Levemir versus Lantus

41 posts, 11 contributors

May 16, 2011 19:00 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	AK said: Just to confuse you with more conflicting advice: I have an active lifestyle and I found that 1 dose of Lantus wasn't flexible enough for me (usually because too much BI knocking around when I was exercising, meaning I just went hypo about 3 times in an hour of sport). Switching to 2 doses of Levimir is as close to perfection as I've come. its not conflicting advice.....its a good example of how these two insulins can all benefit us all in different ways.............try everything in my opinion, test, write it down, and make a decision........... being active as you say would require that flexibility provided by levemir................ i suppose in some ways, you could split the dose into more than 2 a day, theoretically, no one try this though, im no doctor................
May 16, 2011 19:07 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	saxman said: I have switched to levemir and my bg is stable and near normal compared to high spikes with lantus,I havent changed anything else so for me it works, has anyone got any information on using a pump?? what information do you need........... with a pump to begin with there is a lot of background testing, and some times a continuous glucose monitor is used (CGM) to ascertain when you need the most BI and when you need less............... so then different basal rates can be programmed by the hour believe it or not............it can be good in combating dawn phenomenon, by programming the pump to give you more BI in the small hours while you sleep.............. and the QA doses, or bolus doses can be programmed to even more weird and wonderful things, can change lives, but its hard work, harder than following to DAFNE....
May 17, 2011 09:02 AK 16 posts	Do you still use a pump, Novorapidboi? How do you carry it around eg in a pocket? Does it restrict what outfits you can wear? Do you ever get sick of it? Presumably you can't wear it in the shower/swimming? Do you use it on holiday? Even though it's harder work, is the control much better? Have you ever knocked it out by mistake? Does it restrict what positions you can sleep in? Thanks!
May 17, 2011 09:17 saxman DAFNE Graduate The Rotherham NHS Foundation Trust 28 posts	all of AKs questions go for me too. I have been reading about the pump and wondered if it would be better for me, i already do lots of tests and carb count but my bg levels are either low (hypo) or spiking
May 17, 2011 09:19 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	AK said: Do you still use a pump, Novorapidboi? How do you carry it around eg in a pocket? Does it restrict what outfits you can wear? Do you ever get sick of it? Presumably you can't wear it in the shower/swimming? Do you use it on holiday? Even though it's harder work, is the control much better? Have you ever knocked it out by mistake? Does it restrict what positions you can sleep in? Thanks! I wish I could answer all your questions but I cant as I have never had or used one, but I have spoken to many who have, this is where I have got my information. I will try and answer some though: I believe you can carry it in pockets as well as clipped on to trousers, for the women clipped on or position in the bra is an option also, there are also pouches available for purchase. If I had a pump I would imagine it would get annoying, but I assume this feeling may disappear quickly.... Pumps are waterproof, so the shower and swimming is permitted....a change of cannula may be needed after long exposure to submersed condition..... Using the pump on Holiday is essential, as users would not go back to MDI just for a Holiday, however a current issue I have heard discussed recently is how to keep tubing and reservoirs cool in hotter climates.... The stories I have heard from people is that control is much better, perfect even, but this can change just as quick if your background/basal needs changed, which they do from time to time, this means lots more testing, overnight etc...and this can make users feel out of sorts as they try and investigate their new doses.....so like MDI, but if control is really good then you hit a bump in the road, then the effects may be felt more intensely..... I would assume that wearing the pump does restrict some positions, but it depends where the cannula is inserted, if its in a position where it and the connecting tubing is unaffected by movement it will be fine, but as I say, I cant speak from personal experience...... The overall consensus from me, is that the pump is a wonderful device, and if you really need it, then you can get one........you will already be used to the constant testing day and night through your failed attempts to gain control through MDI, so this will make the transition much easier to the pump....... Are you thinking about inquiring...........? What are the your chances at your clinic........? Where are your current problem areas......?
