Difference in long acting insulin ?

Status
Not open for further replies.
CALSHOT

CALSHOT

Active Member
Relationship to Diabetes
Type 1
Hello,

Please could someone advise the difference between lantus and degludec ?

What are the benefits to moving to degludec in laymans terms?

Many thanks,
 
Tresiba (Degludec) is an ultra-long acting insulin analogue.

Lantus (Glargine) is a long acting insulin analogue.

They are both basal (background) insulins.

Both are meant to be fairly ‘peakless’, but forum experience suggests that Lantus can have a little bump of activity at around 5 hours.

Lantus is supposed to have an insulin duration of up to 24 hours.

Degludec is supposed to have an insulin durstion of up to 42 hours.

Neither insulin is particularly responsive to dose change, ‘lantus lag’ can last a couple of days before a dose adjustment settles.

One of the benefits(?) of Tresiba is that after 2-3 days it reaches a ‘steady state’ where insulin added is approximately equal to insulin ending, so it matters less precisely when you take your dose. Lantus does better if taken at the same time each day.

Hopefully some people who have used both can share rheir experiences.

I guess itdepends on whether your background insulin need is fairly flat - so thst you get the same dose-per-hour all the time.

Personally my basal need rises and falls through the 24 hours so a more flexible basal profile suits me better. 🙂
 
Are you having any particular problems that Degludec has been suggested as a change by your HCPs or are you just considering a change yourself?

Just wondering if you are having some issues with Lantus which it is hoped Degludec will resolve or if your clinic just have an enthusiasm for Tresiba (Degludec) as some clinics seem to have.

Tresiba would not work for me as I often don't need any basal insulin at night but I need lots in the morning and a moderate amount in the afternoon, so I prefer a shorter acting basal (Levemir) injected twice a day which I can easily adjust to my needs and is very flexible. Some people with more uniform basal insulin needs find Tresiba great. It is down to understanding how your body works and then figuring out which basal will suit your body and your lifestyle best.

I believe Tresiba can be beneficial for people who do a lot of international travelling, because it doesn't matter so much when you take it.
 
everydayupsanddowns said:
Neither insulin is particularly responsive to dose change, ‘lantus lag’ can last a couple of days before a dose adjustment settles.
Click to expand...
I have not used Tresiba but was a Lantus user for 12 years.
I found it very responsive to dose adjustments and would reduce my dose after exercise which would significantly reduce post-activity hypos.
 
Been on Lantus for over ten years now it suits me just fine. Since starting Lantus I have not experienced a nigh time Hypo at all as I did with that awful stuff Humalin I.
 
HANG ON!!!! Yes Tresiba is Degludec and lasts for blah blah blah - but Levemir is also insulin Degludec and those of us who use/have used Levemir love it specifically because it doesn't hang around for days on end !
 
trophywench said:
HANG ON!!!! Yes Tresiba is Degludec and lasts for blah blah blah - but Levemir is also insulin Degludec and those of us who use/have used Levemir love it specifically because it doesn't hang around for days on end !
Click to expand...
Levemir is Detemir not Degludec
 
But yes, I love my Levemir.
 
Austin Mini said:
Been on Lantus for over ten years now it suits me just fine. Since starting Lantus I have not experienced a nigh time Hypo at all as I did with that awful stuff Humalin I.
Click to expand...
Why would you consider changing then.....Oh hang on! ... Is this all to do with your post about memory pens?
 
rebrascora said:
Why would you consider changing then.....Oh hang on! ... Is this all to do with your post about memory pens?
Click to expand...
Yes, now I’m down to my twenty year old Luxura pens which I thought I could replace with a memory pen.
 
I am not familiar with Lantus and the pens available for it, but maybe one of the other Glargine insulins like Toujeo or Abasaglar have memory pens available, so that you are doing a more "like for like" swap rather than changing to a completely different basal insulin.
 
rebrascora said:
I believe Tresiba can be beneficial for people who do a lot of international travelling, because it doesn't matter so much when you take it.
Click to expand...
I do a fair amount of international travel which is usually very different to my "home life" in terms of activity and sleep.
For example, I am just returning from a 3 day trip of full on customer entertainment (long days with little sleep and no time for exercise).
Therefore, I need flexibility in dosage rather than flexibility in timing.
Thankfully, I now have a pump but if I was on MDI, a basal that took 3 to 4 days for a dosage change to have an effect would be far from ideal.
 
rebrascora said:
I am not familiar with Lantus and the pens available for it, but maybe one of the other Glargine insulins like Toujeo or Abasaglar have memory pens available, so that you are doing a more "like for like" swap rather than changing to a completely different basal insulin.
Click to expand...
Unfortunately not. Toujeo cartridges can only be used in a Sanofi pen and abasaglar in Lilly pens, neither has a memory option.
 
