Lantus vs Levemir?

I will be talking to my doctor tomorrow about starting basal insulin.

I was wondering what people’s experience has been with Lantus vs Levemir? I have talked to my community pharmacist as well as finding research online from reputable journals stating that Levemir causes less weight gain. I am really nervous about starting insulin as I do not want to blow up like a balloon.

I have struggled with my weight my whole life. I have autoimmune arthritis as well as hypothyroidism and keeping my weight down helps my joints. I now have type 1 diabetes to add to my autoimmune collection and I worry that if I gain a ton of weight, My joints will get worse.

I have lost 35 lbs with the diabetes and I know that this is not healthy but I hope to not gain all of it back as I was 180 prior to diagnosis which was too heavy.

What have your experiences been like with Lantus and Levemir? Has anyone tried both? Which one do you prefer and why? My doctor prefers Lantus but he will consider my wishes and he will let me try another brand if I ask. He also would like me to keep my weight down if I can!

I am also planning to look into a CGM, I am a busy person and I sometimes forget to pack my meter. I am a Jewelry artisan and my fingers are starting to get sore from all the pokes. I was thinking of trying a Dexcom G5. I would like to be able to see my blood glucose in real time so I can treat lows quickly and get on top of highs.

Cheers,

Jenn

I can’t offer any personal experience with Lantus or Levemir but I did use basal insulin Tresiba for several months a few years back. If I stopped pump therapy, I would likely use Tresiba as my basal insulin. I like that Tresiba is not sensitive to the exact time it’s taken each day. It gave me very good glucose background control.

I don’t think the brand of insulin itself leads to weight gain. Finding a good balance between insulin and food and exercise is the challenge. If you take too much insulin then you’ll find yourself “feeding it” to prevent hypoglycemia. It’s a delicate balance and a unique challenge for you to solve. It’s not easy but I do think each person is capable of discovering that balance point.

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I am Type 1 for going on four years now. I have done pump therapy but never felt well with it. I went back to shots and realized its really my 24 hour insulin that keeps me feeling as best as I can throughout the day.
I take 50 units of Levemir every morning around 7:30.
I feel like it has a more potent take with me than lantus does.

Remember YDMV, i.e. Your Diabetes May Vary. I am currently using Lantus, which works for me, and is the only basal insulin I have used. Reading this forum a lot, Tresiba seems to be the most popular (but that is not an option?), and opinion is split between Lantus and Levemir. The main difference is the response curve, where Lantus is pretty flat for roughly 24 hours, whereas Levemir has a notable peak. Some diabetics use that peak to address Dawn Phenomenon, which is a problem for many but not all diabetics.

My point is that the better insulin is what is better for you. My recommendation would be to try Lantus first, as it should be the easier to get the basal rate adjusted properly, since it does not have a peak. If you then have issues, figure out if switching insulin is likely to help the problem.

I have only used Lantus, but it’s been good for me. I have it dialed-in and my bg stays quite steady between meals when the effects of my Rapid bolus wears off.

I did gain weight continuously from the time I started and before I switched to a low carb diet. I probably added 40 pounds over 20 years. I don’t know if that’s all (or any of) the Lantus’ fault though. I’ve lost about 25 lbs in the past few months on a low-carb diet, so it doesn’t make it impossible to lose weight.

I agree from my own experience, but there seems to be quite a bit of anecdotal evidence on this forum and others that Tresiba causes weight gain for certain people.

I can’t answer about weight gain as I’ve never experienced weight gain being caused directly by insulin, but I do know that Novo Nordisk claims Levemir leads to less weight gain than Lantus. Whether this is true or just marketing propaganda, who knows. Personally I prefer Levemir because I can take it in split doses approximately every 12 hours without overlap, and adjust the dose to deal with anticipated stress, exercise/activity, eating more before bed that will cause higher insulin needs later, etc. For most people Levemir is not a 24-hour insulin, as taking it in 1-dose will result in a larger peak and it running out at about 16-20 hours. If you would like to take 1 shot a day you are likely better off with Lantus or Tresiba.

I gained weight after starting Tresiba but I’m pretty sure it was because of the stabilization of my BG’s more than anything else. On Lantus my BG’s were very erratic and often high so those highs were likely keeping my weight down somewhat. I would really prefer to never be on Lantus again because of those “Lantus Lows” though.

Before I started using a pump I used, over time, different longer acting insulins as my background basal, including both Lantus and Levemir. One thing I noticed regardless of what insulin I used, is when I first started on it, it worked great! Then, over time, it would require more and more insulin as if I was building up a resistance to that particular type of insulin. My doctor would then switch me over to a different insulin and voila - back to needing less insulin and increased insulin sensitivity. Of course, over time, that insulin would again start needing more and more, so once again, we would switch over to another - or back to a previous one. I was on Levemir before I started on the pump and out of all of the long acting insulins I used I liked it the best (except for the first long acting insulin I ever used which was by far and away the most consistently long acting - pork based L, which is no longer available. Human based long acting insulins do not last as long as the pork or cow based insulins did). It was the closest of all of them to not having a ‘peak’ of action but a more steady time of action. I did find that all of them did not last as long as the manufacturers said they would and I was taking shots both am and pm to keep a constant basal amount in the background because none of them lasted 24 hours or even 18 hours. I was also using Regular or Rapid insulin as a bolus for each meal and for corrections. I know that if I had access to a CGM back then (I have been on a pump for almost 7 years now) I would have been able to do a much better job at controlling my volatility. (Even on a pump I am still brittle because of pancreatic insufficiency).

I never experienced weight gain or loss from insulin. I suspect weight gain would come as your body becomes more efficient at metabolizing carbohydrates and since we often eat more carbs than we need for daily functions, the insulin allows the body to store the extra carbs as fat. The trick to overcoming this would be to decrease the carbs you eat each day and ensure that the ones you do eat are not from processed foods or low in fiber. I eat a lower carb diet - generally around 50 to 60 carbs a day from all sources (and yes, vegetables have carbs too) and include a lot of fiber and healthy fats in my diet. The fats are digested more slowly and help you feel full longer so you just don’t get hungry so it is easier to avoid inappropriate foods.

So, you may find it useful to try each insulin over time and see which one is most effective for you. We all are different but one thing I have learned - nothing ever stays the same, even with the same person. Our needs vary day to day, season to season and year to year, so if something doesn’t seem to be working as well as you would like it to, including insulin, don’t be afraid to request something different.