Lantus and Weight Gain

[steph1]

Hi Everyone,

I recently found this Forum while looking for info. on Lantus and weight gain. I am wondering if anyone else has had the same issue.

I have had Type 1 for 5 years now. I started Novorapid and Novolin and didn't really gain any weight. Last October I started taking Lantus with my Novorapid. I experienced far less hypos at night and was able to positively affect my fasting levels (which is why I switched to Lantus in the first place). I brought my A1C to 6.4 (from 7.1). However, my side effect was weight gain. I have gained over 10 lbs. since starting Lantus. I kept wondering why I was gaining weight and thought it might be Lantus, but my endo could not tell me that was why. I did a million tests and nothing was wrong with me. Finally, my other Family Doctor told me Lantus contributes to weight gain. So, this is how I found this site. I have read about many people saying Lantus made them eat more, but I am wondering if others have had the same experience as me. I am not eating more, just gaining weight and unable to lose weight no matter what. I want to pass along your insight to my endo, so others will also realize the side effects and I'll know I am not going crazy.

Thanks everyone for their input. I have already learnt many new things from this Forum.

Steph :hello:

[valc3]

Hi Steph and welcome to the forum. This is a great place for information and support. I'm on Lantus and Humalog. I haven't suffered with weight gain. Hope someone comes along that can help you.

[grace girl]

I just switched to Lantus and Humalog from Humalog Mix 75/25 in May of this year. My appetite has cut in half and I've lost 5 pounds. I've heard of people gaining weight on it, but I haven't experienced it myself.

[am1977]

I think everyone's experience is different. I have heard that Lantus can contribute to weight gain, but I think that goes for all insulin, in general. Not sure where, but I think I read that a person not only gains the weight they lost prior to diagnosis, but on average gains another 15 lbs in addition :eek:... I really don't want or need those extra pounds, but what can you do, you need insulin if you are T1.

I have also heard that Levemir is better in terms of the weight gain issue. But I've read that, in terms of control, those who are on Lantus have better control. So I guess it's sort of a toss up...

I am currently on the pump and I find it the best thing for me. I can control how much insulin I take for meals, etc... and I like that fact a lot :)

I think overall having good control is what is most important and it seems like you have wonderful control... whether you are 10 lbs more or 10 lbs less isn't as important.

Best of luck!

[jillsp]

One thing to keep in mind with insulin is that once you gain good control, your body is actually using all the calories you are eating correctly instead of dumping them in your urine. It only makes sense that you would gain some weight with good control, but it should level out. All of the studies on Lantus (and there are tons) show that Lantus is weight neutral, in other words, you don't gain and you don't lose. I know I initially gained weight when put on insulin and my doctor explained it to me that my body was adjusting to not spilling sugar all the time and that I was properly using what I ate. I was on Lantus for about a year and a half and lost some weight, then went on the pump and have stayed level (um except for gaining 70 lbs while pregnant!) I still have about 10 lbs to lose from my pregnancy. The problem with insulin is, the more you take, the fatter you get. It's a fact of life. I find that the more I exercise, the less insulin my body requires and that is the only way I can ever lose weight. sucks.

[lgvincent]

I've heard of weight gain with Lantus, too. I don't use it yet but I have gotten some and I'm afraid to use it for just that reason. I've gained about 12 pounds in the last few months and I have no idea why. I want to get rid of that weight, not add more to it.

[poodlebone]

I was only on Lantus for a couple of months and I was finally able to start losing weight once I began taking it. I then switched to a pump, so my Lantus experience is limited. But, definitely weight loss for me, not gain.

[SueM]

I don't use Lantus, but do help manage a web site with 6,000 members and more people than not say they have problems with weight gain while on lantus.
I did see an article the other day where the author commented about levemier sp! now being prefered over Lantus because of weight control problems with Lantus.

[DeusXM]

Lantus can cause weight gain but as insulins go it's got one of the lowest rate gains of them all.

