I couldn’t be more annoyed that Novo Nordisk is discontinuing sales of Levemir in the US. It is my favorite insulin. When dialed in, it gives me completely flat basal rates. I inject 9 units at bed time and 9 units when I wake up. The reason for the split dose is when I travel often my insulin sensitivity increases and I can easily and quickly adjust the doses.
From what I understand Lantus has a longer duration of action. Has anyone else made this type of a split dose transition, and if so, how did you dose your Lantus?
Being on Medicare with a plan D, I switched in January. I started with my same Levemir doses at 10:30 a.m and p.m. It was trial and error. I started going low between 3 and 4 am. So I cut back a unit of the p.m. dose each night until I stopped going low.
I did the same several years ago and stopped going low when I was at 0.5 units or less which was not worth taking so I totally stopped taking long lasting insulin and have just stuck with fast acting Humalog since then. My digital pen delivers in 0.1 units so it took me three weeks to slowly work down my night lows.
I’m type 2, but I split my Lantus doses like you’ve been doing with your Levemir.
It’s also my favorite insulin, and very dependable. (Other one is Humalog.)
Being insulin resistant, I take about 3 times as much as you.
I decided to put away my pump almost a year ago after a very trying day with it. I had lantus with me for that very reason. I added 20% of the total of the basal on the pump and split it into two shots twelve hours away. The next appointment with my endo I asked for a prescription of Tresiba. For me it is way better than lantus, but everyone is different. I like the one shot of tresiba instead of the 2 that I had to have with Lantus.
In order of least favorite to most for basal:
Lantus
Levemir
Tresiba
I really liked Levemir, but I’m comfortable with multiple basal dosing on MDI. I’ve written about Lantus before here, but in short I really dislike it not so much for the activity curve, which is sort of annoying but manageable, but because of the common sting of an acidic injection, and - if you happen to hit a medium-sized capillary - the resetting of the activity curve to what basically becomes a bolus injection. I only experienced this a few times, but it really sucked.
Currently using Tresiba and I like it.
I’m always grateful for the quality of advice I get here. Thank you everyone for weighing in! @truenorth I agree with your order of preference. However, Tresiba’s duration is so amazingly flat for so long, that it doesn’t work for me for precisely that reason. When I travel overseas, which I do a lot, my insulin sensitivity increases. With a split dose of Levemir, I could adjust the dose and the resulting effect quickly. With Tresiba, it takes about 3 days to see the effects of a dose adjustment. If my insulin sensitivity were constant, that would absolutely be my go-to basal
I was looking for posts about going on a pump vacation, which led me to your post asking about taking a break, and now I’m on this post. Are you still on your break? Are you still using Tresiba?
Yes I am still on MDI and tresiba. I am not sure if I ever will go back on a pump. I really enjoy being able to swim, get dressed however I want without figuring out how to wear the pump, and most of all feeling safer at night without worrying about the pump malfunctioning in the night which it did several times. I have more spots to inject so maybe I can put off scar tissue for a bit. My last A1C was 5.6 which is about the same as a pump. I will say that I couldn’t do this without a dexcom. I do have a copay now though on insulin where on the pump it was free but to me it is well worth it. Everyone is different.
Thanks for the reply! My endo gave me Lantus for my long-acting this time around, but it’s probably just short term so that’s easier than trying to get started with Tresiba. If I end up taking a longer break I will see about switching over to Tresiba anyway.
