detemir/levemir whatever its called!

Lizzie G · #1 (**permalink**) 05-19-2008, 03:45 AM

Hi

Can anyone help.....I currently use Lantus as my basal but due to my pronounced 'dawn' effect and high sensitvity during the day is not suiting me very well. Im friendly with a dietician who works with my endo and i asked her to mention the posibility of taking a lower doseage of lantus and adding NPH at night to cover my higher requirement; however he suggested using detemir twice a day as its a 12 hour insulin. when i did some research i saw that detemir is apparently 24 hours just like lantus, so im a little confused...do any of you use detemir/levemir and if so is it a 12 or 24 hour thing?

Thanks

ant hill · #2 (**permalink**) 05-19-2008, 04:10 AM

Lantus & Levemir are 24 hour insulins but it do have some short comings. I have found that Lantus is a good insulin execept their delivery system and may do the 24 hour distance. Also Levemir is a good basel too and also a said 24 hour insulin and a good delivery system enployed. I think that the 24 hours is indeed a sales ploy!! however the peak and trougth is very good as it's flat as a pancake.

I take Levemir @ 44U morning and night. and it's good!!

Stuboy · #3 (**permalink**) 05-19-2008, 05:20 AM

i find that levemir doesn't last as long as lantus, (i've made the switch from lantus to levemir).

lantus used to last me about 20 hours, whereas i think levemir lasts about 13-14 hours for me.

I also found that i needed MORE levemir (16u am and 15u pm) than lantus (9u am 10u pm)

I take my levmire at 10am and at 10pm. It seems to have a "softer" effect than lantus, that's the only way i can describe it really. Almost like Lantus is "aggressive" to blood sugar but levemir is gentle. lol

That's how i feel anyway!

Stuboy · #4 (**permalink**) 05-19-2008, 05:22 AM

oh PS, it's both!

Insulin detemir is to Levemir as Insulin Glargine is to Lantus!

Gary_W · #5 (**permalink**) 05-19-2008, 01:57 PM

It's just a different profile. Lantus and Levemir are the latest in a long line of basal insulins, and upon release both were marketed as a 'one shot every 24 hours' insulin. It is marketing speak, as neither is completely flat. And to further confound the marketing, no-ones needs are flat either

I haven't tried Levemir, but most of the stuff I've read about it suggest that it is a little more peaky than Lantus and is less likely to last the 24 hours. In fact, some folks have trouble making it last 12-14. For that reason, splitting Levemir is extremely common. Splitting Lantus is relatively common on here but in the general population I would venture that it is far from the norm. All of this suggests a shorter profile than Lantus which MAY help with your DP.

I can see why your endo is suggesting it; some folks would regard NPH as rather 'old hat' (not trying to start an insulin war here!). Whilst it may work for you, the more modern approach may be to try Levemir first before going back in history. I'm not advocating this approach, just second guessing where the advice you've had may have come from

Gary

BlueSky · #6 (**permalink**) 05-19-2008, 02:08 PM

Quote:

Originally Posted by Lizzie G

... he suggested using detemir twice a day as its a 12 hour insulin. when i did some research i saw that detemir is apparently 24 hours just like lantus ...

The action period of insulin is dose related. The bigger the dose, the longer it lasts. I suspect that the advertised 24 hour duration was based on single doses of 25+ units. If you are insulin sensitive, you still produce some of your own insulin, and you split the dose, you can expect the Levimer action to be a lot shorter than the advertised period.

xMenace · #7 (**permalink**) 05-19-2008, 02:17 PM

Quote:

Originally Posted by BlueSky

The action period of insulin is dose related. The bigger the dose, the longer it lasts. I suspect that the advertised 24 hour duration was based on single doses of 25+ units. If you are insulin sensitive, you still produce some of your own insulin, and you split the dose, you can expect the Levimer action to be a lot shorter than the advertised period.

Somebody posted an article recently that suggested "appropriate" dosages tend to last only 12 hours. The 24 hour estimates were based on inflated needs. It sounds like split dosing of xamirs and Lantus is becoming standard partly because of this.

It still doesn't address your high DP though, Keep following up on that NPH line of thought.

