Levemir vs Lantus insulin

Treatment Insulin
1

I've heard that Lantus and Levemir work in the same way (in their being long-lasting insulins). However, I was recently told that a side effect of Lantus can be weight gain while Levemir does not contribute to weight gain.

Have any of you made a switch from Lantus to Levemir or vice versa, and if so, may I ask why?

I currently take 20 units of Lantus along with Humalog for meals. I'm having a hard time losing that last stubborn 12 pounds to get to my idea weight, and although I follow a 1400 calorie/35g carb/25g sugar per day diet, I'm not losing any weight but rather starting to gain weight, which is a huge concern for me, since I've lost about 116 pounds over the past couple of years by following the diet I mentioned above.

My next followup appointment is February 27, and before I talk with my doctor about possibly making a switch to Levemir from Lantus, I'd like to hear your experiences and/or opinions. Thanks ahead of time!

Links added by the TuDiabetes Administration

https://forum.tudiabetes.org/topics/kaiser-dropping-levemir-forced-switch-to-lantus

https://forum.tudiabetes.org/topics/583967:Topic:99544

https://forum.tudiabetes.org/topics/lantus-v-levemir

https://forum.tudiabetes.org/topics/different-between-basal-and

http://www.tudiabetes.org/group/insulin_dependent_type2

http://www.tudiabetes.org/group/needlediabetics

http://www.tudiabetes.org/group/lantususers

http://www.tudiabetes.org/group/levemirusers

2

Never had a problem with weight gain and Lantus. Though I don’t know much about Levemir only that it is expensive.

3

Hi Melissa! First of all, great job on losing your 116+ lbs!!! That is truly amazing. What I have heard and experienced is taking (any) insulin makes it difficult to lose weight. My endo has told me that… there was also another discussion on this site about people experiencing weight gain when taking lantus, and as soon I heard that it was definitely with lantus I was SO wanting to change my 24 hr lantus. That discussion also talked about Levemir being the alternative which didn’t cause weight gain but I haven’t asked my endo or had any personal experience. When I first was diagnosed with type 1 about 4 years ago, I (of course) had to start taking insulin (both lantus, and at the time novolog) but I stuck to no more than 45 g carb per meal which was less than what I’d been used to having been a teen. I was pretty thin before I was diagnosed but immediately gained like 30+ lbs like instantly!! It was horrible. So I agree, totally talk to your doctor about levemir, and good luck with your next 12 lbs of weight loss - I know you can do it!

Also I’m wondering if you exercise? That could definitely help with weight loss, since you seem to be on a great meal plan already…

best,
jessica

4

Cherise, Lantus costs me $40 (insurance copay) - I will have to check with the pharmacist to see if there is a price difference between it and Levemir. If they are both the same price, I’m going to seriously talk with my doc about changing me to Levemir.

Jessica, thanks so much for the complement! Like you, I’ve heard that I will have a difficult time losing weight while taking insulin. I had hoped to possibly change to oral medication, but after a failed experiment with 70/30 insulin, my doctor and I both realize that I will have to stay on insulin and not be able to take orals. Thus came my question regarding Lantus vs. Levemir…

I do follow a pretty strict diet, which has been approved by my PCP and my endo. As stated above, I eat no more than 1400 calories/35g carbs/25g sugar each day - but usually one day each month will either count as a “free day” or have a “free meal” where I eat higher carbs (last night’s cheeseburger, fries and banana pudding rofl), and I adjust my insulin dosage to cover the higher carbs, allowing me to get cravings out of the way and allowing for flexibility during holiday gatherings/parties/reunions, etc.

Prior to being diagnosed with fibromyalgia, chronic fatigue syndrome and IBS by my PCP (I’m undergoing lots of tests now to ensure the accuracy of his diagnosis per his referral to another doctor for diagnoses confirmation and/or secondary opinion), I exercised plenty each day. I wasn’t losing weight nor was I gaining weight. However, since I haven’t been able to exercise as much as I was when I was first diagnosed, it seems the weight is slowly creeping up on me - I’m having a much harder time maintaining it now. (GRRRRR!! lol)

Pending the price for the Lantus vs. the Levemir (and taking into consideration that I will have to buy new clothes if I gain the lost weight back too), I will definitely talk with my PCP regarding changing to Levemir. I just hate to do anything that will cause me to gain weight if there is another option, ya know? (I could get on my soapbox about high carbs/higher insulin requirements vs. low carbs/lower insulin requirements here…I just got off the phone with my mom, who worries that I’m “starving” my brain and my body by following a low carb diet… ugh! lol However, I shall refrain from my oft repeated speech, even though I have gotten a lot of practice on it lately.)

