Levemir vs Lantus insulin

Wow, that is great advice.

You see, I only suspect Adrenal Exhaustion due to high stress in my life. I have nearly all the symptoms of it. Especially the memory loss and foggy thinking (no I am not low or high when this happens). I have orthostatic hypotension as another diagnosis from a different doctor.

And when I eat loads of salt, most of the symptoms go away.

I am basically wanting to use insulin for the following 3 reasons:

1) To stop my rapid weight loss

2) To reduce diabetic complications later on in life when control is much more difficult

3) To restore some semblance of my former lifestyle

My diabetes was not acquired in the 'usual' way. Mine was caused by medications I took last year.

Initially, my endo wanted me to use a sliding scale of 1ui for 150-199 BS, 2ui for 200-250 BS, and so forth. That was at my postprandial.

It quickly turned out to be ineffective and problematic as taking that at such a late time caused me to go hypo a couple of hours later.

I started taking insulin at the start of mealtime and eventually figured out that 5 units generally would cover my 'normal' breakfast. This kept my blood sugars in the lower ranges to the point that I can have high spikes into the upper 200's and still come back with an a1c of 5.2 .

Sometimes I would need more if I was sedentary after breakfast so I would take a 2hr pp bolus if needed.

An ex heroin addict (they quit 35 years ago) gave me some very good advice.

He said "you can't go back if you use too much, but you can always take more if you need to"

This is why most of his friends are now all dead and he's alive today. They couldn't go back.

It seems that if you can get spikes to return to normal fasting levels within 3 hours, your a1c should drop like a rock into the normal non diabetic range. Mine did exactly that. It would be even lower but I am sensitive to heat and very sensitive to cold.

I also discovered that Humulog takes me almost precisely 1 additional hour to bring my blood sugars back down to the safe range.

About Basal insulins: Most of my fasting numbers are around 95 in the mornings. I want them 15 points lower. And when using a basal insulin, that can give me tighter control even at mealtimes.

About NPH: it doesn't last all that long. I need the Humulog/Novolog/Apidra for mealtime & the NPH if I am eating pasta. You can Google 'Dreamfields Pasta and delayed blood sugar spikes'. For my digestive system, fast carbs hit me hard and fast, slow carbs hit me hard later.

I tried the same meals over and over, adjusting everything each time. Eventually for a given pasta meal, I need 5-7 units of Humulog at mealtime and up to 10 units of NPH to cover the later spikes. Works nearly perfectly for me. A couple of weeks ago, I ate some pizza and only had my Humulog with me. I took my 5 units at the start. 2 hours later I was in the 200's. I waited another hour and still in the 200's. I took another 5 units. An hour later I dropped just under 200. Another hour after that into the 160's. I didn't bother checking it any more after than. This is how I know the NPH works for me. Same meal, but this time using Humulog and NPH, spikes were reduced and BS stabilized within a reasonable amount of time. But fasting blood sugars were elevated. 119 the next morning.

The only meats I can eat that pull in the reins of the blood sugar spikes are fatty beef and fatty sausage, and pepperoni. I don't need much of either to get the job done. Ham, chicken, fish do absolutely nothing to curb the blood sugar spikes.

Winter is nearly here and I will turn into a hermit. My sedentary lifestyle is here again, except for shoveling snow once in a while. So, insulin or starvation are my only effective choices to control blood sugars. Dr Bernstein's or similar diets cost too much versus eating cheaply.

Here's what happens if I stop or reduce taking insulin:

I get quite weak. I lose 3-5 pounds of body weight in a single night, unless I eat a certain kind of cheesecake - dunno why. But at $7 a day, I cannot afford to eat like that.

I also get muscle wasting.

I was losing weight so rapidly that the doctors were worried about it. At that rate, before taking insulin, my body would have wasted away to the point of no return and I would have literally starved to death. Insulin instantly stopped most of that.

On the good side though, my blood pressure is terrific, my lipid profile is near perfect, and my a1c is almost exactly in the middle of the normal non diabetic range.