[klpants]

I'm on Lantus, no real weight gain from the actual Lantus. Maybe get your thyroid checked? when I was diagnosed with underactive I'd gained 8 lbs and couldn't lose it. Now I'm on meds for the thryroid my weight has gone back to normal.

Better control can sometimes lead to weight gain but shoudn't lead to a massive increase in weight, but all depends on the individual and factors involved.

[bittersweet]

While using lantus i can definitely say that it caused some weight gain and when i got on the pump finally it was quick to come off. it was odd like a puffyness almost. it wasn't that i ate more. it was sort of just there. I never really noticed how much until i got on the pump.

[vrocco1]

jillsp has given the only logical reason I've ever heard for weight gain and Lantus. There is no explanation for the magical weight loss brought on by Levemir. All of the studies just find that it happens (for no apparent reason). :smokin:

Until there is an explanation, some might assume it is not true.

[djacobs]

I just went on Lantus and gained 10lbs right away. That freaked me out because I am not used to weighing this much. I do love the control I have over the sugar, but I am unhappy with my larger than normal stomach. What do we do? Situps?

[JasonJayhawk]

Lantus doesn't cause the weight gain per se -- Insulin does!

[vrocco1]

No, that can't be true! With the way the folks at Novo are playing up the weight-loss advantages of Levemir? Would a drug manufacturer tell an untruth? I don't believe that my friend :-

[DeusXM]

With the way the folks at Novo are playing up the weight-loss advantages of Levemir? Would a drug manufacturer tell an untruth?

Novo have NEVER marketed Levemir as a 'weight-loss' insulin. They merely point out that it has an even lower rate of weight gain than Lantus, presumably because of its even flatter action profile. It is also perfectly possible that people who remain at a stable weight on Lantus could lose weight if they switch to Levemir because then they may end up ingesting fewer calories overall.

but I am unhappy with my larger than normal stomach. What do we do? Situps?

If you're specifically worried about your stomach AND you're regularly injecting into your stomach, STOP. If you want to keep a normal looking figure, NEVER inject into your stomach. I've learnt this the hard way.

Furthermore, I know you're being facitious, but sit-ups will have no effect whatsoever on the fat on your stomach - fat burn isn't localised. Otherwise everyone who chewed gum would be lantern-jawed.

[JasonJayhawk]

If you're specifically worried about your stomach AND you're regularly injecting into your stomach, STOP. If you want to keep a normal looking figure, NEVER inject into your stomach. I've learnt this the hard way.


Egads, I've never heard this! Does this relate to damage to fat (lipohypertrophy)? Or does this suggest that fat accumulates where the insulin is injected?

I'm going to go rub my tummy. :sheep: :creep:

[vrocco1]

Novo have NEVER marketed Levemir as a 'weight-loss' insulin. They merely point out that it has an even lower rate of weight gain than Lantus, presumably because of its even flatter action profile. It is also perfectly possible that people who remain at a stable weight on Lantus could lose weight if they switch to Levemir because then they may end up ingesting fewer calories overall.

Oh, so I guess it is the flatter profile that causes the weight loss? Flatter then what I wonder?

As for the marketing, I've heard nothing BUT the weight loss aspects. Perhaps the marketing is different in Europe then the U.S.? You know how backwards our helthcare system is...

[jillsp]

Novo absolutely markets Levemir using the weight loss claim. I know their reps tell the doctors that and I have read several posts on this forum and others about people wanting to try levemir b/c they heard they could lose weight. Where do you think they heard it? I think from doctors whose reps told them that. Now, you won't find the words "weight loss" on their website b/c the FDA would never allow that b/c it is not true, but I know for a fact the reps are selling it that way. It's a dog eat dog world.

Where have you seen a study of Levemir vs Lantus? I have only seen a poster that was presented at the ADA and it did not show a flatter profile than Lantus and it did not show less weight gain. It showed they were both weight neutral and a higher rate of hypoglycemia for Levemir. The studies that show the lower rate of weight gain for Levemir are vs NPH. Which makes perfect sense!