Thank you so much for your encouraging words - and I will come back and let you know what my PCP says after my next appointment with him. Wish me luck!

hugs
Melissa

5

WELL I DID IT. I PICKED UP THE LEVEMIR TODAY. MY DOC SAID NO PROBLEM = HERE YOU GO. HE DID AGREE THE LANTUS USUALLY MADE WEIGHT LOSS A LITTLE MORE DIFFICULT. I WILL START TONITE. HE ALSO CHANGED ME FROM 100 UNITS AT NITE TO A 50 AM 50 PM. I WILL LET YOU ALL KNOW. AFTER 40 YRS OF DIABETES, IT AMAZES ME THAT IT TOOK THIS SITE FOR ME TO LEARN SOMETHING I SHOULD HAVE BEEN TOLD BY A DR. THANKS TO MANNY FOR ALL OF THIS!

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6

How is it going for your Cheery and the switch to Levemir?

7

i like the levimer better. lost couple pounds & my pooofie belly = midriff - seems to have lessened. i still have night highs but thats my fault for my going to bed at 2am & sleeping till noon. & eating chocolate easter eggs. wish i could have the self control like melissa - 35 carbs per day??? i would be happy if that were per meal. so i would suggest the switch if possible. i just want spring to come - weve had snow for a week or more in salt lake. this weather depresses me, makes me eat more cuz im in the house so much.

8

I was at my Endocrinologist last week and he suggested that my Levemir may not covering me as well as he would like and told me to finish my current pen and move to Lantus with the same dosage. I currently use Novolog pre-meal 2 units pre breafast 5 units pre-lunch and 5 units pre-dinner with a sliding scale. In addition I use 20 units of Levemir before bed. His thought is that Lantus will cover me longer/better than the Levemir. Has anyone else been told this?? Or had this experience??? This goes back to me asking him the differences on how the 2 compare Lantus vs Levemir.

9

I have just started taking Levemir myself about a week ago. I take 20 units of Levemir at night before bed, 30 units of Novolog with my meals, and I don’t eat anything after 6:30 PM unless my blood sugar bottoms out. My blood sugars have been awesome at lunch, dinner, and bedtime. However I have had some really high morning blood sugar levels. When I say high I mean nothing under 200 and I even had one on Tuesday morning that was 555.
Has anyone else had similar experience?

10

I used Lantus and I switched to Levemir 3 weeks ago and I must tell you that Lantus made me gain weight. I have type 1 since 1967 and I am a thin woman. I started Lantus in January 2004 and I started to gain weight and fat. And I had hypos (lows) in the afternoon and in the middle of the night. No more hypos with Levemir and it works 24 hours for me. I really think that Lantus is not a very good insulin and I’m glad that I switched to Levemir.

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11

i totally agree. after i switched, i had am highs - dr told me to increase by 2-3 units of levimer on my pm dose. it worked great. good luck

12

I’m seeing my Doctor next Friday. I’m asking to be moved from Lantus to Levemir. I was diagnosed in Jan 2009 with Type 1 at age 42. I was already at about 237 for my weight. I carry it well as I’m a bit muscular. But still overweight by at least 40 pounds.

So my CDE started me on Lantus and Novalog. I’m at 40 Lanuts at 7:30am. I take about 18units of Novalog per meal of about 45 carbs. My BS is around 85 to 150 depending on the types of carbs I’ve eaten.

I was having a very tight control earlier in the year. But I was also working out 5 to 6 days a week and 2 hours workouts. Since then my job has had be traveling again and I’ve not been able to work out. No change in meals and I’ve gaing 18 pounds in the last 3 1/2 weeks.

I’ll let you know how it goes after the switch… Give me some luck…

13

i think you will like it better. i take mine every 12 hours & have to set an alarm to remember. the weight loss has slowed alot but i havent gained either. good luck let us know

14

Hi! About Lantus and Levemir: They both are good insulin but it depends on the individual as to how they will work because for some diabetics they are NOT a 24 hour coverage insulin!!. For many years I took Lantus with quite a variance in daily blood glucose levels (BGL). My Primary suggested, and my Endo agreed, that I switch to Levemir. That was just a couple of years ago and it is working very well for me.

Lantus has a sharp increase and decline; Levemir has a more gradual increase and a longer tail giving more support for a longer time say my doctors.

I also learned that for some of us, one injection of either of the long acting insulin does NOT work well. I split my dose of Levemir (7 U A.M. and 6.5 to 7 U P.M.) It works well except for late afternoon. About 4 PM I need to take 1/2 U of Humalog to stop the continued rise of my BGL until dinner time at 7 PM. Normally one would NOT take Humalog without eating but with a BGL of 180 by 4 P.M. I usually need it. If I boosted my Levemir A.M. injection I crashed by Noon. Isn’t this frustrating how we must fine tune ourselves but that is the answer.