I am also aware that when I switch to novolog, I have to adjust my dosage downward a bit. And when I start taking the Levemir, I should lower my dosages even further.

I am not opposed to taking many shots per day if that is what can keep me alive and healthy.

My doctor can't understand how I can have regular spikes into the 200's and still have an a1c in the normal range. My doctor last time said "You're not insulin resistant", then handed me the 3 types of insulin, with no instructions whatsoever.

I did tell her that if I needed less than 1 ui of Levemir per day, then I don't need any.

I will start with 5ui and see how it affects me. Adjust accordingly.

My daily routine will be pretty much fixed most of the time with a set schedule. Basal insulins work very well under those circumstances.

I know how Lantus affects me. I need Levemir to provide contrast. Then choose which works best for my situation. I only need either during the sedentary months when it's cold or too hot for me to control spikes on my own.

I will see about the book you mentioned. Don't know if the Library has it or not. How much is the book if I buy it outright?

I would write more but have to pick up my son from school.

I look forward to your reply. I need to dwell on others experiences as much as I can. Don't want complications later..

Hi! The question you ask mostly depends on the individual because diabetes and a method of control, weight gain really is a very individualized matter.

My view and that of my endo is that no insulin is NOT the sole reason we gain weight. It depends on amount and type of carbs, exercise and general lifestyle,

If you are within 12 lbs of gaining your optimum weight - give your current method of control a bit more time . Also, know that certain carbs, again on an individual basis, may/can cause weight gain ie roots veggies, peas, squash, beans, some breads and baked goods. I found that I liked these so limited them to once or twice a month in a single meal and spread out the "treats ans I thought of them". Personally, when I was over weight I completely left out white potatoes, white rice, ice cream, bread, gravey, pancakes, waffles, any baked goods. However, being human I did miss some of this. So, I found a way around the ingredients or choice of food items.

I first started using carbalose flour (link to its main page for explanation and how to use it:cookies, pancakes, gravy, can be only as little as 5 grams of carbs per each. Here is the LINK to Carbalose flour:


I also switched to using Stevia and also long-grain wild rice, red potatoes (baked only). I also reduced my carbs per meal from 150 a day down to 80 - 100. It sounds drastic but for me it worked; you may need a different percentage of how much you reduce your current intake of carbs and inslin

Keep in mind that any change in your meal plan willl/may also reduce the amount of insulin needed. If not confident about this be sure to ask your doctor or Certified Diabetes Educator to assist you for a while until you "get the idea".

Also exerciseing for 10 to 20 minutes every other day was a huge help to me.So whatever method you used to loose what you have will continue to help you. While trying to loose weight we also transfer fat to muscle which does show a weight gain. But it is a healthy weight gain and what a healthy metabolic system needs to support us.

Good Luck

Type 1 since November 1957

If you are happy with your results then keep on using the same method of control But if you are asking why the high tests results - the answer could be, just might be - not enough of the fasting acting insulin pre meal. If your test results ar high over night, your basal or long acting insulin might need a review and be increased.

I still do not undeerstand why you take NPH to cover pasta? Are you sure this is what was suggested to you by your doctor? If so, there is a reason not yet explained in your posts.. My thought is that you were 200 something after having pasta with only Humalog used - well, surely it was not enough fast acting insulin to cover the amount of carbs per the meal. Humalog, Novolog, and Apridra are fasting acting insulin and that is what Type 1s use to control pre each meal time to cover the amount of carbs per meal. The Lantus, Levemir and NPH are long acting insulin and are used to cover between meals and over night. Some Type 1 split their dose of long acting insulin as none of the current products cover us for 24 hours regardless of what they are advertised to do for us.

If it were me I would ask my doctor or certified diabetes educator or nutritionist to explain about the correct insulin to use and when. There are always exceptions and each of us has ar particular method that works best for us. Knowing our carb count and the correct use of insulin can and is a huge help for better control.