[DeusXM]

http://www.diabetesforums.com/type-1/10388-lantus-vs-levemir.html

ADA: Ten Thousand Patients Using Levemir Insulin Show Improvements in BG Without Weight Gain
on Tuesday, June 13 @ 13:11:26 CDT

Levemir reduced mean A1C levels by 0.54 percent for type 1 and 0.89 percent for type 2 diabetes patients.

Novo Nordisk announced results from the German cohort of 10,276 patients enrolled in the observational PREDICTIVE(TM) trial, which found Levemir(R) (insulin detemir [rDNA origin] injection) improved blood sugar control (A1C) and reduced episodes of major hypoglycemia (low blood sugar) with no weight gain in actual clinical practice. The primary endpoint was safety.

In PREDICTIVE, Levemir demonstrated significant improvement in blood sugar control - A1C levels were reduced significantly in both type 1 and type 2 diabetes patients. In addition, patients with type 2 diabetes lost weight, while type 1 patients maintained their weight while using Levemir. Weight gain is a common side effect of insulin therapy(1) and Levemir is the first insulin to show less weight gain versus other basal insulins in 12 of 12 controlled clinical trials. Among people with diabetes, 90 to 95 percent have type 2 diabetes(2) and 80 percent of people with diabetes are overweight or obese(3).

Additionally, an analysis of a sub-group of this study of type 2 diabetes patients (n=511) focused on patients who switched from NPH or glargine to Levemir. These patients experienced significant improvement in A1C, and reduced episodes of major hypoglycemia. Both patient groups also experienced weight reduction.

PREDICTIVE Study Key Findings (Poster# 511-P)
These results and the findings of a separate sub-group analysis were presented at the 66th Scientific Sessions of the American Diabetes Association in Washington, D.C.

As for the marketing, I've heard nothing BUT the weight loss aspects. Perhaps the marketing is different in Europe then the U.S.? You know how backwards our helthcare system is...

Levemir is NOT marketed as a 'weight loss' insulin. It is marketed as an insulin that causes a significant reduction in weight gain in comparison with NPH therapy. That is a subtle but important difference.

By all means, be suspicious of pharmaceutical companies, but at least get your facts right first. I can see exactly what's happened here, and it's all part of the marketing plan. Novo says ' Levemir will cause you to gain less weight' and the general public reads what they want to read and believe this means Levemir causes weight-loss.

As for the marketing approach in Europe, unfortunately I'm not privy to the current strategies anymore (since I'm no longer on the Levemir trial), but from what I can tell from my clinic, it would suggest that Levemir is being marketed as a Lantus replacement for patients who don't get full 24-hour coverage or suffer from severe Dawn Phenomenon. I've also heard statements such as 'you can't split your Lantus dose', which I'm not sure is true. In my own case, I was encouraged to go for Levemir because I was on NPH and had issues with Lantus.

FYI, I am now back on Lantus because I found Levemir simply didn't work for me. So it's not as if I have any vested interest in defending Levemir.

[vrocco1]

Levemir is NOT marketed as a 'weight loss' insulin. It is marketed as an insulin that causes a significant reduction in weight gain in comparison with NPH therapy. That is a subtle but important difference.

Thanks DeusXM... You made the point I tried to make in another thread. I was thrashed by other users for making that point, and all of my posts were deleted.

It's really hard to put the results experienced by T2s to use in T1s. There are so many factors that affect weight gain (particularly in T2s, since they suffer from insulin resistance) that the study is completely meaningless. My only wish is to put the entire Lantus "weight gain" thing to bed, since it simply is not true.

I've seen it said many times in this forum that "I'm less hungry now that I'm taking Levemir". That is just impossible to believe. The only way that insulin makes you hungry, is if you take too much. Then you eat to make up for it.

As for the flatter curve, hmmmm.,, seems that Lantus is much flater then both NPH and Levemir.

[DeusXM]

Recent studies also suggest that Levemir can offer lower weight-gain than Lantus - however, presumably these studies aren't extensive enough or conclusive enough to allow Novo to make such claims.