Also, a sliding scale is sort of old routine these days. Do you know about the newer approach to control using a Ratio of insulin ot carbs? My Ratio is 1 Unit of Humalog for every 18 to 20 grams of carbohydrates. The usual ratio to start with for most of us is 1 to 10. Carbs have different effects on all of us and as the saying goes “Milage May Vary!” :-))

In the end it depends on the type and amount of food choices we make. Some of us can have and some of us can not have just any food choices. I have a large B’fast and less carbs for lunch and dinner; for others it may be sligihtly different.

I have been a Type 1 Since Nov 1957

15

My daughter was on Lantus when we first got her home from the hospital and due to insurance issues we had to change her to Levemir. Ever since she’s been on Levemir she’s been high in the mornings, it just doesn’t seem to be working as well as the Lantus. As far as the weight is concerned, my daughter lost so much weight that it was nice to see her gain some back.

Lisa

16

Dear Melissa,
Congratulations for losing the weight some time ago! It is hard to do for some of us but possible with lots and lots of determination! :-)) Just keep working at it until you reach your goal!

I switched from Lantus to Levemir with great results. Using Lantus I was often high in the morning and sometimes in the late evening. My endo suggested a split dose of Lantus, but it did not work well for me at all. I did continue to gain weight. My Primary doctor suggested that I switch from Lantus to Levemir as he thought it might help me to gain better control, also. Neither type of long acting insulin covers some of us for 24 hours. My endo concurred with my primary on this one!

Not a single professional word about what or how much I was eating at the time!

I switched to Levemir, I reviewed my meal plan and realized that I did not always want 30-35 carbs per meal. I was on a 1200 calorie meal plan and felt it was just too much for me most days… Often I was just not that hungry but kept to the 1200 calories my doctor had given to me to follow. I gained weight! Was it the insulin or the amount of carbs that caused the weight gain?? I say BOTH! More food means more insulin! Dah!!

When I learned about the Ratio of insulin to carbs the world of food became friendly again! I now have between 17 - 28 grams of carbs per meal (900-1000 calories per day: 17 to 29 grams of carbs per meal; snack of 10 grams once a day, sometimes) I lost some weight and it has remained steady every since. My pre meal Humalog dose is usually not more than 1.5 units per meal. Levemir is 7 units A.M. and 6.5 units P.M. I will soon reduce the A.M. 7 units down to 6.5 units.

The amount of carbs, and long or short acting insulin depends entirely on each individual’s metabolic system, lifestyle and activity level. Injection site and timing are also factors to consider. What we do depends on so many factors in our life and it takes each of us to figure it out because our doctors are not with us every day.

My motto: If it’s going to be, it’s up to me!

A Ratio of insulin to carbs: Google it and read the many different pages; they all say about the same thing but some web sites are easier to understand. Since I have used the Ratio plan my weight has remained steady.!

I have lived with Type 1 for almost 53 years and have good and bad days but far less turmoil than it was in the past. . With the knowledge we have today about diabetes, and the supplies and equipment - we can work it out but it takes time, and thoughtfulness for both us and our doctors.

Good Luck!

17

I tried Lantus for about a week or so. It took me 20 units a day just to lower my blood sugar to where I wanted it.

I still needed to supplement with Humulog - about 5 units in the AM and similar depending on the meals I ate the rest of the day.

Anyone try using NPH in the morning and Lantus/Levemir in the evening?

My endo gave me some Novolog, Apidra, and Levemir pens to try.

I fear that at 20 units per day, the Levemir pen will run out in 5 days, and not allow me to determine it's effectiveness.

18

Hi! I have tired to to answer some of your question: I believe that there is 100 units of Levemir in the Flex pen but not sure of that. What is the reason for 20 units a day of long acting insulin? Only 5 units of Humalog is a very small dose to take for a pre meal injection.

  • Slow acting insulin Levemir, Lantus or NPH is used to cover between meals and over night and also to help to level out your control throughout a 24 hours period. For some of us none of these long acting insulin types cover us for 24/7. We split the dose in half between A.M. and P.M. For some people one of the long acting insulins is better for their system than another.

When you try the different types of insulin given to you, be sure to use one at a time for about 3 to 4 days. Keep a Daily Log to help you remember and to show to our doctor. You need to know how each insulin works for you - as most of us have a slightly different method of control. dur to our individual metabolic system.

  • Humalog, Novolog and Aprdra are short acting insulin and used to cover the carbohyrates within each meal.Their duration is about 2 to three hours depending on the individual's system of digestion.
  • FYI: You would naturally need Humalog, Novolog or Apridra for a pre meal bolus injection to cover the carbohydrates of your meal.