Example: When I have beef, beans, squash I always take 1/2 to one additional unit of Humalog pre meal that gets me through without an abnormal test result - you may need more or less of a bolus. Keep in mind that anyone who eats, regardless of being diabetic or not, their blood glucose level will rise for about two hours but not usually exceeding 130 or so. The rise is perfectly normal for anyone however, we, as diabetics must make the correction instead of depending on the pancreas.

Good Luck!

I like your wisdom and suggestions.

My AM fasting is in the mid 90's and I want it around 80 or less.

I take 5ui humulog for my breakfast coverage. And that usually isn't enough. Doc said not to exceed 4-5 ui in a 4 hour period for the fast acting.

When she handed me Levemir, Apidra, and Novolog, she did not tell me how much to take of any of it. But I am wise enough to start with small doses and see how they affect me. Remember, small inputs make for small errors as Dr Bernstein always says.

5ui of Levemir per day is what I will start with. All I need is about 10-15 points lower on my fasting. The other fast acting I will remain at 5ui per dose, unless I know ahead of time I will be eating something awful for my blood sugar, like Christmas Dinner. Then I double that amount.

I have even gone so far as to take 29 units at one time. A bit tough on the system, but I didn't go hypo. So, that is my upper limit. With this knowledge, I can calculate my dosages with far more efficiency.

If I add say a cinnamon roll to my usual breakfast, I need 8ui. A chocolate covered donut I add 7ui. A bowl of oatmeal (2 cups) add 5ui. Birthday cake with a terribly high carb dinner I shoot 15-20ui.

The 29 would be if I drank a 32 ounce chocolate malt and ate a large french fries with that. And sit on my butt for 2-3 hours.

Yep, I experiment a lot. I am still learning how my body responds to everything.

It was getting to the point where I had to take my Humulog one hour before eating just to keep the spike down.

Doc didn't like that much, but I have to do what I have to do to control this affliction.

If you look at my sugarstats profile, you will see what my spikes are. Some of those are even WITH Humulog.

About humulog - I discovered that it take an additional hour to bring my BS back in range for most meals. Pasta keeps me high for 4-5 hours. Hence the need for NPH when eating pasta. Works perfectly for me. Don't need a whole lot either.

I have to run. Have to get up in 4 1/2 hours....

Try dividing up your meals more. Eat the sum total of your daily caloric intake evenly divided over a 12 hour period.
That can raise your metabolism.

zolar - I believe that the idea to spread out our food consumption does not necessarily allow for weight control and would require a strict timing of the bolus insulin pre meal.

Weight gain or loss usually depends on amount of carbs, type of carbs, and how much exercise we do each day. Of course, our system reacts differently on an individual basis.

Then too , if we were to spread out our intake of food, it seems we would have to take injections of bolus insulin more often! That could mess up one’s daily routine and free time for sure!.

Besides, Lantus or Levemir are not taken to control weight and cover our carb count. It is a basal insulin that helps maintain control between meals and over night. Some diabetics take a split dose of Lantus or Levemir because neither one covers a 24 hour period for everyone.

Whether we use either Lantus or Levemir depends on the individual. If it were me, I would try both and see which one works best is my suggestion.

If you have a choice take Levemir because there is a difference in it. The split dose works for me and and Lantus seems to need more I have been on Lantuis for only 3 months and I have gained 23 pounds I was on Levemir for about a year and it did not have much effect on weight.

You are absolutely that by eating every 3-4 hours will raise your metabolism, thereby helping with weight loss over someone who eats the same foods, but have a greater amount at less meals.

Insulin doesn’t cause weight gain…it’s getting blood sugar under control without adjusting your diet that gains the weight.

yes it does!

