Lantus, Levemir or pump therapy advice.

Hello, I have been given the choice to change from Lantus to Levemir or possibly Pump therapy.

1) Any advice on the pros and cons of Levemir would be appreciated .

2) Also how easy is it to combine pump therapy with the DAFNE regime? Will I have to leave my DAFNE security blanket as my PCT does not offer DAFNE anymore. (I do not know why)

Levemir gives you more flexibility for exercise and alcohol and is suited better to a split regime. But naturally some folk do get on better with lantus but for the most part it's compatible with most.....

If you do get a pump then you will actually be taking the next step in your diabetes management, so DAFNE will still very much apply however there will be more things you will need to learn about like several basal rates, different kinds of QA delivery, the possibility of needing to give QA for non carb items......

If you do get a pump then your bound to get support with it, but being a DAfne graduate, your the best person to advise yourself when it comes to the DAFNE side of things, so the fact your pct or clinic don't offer it won't be a bad thing.

I would imagine your clinic staff are still DAFNE educated, no?

Hi "thebatoutofhull",

I'm in the same position as you at the moment. My DSN's are trying to fix my dawn phenomenon and these were the choices I was given.

Pre 2007 I was already on Levemir but was switched to Lantus because I was getting a lot of stinging/bruising on my injection sites.

So I am unsure I want to go back onto Levemir and I am starting to think that the pump maybe the answer.

Have you decided what path you are going to take?

All the Dafne principles work well with a pump, especially the carb counting/meal flexibility issues. A pump is just a logical extension after Dafne. Obviously you have to make some changes but none fly in the face of reason after applying Dafne rules. My pump therapy is still not as smooth as I would like but it is certainly better than the Lantus/novorapid schema I was on before. One caution: to do a pump well requires an inordinate attention to detail/changes. The rewards are there, however. Received my second pump yesterday!
Helen

What's best levemir or lantus if you are trying to loose weight???

I couldn't say for sure, but I would think that neither is better than the other for losing weight............

Obviously taking less insulin will help, but in theory you will always have the same background requirement regardless of whether it is delivered in one dose of Lantus, or a split dose of Levemir.

I have approached my HCPs for advice on weight loss and the advice always given is activity levels and calorie intake, and trying to avoid hypos.........

To date I am still about 4-5 stone overweight...........

Hi,

I also find dieting a problem as a hypo can ruin everything

Phil

I am having hypo problems at the moment, and by problem, I mean lots of them, with no obvious pattern emerging........but I had a bad one the other night, a few hours after going to bed, 2.0 I was, I then proceeded to totally over compensate with roughly 120g of carbs, which I am sure was pushing the 1000 calorie mark....took insulin for it all obviously minus that of the hypo treatment.......that's me being bad obviously, but at that time of night and at that level, you just don't care to be honest......

Hi Fishnetsboi,

When I started carbohydrate counting, I was still on Lantus and managed to lose over a stone in weight. The DSN and dietician moved me from Humulin S to Apidra but kept me on lantus because the Humulin S doesn't work well with carb counting and I was on quite a high level too.

So there is definitely the potential to lose weight on lantus. What seems to make the difference is getting your ratios and BI right first of all, which should then, in theory, mean that you can reduce your food and insulin in-take at meal/snack times (or even exercise more) and as a consequence lose weight.

fishnetsboi said:
What's best levemir or lantus if you are trying to loose weight???

Hi BMuffs,

You say that Humulin 'S' doesn't work well with carb-counting. Could you expand on that please?

Kind regards,

Roger

When I started carbohydrate counting, I was still on Lantus and managed to lose over a stone in weight. The DSN and dietician moved me from Humulin S to Apidra but kept me on lantus because the Humulin S doesn't work well with carb counting and I was on quite a high level too.

So there is definitely the potential to lose weight on lantus. What seems to make the difference is getting your ratios and BI right first of all, which should then, in theory, mean that you can reduce your food and insulin in-take at meal/snack times (or even exercise more) and as a consequence lose weight.

fishnetsboi said:
What's best levemir or lantus if you are trying to loose weight???