If you have not read the book Think Like a Pancreas, I strongly suggest you get one from the local library or purchase one. It gives a great deal of info on basics of insulin, and carbohydrate control, the how to, when and/or if questions.

Has your doctor thoroughly explained the use of short and long acting insulin? I hope so but if not, please ask him to do so, or his Certified Diabetes Educator or Nurse on staff. I am thinking that perhaps you have misunderstand the use of insulin for the best control of your diabetes blood glucose levels? OR perhaps I misunderstood the content of your post>?:-))

I hope the above begins to help you.

Good Luck

19

Thanks for the reply Lee.

5 units is a *safe* amount for me. I can always take more if needed and many times I do.

I have a random lifestyle. If I take the needed amount and have to leave unexpectedly, the exercise that I would do plus the insulin would make me go hypo.

I determined my I.S.F. to be 16.67g of carbs to 1 ui of insulin.

If I eat the wrong type of carbs or eat them at the wrong time of day, then I need double that amount of insulin.

The Basal insulin would keep my blood sugars a bit lower than usual. Lantus did just that, but tended to make me go slightly hypo in the mornings. Levemir is supposed to last less than 24 hours so the risk of Hypo is diminished.

Humalog takes almost exactly 1 additional hour to bring my blood sugars back down to a reasonable level. Doc gave me Novolog and Apidra to see which one worked better/faster.

My goal is to be part of the 4% club. I am in the 5% club right now.

Another reason I only use 5 at a time is because the doctor gave me a correction dosage sliding scale, which is moronic to say the least.

So, I take about 5 units at a time, unless it's thanksgiving or a birthday. Then I will take 7-10 units to cover the extra carbs.

I am looking to have my fasting blood sugars between 70 and 85, with spikes no higher than 120.

It's a tough balancing act to get such good numbers and maintain my weight.

If I don't take insulin, I lose up to 5 pounds of body weight in a single night. With insulin, that number stops or even reverses.

My diabetes is a bit of an anomaly. Doc expects me to be like other diabetics with difficult or no control.

I on the other hand know exactly how to control my numbers with diet, exercise, and use of insulin. One day I asked my endo what a1c number she wanted. She said 6.3 . Do, I gave her better than that - 5.3 .

Can anyone here get an a1c of 5.3 without any meds or insulin? I did.

Or an a1c of 5.2 with insulin? Did that too.

I am not wanting to be a slave to this disease. I am looking for a suitable treatment to accommodate both my disease and my lifestyle.

Having to alter my lifestyle to keep blood sugars under control only works in fair weather for me. As soon as it turns cool or cold or hot, I need insulin.

I tried the Lantus. I tried NPH. Soon I will try the Levemir. I think the Levemir will be more suitable for most of my needs. I can still have a use for NPH. I can use that for pasta meals whereby your blood sugar spikes much later.

I suspect I have Adrenal Exhaustion. If so, blood sugar control will be ever more difficult as time goes on.

I want to get the best control now while I am able to.

Is there anything wrong with wanting tight control AND a reasonable lifestyle?

20

Hi! There is nothing wrong with your wanting a 70-85 range for test results nor is it wrong that your doctor wants you to have an A1c of 6.5 and that you bested that with a lower result. What concerns me IS your method of control. Knowing your Ratio and using a sliding scale are two different methods of gaining control. I would choose one or the other to help with your control and you may find that your rhythm of control would settle down no matter what kind of insulin you took or how many carbs per meal. I would stick to one method of control for at least a month, and the use of any type of insulin for couple weeks which usually is enough time to see how your system will adjust. It does take patience and time......but the effort is well worth it. .

If it were me I would discuss the differences between Ratio and Sliding Scale method of control with my doctor and choose one or the other method. Also, why would you use NPH to control having pasta? This is what using Humalog, Novolog or Apridra is for, not a basal insulin like Lantus or Levemir or NPH..

If you read the book Think Like a Pancreas, a review would be helpful; if not yet read you might try it as it could help you to maintain your goal of tight control - perhaps in simpler ways.

If it were me I would use a more modern way to figure my control. The Sliding Scale method is older and is more "guess work" than providing a more accurate results of your efforts for tight control by using the ratio of insulin to carbs..

The type of insulin we use depends on the individual system - we all vary slightly in our method and use of insulin and carbs. Adrenal Exhaustion? OK, athletes use a lot of adrenal without excssive exhaustion. Have you spoken with a sports doctor about this issue?

If it were me with what you have described I would seek another doctor who uses modern methods to help their patient. However, if you are happy with your current doctor then just keep trying to work it out - it does take a lot of patience and time for us to do so. The end results of good control is what we hope for - and with determination - we can get there!

Good Luck

Trrying different types of insulin may help you, of course, but your doctor hsould help yoi

Weight gain comes from too many carbs and then too much insulin.