No it doesn’t. PWOD use insulin too (from the pancreas) and there are plenty of non-obese PWOD. All insulin does is allow your body to process glucose from the bloodstream into where it needs to go. That’s it. If you don’t believe me do this. Go on an extreme low carb/no carb diet. Eat 4000+ calories a day of fat and protein. Your insulin needs will go down from the lack of carbs. Your weight WILL go up. Period. Calories are calories. If you eat too much you gain weight. It doesn’t matter if those calories are carbs or fat. Your body will shove them somewhere, and if it can’t burn em or dump em then it’s going straight to your thighs.

From what I read, insulin shuts down the fat metabolism in favor of carb metabolism.
When you are insulin resistant, this means the BS are converted into fat at a rapid pace since the body doesn’t want to incorporate the BS much.

Yes, too much of a good thing is bad. But I don’t know of anyone who eats 4,000 calories a day from fat. They would have to eat spoonfuls of lard. Who can actually do that?
How many pounds of hamburger can a normal person eat in a day and not eat after 6pm?

It takes a LOT of energy to metabolize fat and protein into energy.

When I didn’t take insulin, I had a serious problem with rapid weight loss. VERY SERIOUS. It was so bad that the calculations indicated that I would die from STARVATION within 2 months. I couldn’t eat carbs due to blood sugar issues. I did eat greasy sausage and hamburger and peanuts. And I still couldn’t stop the weight loss, with one exception. A certain german style cheesecake sold by a bakery up the street.
The problem with that is it costs $8 each and I would have to eat 2 or more a day.
Economics dictated that the cheesecake diet was not sustainable.

When I started using insulin, my weight loss immediately stopped and I began to gain weight. Too much now.

I did an experiment over a few days. No insulin…

1st day only lost 1 pound.
2nd day lost 3 pounds
3rd day lost 5 pounds.

I went back on my insulin. My weight stabilized again.

If I don’t have insulin (or cheesecake), I can waste away to nothing in a few weeks.

Between high PP blood sugars and rapid weight loss, my endo gave me insulin.

Note: a normal person’s pancreas usually doesn’t give a person a low blood sugar.
Insulin does.
I know of no one who has 100% predictable results with insulin.
You start to (or even get) low, you eat carbs. You get high, you take more insulin.
A vicious cycle begins.

Lately I have had to double my insulin dose for the exact same meals I eat every day.
But to combat the high BS, I divided up the dose into 4.
I took 1/4 of the dose in each of 4 locations at the same time frame.

The results were really nice. BS was in the 90’s and no low’s either.

Do you take 30u of Novolog with each meal or total between 3 meals? 30u of Novolog before eating would get the paramedics out to my house for a glucose IV!