I've seen it said many times in this forum that "I'm less hungry now that I'm taking Levemir". That is just impossible to believe. The only way that insulin makes you hungry, is if you take too much. Then you eat to make up for it.

Something that can be easily explained by split dosing. Those people were probably taking 'too much' Lantus inasmuch that their insulin requirements change throughout the day - something which cannot be budgeted for on a one-dose of Lantus, but can with a split dose of Levemir.

[vrocco1]

Something that can be easily explained by split dosing. Those people were probably taking 'too much' Lantus inasmuch that their insulin requirements change throughout the day - something which cannot be budgeted for on a one-dose of Lantus, but can with a split dose of Levemir.

Or, a split dose of Lantus

[jillsp]

[url from NPH or glargine to Levemir. These patients experienced significant improvement in A1C, and reduced episodes of major hypoglycemia. Both patient groups also experienced weight reduction.



Right, my only point to this, and I'm not trying to be combative, is that this is not a head to head study of Lantus vs Levemir. They group Lantus and NPH together so that they can make the weight reduction claim with the word Lantus in it, but was it just the Lantus group that lost weight on Levemir or was it b/c the NPH folks were grouped in there and they helped the weight numbers? Most likely, if they had hard data of weight loss compared to Lantus I can guarantee they would be touting it. This is a classic case of pharmaceutical word smithing to make people think, I'm on Lantus, I might lose weight if I switch to Levemir, when in all reality it was probably the NPH patients that lost the weight. I'm jaded and synical and read into every detail of these things....you have to.

[vrocco1]

Hmmmm that is something I never thought about. Amazing how sneaky these marketing people are. Lucky we have someone as smart as jillsp to help us sort it all out.

[jillsp]

Hmmmm that is something I never thought about. Amazing how sneaky these marketing people are. Lucky we have someone as smart as jillsp to help us sort it all out.

Are you taking a shot at me or really marveling at my pure brilliance??? :proud:

[DeusXM]

Or, a split dose of Lantus

Indeed. Unfortunately, there's a school of thought (presumably influenced by Novo) that says Lantus can't really be split because it lasts so long. It's not one I necessarily agree with. As I said, this is how they're marketing Levemir - nothing about weight loss at all.

They group Lantus and NPH together so that they can make the weight reduction claim with the word Lantus in it, but was it just the Lantus group that lost weight on Levemir or was it b/c the NPH folks were grouped in there and they helped the weight numbers? Most likely, if they had hard data of weight loss compared to Lantus I can guarantee they would be touting it.

They probably have a few who switched from Lantus to Levemir and experienced weight reduction. However, I would say that you're right inasmuch as the data wasn't conclusive enough to make bold claims that could totally stand up on their own.

[BriOnH]

Has anyone on Levemir had a reduced appetite for carbs compared to other insulins? While I was trying to come off Paxil it totally reduced my appetite. I just wasn't hungry, ever. I wonder if their could be something about Levemir that curves appetite.

Deus, great point about the injecting in the stomach. So much harder to get rid of love handles if I inject there.

Type 1 and Type 2 studies need to be segregated imo.

[vrocco1]

Are you taking a shot at me or really marveling at my pure brilliance??? :proud:

That was pure brilliance. I don't count myself among the gullible, but I never thought you would have to parse a statement by the marketing people to such a degree! I’ve just added you to my most favored posters list. :)

[JasonJayhawk]

Deus, great point about the injecting in the stomach. So much harder to get rid of love handles if I inject there.

You're the second person to mention this. Are you serious!? I never really thought of the insulin localizing and generating the fat in that part of the body.

And, it leaves me to wonder -- do we have any cells in our body that do not get access to the insulin, and therefore, are "not happy" biologically because they're constantly using a pathway void of glucose-6-P?

[DeusXM]

I wonder if their could be something about Levemir that curves appetite.

That is also a possibility, but anything that would do that would be in addition to the actual insulin - it'd be the result of the other chemicals in the vial. As I've mentioned before, some of the ingredients they add to insulin can have surprising results.

I never really thought of the insulin localizing and generating the fat in that part of the body.

