Lantus to Levimer

I would stick to the 21:00 BI time if its working for you......

The likely cause of the rise from waking to when you do have breakfast is the Dawn Phenomenon.........

In order for your liver to stop releasing the load of glucose it has supplied to help you get going after hours of fasting, the best solution is to eat something with some insulin, this will let your body now, by digestion I assume that fuel has been given and the livers help is no longer needed.

This is obviously the best option, at least in my opinion........another option, which didn't really work for me is to have a carb free, high fat snack at bed time, so cheese, or peanut butter etc... This means that the you will have something in your stomach digesting for longer and therefore you may minimize or possibly avoid the effect of the Dawn Phenomenon.......

I have heard success stories, but I personally don't think its that reliable, definitely worth a go though.......

To answer the original question, from the book "Think Like a Pancreas" by Gary Scheiner page 40:

"Insulin is measured in units. A unit of insulin should lower the blood sugar by the same amount no matter what kind of insulin you use. A unit of short-acting insulin will lower your blood sugar the same as a unit of long-acting insulin ; it just does so in a shorter period of time. One exception is a long-acting basal insulin called detemir (brand name Levemir) which is approximately 25 percent less potent than other insulins.

In summary, if switching from Lantus to Levemir, then you would expect to need to increase your dose to get the same results.

I'm interested in hearing others' experiences in switching from Lantus to Levemir. I'm on a split dose of Lantus right now (because it wasn't lasting 24 hours for me), but the lag between changing the dose and its effect is annoying.

I cycle to work every day, and my BGs are excellent throughout the week as I have a desk job so activity levels are predictable, but reducing BI before the weekends which are much more active aren't giving me the reduction in hypos that I want, and instead, Monday and Tuesday tend to run a little high as a carry-over from the BI reduction at the weekend.

Looking through some of the threads on Levemir, there seem to be more users of it experiencing unpredictable results than stable ones. Lantus is very stable for me; it is only the lag between changing doses that I don't like and I won't make a switch if it is likely to cause more unpredictable results.

I'd love to hear from anyone who has switched as to whether they would recommend switching, especially from anyone who is reasonably active and exercises frequently.

Thanks,
Warwick.

Hi Warwick

I haven't switched to Levemir as I was put on it from the start, but I do find it quite versatile. I am on 2 doses of BI daily. This means that I can reduce the dose prior to exercise in the morning, or if I have been exercising in the evening I can reduce the overnight dose. Also, not that this will affect you in sunny Melbourne, but on cold inactive days in the winter I increased the BI to cover. I have found the quicker reacting effect of Levemir over Lantus suits me well.

I switched the other way from Levimir to Lantus but only because I didn't want to be taking two shots of background each day. I never really found it to be unstable, the results were quite predictable just didn't last long enough on a single shot.

I don't know how prescriptions etc work in Aus, over here before I switched the diabetic unit gave me a single cartridge of Lantus (which was enough to last me almost 2 weeks) and said have a play and see how it works for you, could you do the same?

or could use your Lantus only for mid week and then on the weekends still take your lantus but top it up a bit with some levimir? That way you get the boost to your BI that you need on the weekends and everything is back to normal again come Monday.

Thanks NuMo and Apollo. It ain't that sunny in Melbourne right now :-( I am actually finding that I am having to up my BI to cope with the season change right now.

Interesting idea Apollo. Insulin prescriptions give about a 6-month supply here in Australia, but I could ask my GP about a 2-month supply of Levemir and go back to Lantus if it doesn't work for me. The idea of mixing BI insulins is one that I hadn't considered. I have my 12-month DAFNE review on Thursday. I'll mention it to my DAFNE diabetes educator and get her opinion on that.

Thanks,
Warwick.

Just come bact to DAFNE. Had 6 month break due to problems with Levemir. Am now back on Lantus, which I have had before, just injected a quick acting at meal-time years before DAFNE was even thought of.

I have to say I've never heard of anyone using both Levimir and Lantus so I don't know if there are any potential complications that could arise from it but I'd have thought they would work together in much the same way that BI & QA do. Obviously it's going to make it more of an arse to get your background set right as you effectively have to 2 modes you need to define so certainly worth trying a total switch to Levimir first and seeing how you get on with it, but if you need to take 2 shots of BI anyway then I'd have thought you would get on with it fine. If you look at those graphs I posted back on page 1 of this it will give you a better idea of the difference of how aggressively each works from the time you take it so you have a better idea of what to expect.

Certainly if you take a shot before you go to sleep make sure you are over 8 before hand as it was normal with Levimir (atleast for me) to drop a little in the night.

A question just to clear some things up for me, people say that Lantus is not quick to change, so if they lower the dose it takes a few days to see the result of that. I can't say I have really had cause to play with mine to much in the last year since I changed but I have had the odd day where I've forgot to take the shot due to exhaustion and the next day I've been stupid high because there was no background in my system.

To me that says that the Lantus had all left my system so if I'd taken say a half dose the night before because I was going to do something the next day that was going to be seriously physically exerting then that change would have taken for the next day. I accept that once you put the stuff in it's there for 24 hours and if you put in to much then you're going to have to manage that with extra carbs but it almost seems like Wariwick and a few others are saying that if they change what they take Sunday bedtime then they won't really see that change in their readings till Wednesday. Have I got the wrong end of the stick here or is that most peoples experience?

Hey everyone.

Thanks for the info on insulin Warwick. That makes sense to me and explains why I am needing more Levimer compared to lantus. Although I am struggling slightly with the fasting BIs over night, I have found the Levimer really useful after exercise. Reducing it by 1u really helps stop those post exercise lows. So definitely work considering if you are quite active.

Regarding the lantus effects, Apollo, to be Honest I didn't adjust my lantus dose at all, as just took hospital advice, that the changes take a few days to take effect. So didnt really give it a go as took their word for it!

As for my troubles- I got one good week of morning blood sugars but back to being a bit Stuck now. Fasting tests for me through tonight!