Ok, everything that follows is for a T1. T2s & insulin resistant have a different can of worms to open -
The body is designed to run on carbohydrates - it’s the basis of metabolism (both catabolism and anabolism). Carbs are broken down to sugar. Sugar is the primary energy we are designed for (study how the muscles and liver suck up glucose post workout). A T1 takes insulin and the body DOES go into carbohydrate mode - carbs are easier on the body than converting fat to burn as energy. Quit taking insulin and you begin a spiral into DKA - the body can no longer process carbs and all that weight you lose is your body converting fat (and later muscle) into energy to burn. Low/no carb diets are based on controlled ketosis which is the burning of fat but take note that even these diets require insulin as some of the fat and protein will be converted to glucose (much less than if an equal amount of calories in carbohydrates would be consumed).
So insulin causes you to gain weight? No. It causes your body to process carbohydrates the way they are meant to be processed. You still have to burn more calories than you take in in order to lose weight. That was my point about 4000 calories in fat and protein with no carbs - you will still gain weight (unless you are burning 4000+ cals a day). And notice I said eliminating carbs reduces the need for insulin. It doesn’t eliminate it completely. A low carb diet requires a reduction in insulin to prevent going low and thus prevent having to eat carbs.
So insulin doesn’t cause weight gain? No. Insulin is a requirement to shuttle glucose (and corresponding amino acids which come from protein) into muscles. This allows the muscle fibers (cells) to grow in length and breadth, which in turn increases muscle size which increases weight. If you balance exercise, diet and insulin you will either maintain your muscles or cause them to grow.
A better question is, “Will insulin make me fat?” Well, I’ll answer this by re-wording the question AND making it apply to everyone on earth (diabetic and non-diabetic). A person without any insulin in their system will lose weight. Fast. Unchecked they will die. There is no way around this fact. So insulin does cause fat gain. But that is only if you are consuming more calories than your body is burning. If you are burning 1800 calories daily and you eat 2600 calories you will become fat. There is no way around that. One pound of fat = Approx 3,500 calories. Eat an 800 calorie surplus each day and you will gain one pound every four to five days. Fat itself though has a caloric maintenance requirement (study how ATPase pumps in the body work and how many calories they burn per type of cell they are in). So the more fat you have the more calories you need. This is why a person weighing five hundred pounds can drop so much fat in a 2 month period and then begin a slow crawl to their target weight. The more weight you lose the tougher it is to lose weight.
You can also be on a carb-high diet, be T1 and stay skinny. I eat more than 4000 calories a day, and at least 500g of carbs. I’m 5’11", weigh 168lbs (as of this morning) and have about 10% body fat. I take more than 50 units of insulin a day now to keep up with my diet. I don’t gain weight. Why? I row for over an hour a day, lift weights every day and go running every day. Combined with the amount of walking I do plus my metabolic caloric requirements I eat whatever I want (plus a lot I don’t want to). By the theory that insulin causes weight gain at 50+ units I should be gaining a pound a day.
A normal person’s pancreas WILL cause low blood sugars - it is rare though as the pancreas tends to be better at insulin dosing and maintaining glucose homeostasis than our conscious brain is. In order for a non-diabetic to go low they need to go many, many hours without eating and drinking (other than water). An outstanding example of this is soldiers in extended combat. After about 6 hours of combat the body will burn every ounce of glucose it can; it will dump all its reserves into the bloodstream after that. Then the soldier will survive on pure adrenaline keeping him going (death is an amazing motivator). Once safely back in camp they will start shaking and have ravenous hunger. And we all know what that is. These are not diabetics - they are normal pancreatic utilizing folks who consume what they want to.
Injecting the same dose into multiple areas works faster due to quicker absorption - you’re spreading the dose over a larger area of subcutaneous fat which allows more vasculature in the hypo-dermis to take the insulin throughout the body.
And insofar as your cheesecake diet - a German style cheesecake averages 6,000 calories. Some go as high as 10,000. Google “German Cheesecake Nutritional Facts” to see the information for yourself.

Good info!

I did have to eat at least ONE of those cheesecakes a day, plus my regular low carb diet just to maintain my weight, without the use of a single med or insulin. That’s how I know it worked.

And I don’t do squat for exercise. I walk from the house to the truck, from the truck into a store, and reverse the trend.

Once springtime rolls around, I will have a lot more exercise.

I have yet to experience any normal person who is non diabetic get low blood sugars.
The soldiers are the exception, not the rule.

Normal people will begin depleting fat reserves when glucose is low, and eventually experience muscle wasting (my experience here as well).

I MUST eat significant amounts of carbs to survive, diabetes or not. And I must have insulin to prevent the weight loss. Without both, I will die in a matter of a few months. Also, my weight loss doesn’t slow down as I lose weight. It speeds up.

FYI: for every 16% in body weight you lose, you DOUBLE your metabolism. And this is entirely without exercising. Exercise and the rate is much higher.

I had to split my doses in order to keep blood sugars under control.
I must have a screwy system…

And the vast majority of my weight loss occurs while I am sleeping ONLY. I have no idea why.

You sound like you are into the medical field. Are you? I hope not. I don’t trust ANYONE in the medical field any more. At least not with my health. I have too many bad experiences with the medical field to trust any of them again. Things like DIEING because no one would listen to me, but later I managed to convince them of the problem, THEN they treated me.
Ain’t gonna happen again.