I've always been told that human insulin isn't supposed to cause the fatty lumps associated with animal insulin, but the prevailing wisdom appears to have changed now. Insulin is the 'fat' hormone though and so it would make sense that it would cause the most fat deposits in the area where it first starts working. There is also the obvious idea that if you repeated put a needle somewhere, your body will do things to 'toughen up' the skin - like if you play guitar, you get thicker skin on your finger tips. So your body puts fat deposits down under where you inject the most, and the more you do it, the tougher the fat gets.

do we have any cells in our body that do not get access to the insulin, and therefore, are "not happy" biologically because they're constantly using a pathway void of glucose-6-P?

I wouldn't have thought so. As far as I'm aware, insulin starts out by residing in the subcutanous fat, and then is picked up by the tissue fluid and thus enters the blood stream - so anywhere your blood or tissue fluid can get to, so can your insulin.

[2sweet4now]

While using lantus i can definitely say that it caused some weight gain and when i got on the pump finally it was quick to come off. it was odd like a puffyness almost. it wasn't that i ate more. it was sort of just there. I never really noticed how much until i got on the pump.

Funny, this is my 3rd week on a pump. Taking Humolog, now have way better control!! Nite & day!! I'm doing just like you did - a little weight gain, about 5 lbs. and puffy. (I actually had gained 7 lbs., but has since dropped by 2lbs. so not real worried.) Could this be because my body was in some state of being dehydrated while BS out of control?

[2sweet4now]

While using lantus i can definitely say that it caused some weight gain and when i got on the pump finally it was quick to come off. it was odd like a puffyness almost. it wasn't that i ate more. it was sort of just there. I never really noticed how much until i got on the pump.

:topic:
Funny, this is my 3rd week on a pump. Taking Humolog, now have way better control!! Nite & day!! I'm doing just like you did - eating less and a little weight gain, about 5 lbs. and puffy. (I actually had gained 7 lbs., but has since dropped by 2lbs. so not real worried.) Could this be because my body was in some state of being dehydrated while BS out of control?

[DeusXM]

Depends how 'out of control' you were. However, the puffiness you're talking about suggests rehydration.

[notme]

The one thing we have not discussed is the predisposition to gaining weight due to genetics. My family has always had an issue with fat. I worked hard to keep weight off all of my life and have had success staying on the thin side. However, that being said, I gain weight by thinking about carbs. When I started on insulin, I gained weight very quickly. I had lost thirty pounds before being diagnosed type one so I did not worry about putting the weight back on. Slowly, I gained all of my weight back and then some. I started trying to lose the weight and found it near next to impossible if I wanted to have control of my blood sugar. I gained 25 extra pounds in total. I gained on Lantus, I gained on the pump and I gained on MDI. All of it was because I was trying to keep tight control.

I have lost 20 pounds so far, but couldn't really tell you what I have done different except I barely eat. I eat yogurt for breakfast, no lunch and a small normal dinner.

I think much of the weight gain issue has to do with genetics. If you were thin before without much effort, you probably won't have much issue with insulin weight gain. If you are prone to weight gain easily and you shoot a fat hormone in to your body, you will find that weight gain is very easy. I think naturally lean men have the least amount of problems with weight gain and insulin.

The less insulin I inject, the less I gain, the less I must eat. Sucks to be me......:1eye:

[Lorna]

I used Lantus for 4 years before changing to Levimer last Easter. I gained 5 stone on Lantus 2 of which I have lost again on the Levimer.

[Cheer-Phil-ly]

I started on Lantus on 5/5/06 and within two weeks noticed notable weight gain... 30# in 2 months and also retaining a lot of fluids.

Just Tuesday I switched to Levemir and got some water pills.... hopefully the Levemir will control my sugar as good as Lantus (A1C in April=12.2, A1C in June=9.2) and allow me to loose weight... I really don't need the extra weight.

[Lorna]

I'm finding Levimer fractionally less flexible than lantus, but control has actually improved- possibly because I am being forced to take interest again.