JJay said:
Unfortunately not. Toujeo cartridges can only be used in a Sanofi pen and abasaglar in Lilly pens, neither has a memory option.
Click to expand...
Guess I am just spoilt having only ever been on Novo Nordisk Insulins and having NovoPen Echoes. Really hard to understand why other big pharmaceuticals don't do similar pens for their insulins considering how useful that memory feature is.
 
rebrascora said:
Guess I am just spoilt having only ever been on Novo Nordisk Insulins and having NovoPen Echoes. Really hard to understand why other big pharmaceuticals don't do similar pens for their insulins considering how useful that memory feature is.
Click to expand...
I agree. It seems astonishing to me that no-one else wants a slice of this particular cake!
 
In simple terms, if you find that lantus tails off around 24hrs after your last dose, you’d probably find this doesn’t happen with tresiba.

This meant tresiba was worse for me. I’m more prone to hypos around 5-6pm so I take my lantus at tea time to make sure it’s tailing off at the time I’m more sensitive. When I tried tresiba my basal worked at full strength at 5-6pm at it’s longer acting and so I had more hypos then.
 
rebrascora said:
I am not familiar with Lantus and the pens available for it, but maybe one of the other Glargine insulins like Toujeo or Abasaglar have memory pens available, so that you are doing a more "like for like" swap rather than changing to a completely different basal insulin.
Click to expand...
My Lantus is delivered in throw away pens in a box of 5 pens.
 
helli said:
I do a fair amount of international travel which is usually very different to my "home life" in terms of activity and sleep.
For example, I am just returning from a 3 day trip of full on customer entertainment (long days with little sleep and no time for exercise).
Therefore, I need flexibility in dosage rather than flexibility in timing.
Thankfully, I now have a pump but if I was on MDI, a basal that took 3 to 4 days for a dosage change to have an effect would be far from ideal.
Click to expand...
You've missed the point @helli. Unless you were flying to the other side of the world AND staying there for months not days - you wouldn't be changing your Tresiba. You might consider an interim dose to loosely match the clock change, but you might not bother. As @everydayupsanddowns said earlier once you've arrived at a natural steady state for Tresiba the 40hr profile and thus carry over from yesterday allows you to carry large gaps of discontinuity in Tresiba daily topping up.

Of course if the lifestyle change, eg when "down under", affects your new BG behaviour - you might find your Tresiba needs a small tweak, just as you might from winter to summer, without travelling long haul. What Tresiba won't do is allow you, on MDI, to use your basal to accommodate variation in exercise or activity. Your particular method of doing that is unusual.

Nothing wrong with unusual, we all try to find ways of making our MDI provide best help for each of us. But it was NOT considered as a possibility on my DAFNE course and I suspect won't be promoted or assisted by most DSNs; it sits in contradiction of how the experts think MDI should be applied. But my DAFNE DSN was against the idea of snacking to fend off potential lows or near hypos (but do treat hypos) and trust your basal and bolus to look after you. She was teaching get the basal and bolus right (by understanding the principles and apply the rules) then just have 2 or 3 meals only a day. Which was fine in theory, but didn't match many of the attendees lifestyles, in terms of work and family patterns. Didn't make great sense to me - but use of CGM was deliberately excluded from any discussion ( its not in the DAFNE syllabus!).
 
Austin Mini said:
My Lantus is delivered in throw away pens in a box of 5 pens.
Click to expand...
In that case could you not use the Timesulin pen cap to remind you of your last dose, if a memory pen is the issue here. Many of us have moved away from disposable pens as they are not environmentally friendly, so this would not be a solution we would consider, but if you use disposable pens anyway, then just a pen cap with a timer might be the answer for you.
 
Status
Not open for further replies.
Back
Top