HelenM · #8 (**permalink**) 05-20-2008, 12:08 AM

When I changed over to the pump, the doctor prescribed levimir for a back up in case of pump failure. Pump replacement should be very quick so they chose it in preference to lantus (using 1/2 doseage) because 'it only lasted about 12 hours' Nobody on the course used very large amounts of basal.

Cloudedbrains · #9 (**permalink**) 05-20-2008, 12:24 AM

Both lantus and levemir can be taken twice daily if thats what you drs determine would be best.
When I was on them I had to take them twice daily.

shabbie · #10 (**permalink**) 05-20-2008, 02:09 AM

ive only used levemir, and found it only worked for max 18 hours for me. i beleive its supposed to be a 24 hour insulin

i use a pump now which is only rapid acting insulin, (novorapid in my case

) so now my basal covers all 24 hours of my requirements

Lizzie G · #11 (**permalink**) 05-22-2008, 12:27 AM

Quote:

Originally Posted by BlueSky

The action period of insulin is dose related. The bigger the dose, the longer it lasts. I suspect that the advertised 24 hour duration was based on single doses of 25+ units. If you are insulin sensitive, you still produce some of your own insulin, and you split the dose, you can expect the Levimer action to be a lot shorter than the advertised period.

This is really interesting, I wonder why this is. Does this mean that if you take massive doses they could potentially last longer than 24 hours? Bluesky what do you think? I know from what you have previously said that you experience similar DP and cover yourself at night using the shorter acting 'old fashioned' insulins. Im just worried that the Detemir would cause me problems whilst I figure out how long it lasts and so on. And that I might figure out that it doesnt work that much differently in me than Lantus. I would have thought NPH would be ideal for my needs, seeing as I need to take someone at 10 pm that peaks 3 or 4 hours later and lasts 12 hours?

danlad72 · #12 (**permalink**) 05-22-2008, 12:39 AM

hi everyone
i dont always msg on here as i feel like a bad diabetic as i always believe what my docs tell me.
im on 22 units of levemir and it seems to work for me. but im not very strict on when or what i eat. im also on novorapid which has really helped so i just do a sliding scale for that.

Gangrel · #13 (**permalink**) 05-22-2008, 05:36 AM

Levemir lasts me about 20 hours, which seems to be the norm.

I take mine at 11pm, then 7am before I go to work. This leaves me a bit of a "hole" from about 7pm to 11, which I mostly can handle with my supper bolus (not all the time tho)

I've never tried Lantus, but compared to NPH, Levemir is a dream......

As for bigger doses lasting longer, it makes sense to me. I would thinkg one unit wouldn't last 20 hours, but 30 units would......

Lizzie G · #14 (**permalink**) 05-22-2008, 08:14 AM

Quote:

Originally Posted by Gangrel

Levemir lasts me about 20 hours, which seems to be the norm.

I take mine at 11pm, then 7am before I go to work. This leaves me a bit of a "hole" from about 7pm to 11, which I mostly can handle with my supper bolus (not all the time tho)

I've never tried Lantus, but compared to NPH, Levemir is a dream......

As for bigger doses lasting longer, it makes sense to me. I would thinkg one unit wouldn't last 20 hours, but 30 units would......

im still not convinced on this levemir thing. everyone's comments are really helpful and so on, but my basal requirement is so dramatically different that if i took it at say 10pm at the sort of dose that would work for night, im still in a real danger zone late afternoon when my basal requirement is very low. would you not recommend small doses of NPH just to cover night-time where I struggle with highs?

novorapid · #15 (**permalink**) 05-22-2008, 10:08 AM

i take levemir twice daily 30 units each time morning and night and novorapid 3 times daily at meals, i had been taking nph twice daily as my basal, sometimes i do and don't see a difference with levemir, though i do think it is probably better than the nph. very costly at $136.00 dollars canadian for 5 penfills thank god for insurance which covers levemir for me i only pay $40.00 dollars. if i'm a little high before bedtime i must admit the levemir does get me down overnight really well though, whereas the nph seemed to have a hard time achieving that. so the bottom line i guess levemir for me anyhow is a little better than the nph, but i don't think it is cracked up to be what they say, i'm going to talk to my doctor to see if a larger dose of nph, would do the same as the levemir and if so i'll switch back to the nph, much cheaper even if the dosage would be higher. that's just my opinion on levemir.