It seems they have their facts all wrong and backwards. I am proof of that.

The food pyramid is politically engineered, not health engineered.

I go by my own plan, and my health is near perfect, without eating a single vegetable or doing all that useless unproductive exercising. If I am going to exercise, I will do something productive.
My time is far too valuable to waste on anything unproductive.

I went by their plan, and gained weight rapidly - 25 pounds in a month.

All for the same meals too. My diet rarely changes.

Once I get a chance, I will design an accurate - non political - food pyramid for everyone. Just no time right now.

Actually two of them. One for type 2’s and one for everyone else, assuming no other health problems.

Please note: I saw a dietitian once. The moment I got home, I threw her diet plan in the trash.
If I went by that, I would have high a1c’s and still be significantly fat to this day.

Follow up:

I did exactly what you told me to do:

Google “German Cheesecake Nutritional Facts” to see the information for yourself.

It came up as this is the only place on the internet that mentions the cheesecake facts.

I was wondering if anyone had a source that states that you gain weight due to Lantus…

Lantus works very well for me so there would be no reason for switching to Levemir.
Though, I have trouble with my weight. I’m not overweight - yet. But I can’t eat as much as a normal person can without gaining weight and it’s frustrating because I’m actually trying to lose some, which turned out to be impossible.

So, I would definitely be willing to try Levemir if it meant that it would be easier for me to control my weight.

Thinking back, it does make sense that the Lantus has something to do with it since I never had as much trouble before I was on that insulin as I have now. But then, I was a teenager then and you can’t always compare your reaction to a certain insulin in your teen years to your reaction as as an adult.

My next appointment will be sometime in 2-3 weeks.

I was a little worried about control a few weeks ago and I talked to my Dr. about switching to Lantus, I have not been on insulin very long and I’m still not under control yet. I’m pretty heavy and I realize my weight has much to do with my BG control. He said that Lantus would not be a good choice for me because of the weight gain issue. One issue I have read about with Levemir is that is might not last as long in some patients as does insulin glargine (Lantus). Levemir is a detemir; my Dr. said that according to his reviews of the clinical studies that the time it lasts is not significant according to the manufacturer. He told me that if I needed to go over 60 units per day we might consider splitting the dose morning/evening. I am at 75 units now and I am splitting the dose. I disagree with him on the question if Levemir lasts as long as Lantus, I do not believe it does just because of the sheer number of folks that are stating otherwise that have used it longer than me. I do believe there are issues with weight to be considered. If you are under control and weight is not an issue, I believe I would stick with Lantus.

Well, I wouldn’t say my control is bad (get my new A1c in 1.5 weeks) but my experience showed that Lantus does not last 24 hours for me!
Others may disagree but to me it’s pretty much clear. If I have something for dinner I don’t take extra insulin for , my bg goes up. So what keeps it down in the evening is just the short reacting insulin, not my Lantus as it’s supposed to be. Also, the Lantus seems to lower the bg more than it should after I take it. Which is the case if your body ran out of it some time before you take the next dose.
Increasing my dose of Lantus or splitting it did not work out well, the latter caused rather the opposite. My bg went to low one dese cut across the other.

Lantus works fairly well for me - though only during the time it’s actually there and only if there’s not too much of it either. So I consider switching.
In my last post, I said I don’t have any other reason than my weight but after that I took a closer look to my bg level durng this week and my log entries and saw that it wasn’t just a temporary problem.

Great info I just saw Levemir on TV. I’ve had non stop weight gain with Lantus for the last 4 years about 3/4 of a pound a month. I only use 1 type of insulin and have been looking for an alternative to Lantus. What good will good numbers do me if I weigh a ton. The funny thing I really don’t use more insulin with all the weight gain. I find no rhyme or reason to Lantus. I can eat more carbs and need less when doing the same things. No my Dr.s have not been helpful, maybe I need to break down and go to an endo again.
On TV they list weight gain as a side effect of Lantus. ITA. I hate it!