24-hour Basal insulin besides Lantus (available in Canada or US)

[kemist]

I've heard of Detemir (Levemir)... but don't see any mention of it being available in the US or Canada. I am wondering if a switch to a different basal insulin might help me.

Does anyone know if switching between two types of identical TYPE insulin (ex: humalog/novolog or lantus/levemir) might help keep the body from getting to accustomed and resistant?

kemist

[Cinnabon]

Sorry can't help too much here, But I have heard GREAT things about Levemir, even preventing the whole weight thing associated w/ insulin. It should be coming soon but I don't think they can let out an exact date.

[DeusXM]

If you go onto Levemir you may find that you need to massively increase your dosage. I was one of the first 100 people in the UK to go onto Levemir, and my dosage racked up from 6/9/11u bolus and 24u basal to a basal dose of 60u, and bolusing EVERY HOUR with 5u and my bg just wouldn't go below 12. I was taking up to 150u of insulin a day and I was running bgs like a non-dxed. After 2 weeks I just point blank gave up and went back onto Isulatard, which I was on in the first place because of the hilariously terrible side-effects I had when I was originally on Lantus.

Having tried all three, my verdict is as follows:

Lantus is usually a very good insulin for bg control but it's not as effective as Aventis make it out to be. It also has a higher rate of much more severe side-effects in users.

Levemir is also a very good insulin for bg control but it does have issues with dosages - I was certainly not the only individual on Levemir who encountered the same problem. However some people found that they had no trouble at all. Levemir also is statistically far less likely to cause side-effects and is generally better at preventing weight gain.

Insulatard is an ok-to-good insulin for bg control but you do have to pay a lot of attention to what you're doing if you want to get decent results. It's the least likely to have side-effects (although these still exist) but it is also more likely to cause weight gain and hypoglycaemia. However, you can actually use the fact that it peaks and troughs to your advantage in managing both mealtimes and also unconscious rises in bg such as Dawn Phenomenon.

Basically it's horses-for-courses. If I was choosing an insulin and in a perfect world then I'd go with Levemir because it's simply a better insulin in every way - although sadly I was unable to experience it myself.

Switching from Lantus to Levemir would certainly change your insulin resitance because the two are very different insulins despite having the same function. Lantus works by being at a different pH to the rest of your body, which is how it slows down its release at a constant speed. Unfortunately a change in body pH can have rather drastic effects on brain chemistry. Levemir works by changing the shape of the insulin molecule so that it binds to albumin in the body, thus slowing down its release. The scientific terms are insulin glargine (Lantus) and insulin detemir (Levemir).

However (and I may be wrong on this) I was under the impression that insulin resistance does not occur in T1s - insulin requirements in T1 change as a result of metabolic process or weight change, rather than any cellular resistance. As I said though, I'm not 100% confident on that.