May 17, 2011 11:46 MelissaF DAFNE Graduate South West Essex PCT 56 posts	BigManRestless said: I was moved to Levemir a few weeks ago, and started off the dosage recommended by my specialist at the hospital. My readings rocketed to an average of around 17mmols, with results in the high 20s not uncommon. I quickly upped the background dose, twice and still I'm not geting very good results at all. I'm lucky now to get anything under 10. After three weeks of this, today I feel sluggish, with no energy at all. I'm really, really angry that I was taken off a background insulin that was working for me because I was taking "too much" according to the doctor, and now I'm having to take even more than I was before, for worse results. Hi BMR, Just seen your post - it was me who started off this thread. I think, as NRB says, there's no hard and fast rule for everyone as everyone's body reacts in completely different ways. I tried for 5 months on the Levemir and couldn't get any sort of balance at all so went back to the Lantus in the end which suits me much better. My results are a lot more consistant and a lot more predictable and I find it much much easier to apply the DAFNE principles. I have no problem with it lasting for the full 24 hours but I think that the only negative point for me is the waiting for 3+ days to see results to dosage changes. No way around that I think. From the research that I did, I've found that Levemir works very well for a large amount of people but I've also found a fair percentage of people that it hasn't suited at all who have experienced the same problems that I did and that you are now. I think that it's widely recognised that, with Levemir, it's fairly usual to have to up your doseage so, if your doc put you on it to reduce units then that seems strange. Maybe you should discuss further with them. Maybe there were other reasons though? Personally I found that my levels veered between very high and very low with particular problems with very high morning readings. As I mentioned, I found that results were very unpredictable with patterns being very hard to spot and therefore treat. I also had real problems trying to work out how to split the two doses - nothing I did seemed to work. I would keep in constant contact with your HCP and keep talking through everything with them, ask for the reasons why they changed you and take advice in trying to sort it. Sometimes these things take a long time to sort but I understand your frustration with such high levels. See what happens with an increased dosage though. If you (and they) feel that you have given it a good enough trial and you still feel that it's not working for you then it may well be that the insulin just doesn't suit you and you need to switch back to something else. Your instinct is probably a pretty good one but obviously give it a good attempt first as it may settle and improve. I got very frustrated as I was communicating weekly with my nurse who was telling me that she had never heard of anyone experiencing problems on Levemir before and that I should just keep trying. This went on for months. In the end I made the decision myself to switch back. I mentioned my problems a few weeks ago to my consultant at a clinic appointment and straightaway she said that she had heard of several of her patients experiencing similar problems which was a bit frustrating. Let us know how you're getting on. Good luck with it. Melissa xx
May 18, 2011 15:14 saxman DAFNE Graduate The Rotherham NHS Foundation Trust 28 posts	novorapidboi26 said: AK said: Just to confuse you with more conflicting advice: I have an active lifestyle and I found that 1 dose of Lantus wasn't flexible enough for me (usually because too much BI knocking around when I was exercising, meaning I just went hypo about 3 times in an hour of sport). Switching to 2 doses of Levimir is as close to perfection as I've come. its not conflicting advice.....its a good example of how these two insulins can all benefit us all in different ways.............try everything in my opinion, test, write it down, and make a decision........... being active as you say would require that flexibility provided by levemir................ i suppose in some ways, you could split the dose into more than 2 a day, theoretically, no one try this though, im no doctor................ Hi all, I have started having problems with high readings in the mornings,I am wondering should I try moving levamir bedtime dose or trying 3am test because my evening bg are normal but am are high,comments please
May 18, 2011 15:19 MelissaF DAFNE Graduate South West Essex PCT 56 posts	I guess, following DAFNE principles you should test at 3am for a few days to see what's happening. If you think that the high morning BG readings are due to your sugars rising overnight rather than as a reaction to overnight hypos then you should increase your eve BI dose? I had issues with very high morning readings on Levemir too. Interesting. How long have you been on it? Melissa xx
May 18, 2011 15:35 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	saxman said: novorapidboi26 said: AK said: Just to confuse you with more conflicting advice: I have an active lifestyle and I found that 1 dose of Lantus wasn't flexible enough for me (usually because too much BI knocking around when I was exercising, meaning I just went hypo about 3 times in an hour of sport). Switching to 2 doses of Levimir is as close to perfection as I've come. its not conflicting advice.....its a good example of how these two insulins can all benefit us all in different ways.............try everything in my opinion, test, write it down, and make a decision........... being active as you say would require that flexibility provided by levemir................ i suppose in some ways, you could split the dose into more than 2 a day, theoretically, no one try this though, im no doctor................ Hi all, I have started having problems with high readings in the mornings,I am wondering should I try moving levamir bedtime dose or trying 3am test because my evening bg are normal but am are high,comments please 3am testing is the first thing to do........if your sugars are rising overnight gradually, up your evening BI dose, and then 3am test for a few days, continue till you hold steady from evening test till 3am test......... If its rises from 3 am onwards it most likely dawn phenomenon and then moving the dose till later on at night may be an option...
May 18, 2011 16:38 saxman DAFNE Graduate The Rotherham NHS Foundation Trust 28 posts	MelissaF said: I guess, following DAFNE principles you should test at 3am for a few days to see what's happening. If you think that the high morning BG readings are due to your sugars rising overnight rather than as a reaction to overnight hypos then you should increase your eve BI dose? I had issues with very high morning readings on Levemir too. Interesting. How long have you been on it? Melissa xx Hi melissaf, I have only been on it since friday and i have posted my bg diary to see if anyone can see a pattern I will try a few 3am tests to see when my bg starts to rise first