take Levemir in one dose or two was largely dose dependent. Those that took large doses, primarily type twos, could often get away with a single dose, but type ones, who usually take a smaller dose, usually had to split the dose. With Lantus, one was much more likely to get away with a single dose even if taking a low dose. At the time I was only taking six units daily, though that has since increased to eight units. But that’s primarily the reason I’ve never wanted to try Levemir. I’ve had to change Medicare insurance part D several times to keep on Lantus instead of being forced to change, too.
I have taken lantus in a split dose for years. I have had no problem. I take a larger night time dose. Nancy
My doctors have never made this recommendation to me. It wasn’t until I read Dr Bernstein’s book that I decided to give it a try and it seems to be the solution to keeping my numbers in range after struggling for two years. I normally would take 13 units of Lantus at night and now split it 6 and 6. After 2 nights I keep on going low so lowered it to 5 last night, but still went low 3 times. I try not to over correct.
David ~ Dr Bernstein says Levemir cost less and has a 60 day shelf life (versus 30 days for Lantus). He does mention the cancer study on Lantus floating out there, but feels that since Levemir is equally effective, cost less, and has a longer life, why use Lantus.
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Sound logic with one caveat: invididual variation must be taken into account. Different people react differently to a given insulin. For some, Lantus just plain works better. For others, Levemir is the winner. For some people—not all—they really are of equivalent efficacy. It just depends, which is why empirical testing is the only way to really know what will give someone the best possible results.
As for shelf life, I think those published numbers are highly conservative. My Levemir typically lasts until the vial is empty, and that’s usually somewhere in the range of 100 days.
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I changed from Lantus to Levimir after reading Dr. Bernstein’s book, and Levimir works so much better for me than Lantus, yet my sister uses Lantus 1x a day and it works for her. My doctor is very accommodating to what I want to try as long as it works for me.
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Has your sister ever tried Levimir? Are you both type 1?
I tried Lantus and Levemir. Neither lasted a whole day for me, though Lantus worked a little longer for me. Real cost-wise, Lantus was a LOT less expensive for me, as it was a lower tier copay at the time; however, I felt better with Levemir – no sting, no bruising and when taken in two daily doses, I had similar results.
On a pump now, but of those two, I preferred Levemir.
Yes we are both Type 1’s. No she hasn’t been on Levimir in her 20+ years as a Type 1. She got a letter from her Insurance company saying that they weren’t going to cover Lantus anymore and that she needed to switch to Levimir or Tresbia. Her Endo put her on Tresbia but she did horrible on that, fortunately she had a couple of Lantus pens left and switched back until she can get back in to see her Endo so she can be put on Levimir.
Now both of us are considering switching to a pump - at least researching it.
Well, as always, YDMV, but if you want lots of customization with your basal insulin that would be a reason to pump. After all these years I’m still on MDI, emphasis on the M, but it works well for me.
For MDI basal insulin, I did not like the Lantus burn or how it worked. Levemir was just fine, but it definitely needed 2x per day and I can see why some people even use it three times a day to meet their needs.
I’ve been using Tresiba for a while now, once a day, and it serves me very well.
Good luck to you. As you probably know there’s lots more information on this site, here are some discussions with more comments:
https://forum.tudiabetes.org/t/switching-from-lantus-to-levemir
https://forum.tudiabetes.org/t/tresiba-basal-insulin
https://forum.tudiabetes.org/t/levemir-split-or-a-single-dose
https://forum.tudiabetes.org/t/insulin-degludec-tresiba
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