Switching from Levemir to Humulin - is dosage the same?

[Hobbit]

I've been forced to switch from Levemir to Humulin because apparently it's being discontinued. I'm down to my last few days dose of Levemir and wondered if I'm supposed to use the Humulin exactly like Levemir? I'm currently taking 12 units of Levemir at night.

Also I did a test squirt of it in the air because I wasn't sure if my needles would fit on it. When I pressed down there was no click, it just went down silently. Is it supposed to do that?

 

[Inka]

Presumably it’s Humulin i you’ve been given @Hobbit ? That’s an isophane basal insulin and a perfectly good one 🙂 I use an isophane basal insulin when I take a break from my pump but I take it twice a day. Your nurse should have told you how often to take it. Are you also taking a bolus/fast/meal insulin?

What pen have you been given for your Humulin?

ETA if it’s the Savvio pen, then that doesn’t click when you depress the button. It just goes down like pressing the end of a syringe. You still need to do airshots the same and dial your dose, but when you inject you won’t hear any clicks.

 

[rebrascora]

Quite surprised that you just injected Levemir once a day and that you have been switched to Humulin I. If you were injecting Levemir twice a day, then I could understand moving to Humulin, but if you can manage your diabetes well with just a single dose then I would have thought you would be switched to one of the newer basal insulins like Tresiba.

I will be interested to hear how you get on as I currently use Levemir and my consultant has agreed I can stay on it until supplies run out next year as I absolutely love the flexibility of it in taking it twice a day and being able to adjust day and night doses independently of each other and get more or less real time results, but if you don't do that then I suppose your experience with Humulin will be different.

Sorry I can't answer your question. In your situation I would either clarify with my clinic via the helpline where I can ring and leave a message and they ring me back within a couple of days or go with the same dose but make sure to set my low alarm a bit higher in case it is slightly more potent. Unfortunately some clinics don't have a helpline but the hospital switchboard should be able to tell you if they do or put you through.

There is always a question of how any individual body will respond to a change, so it is a bit of try it and see, but making sure to keep yourself safe by taking extra precautions to prevent possible hypos.

I personally couldn't get away with taking such a large dose of Levemir at night. I need a large dose in the morning but just a small one or sometimes none at all at bedtime, but we are all different.

Do let us know how you get on with Humulin I as there are a few of us here who will be hoping to get that option when Levemir runs out.

 

[helli]

Quite surprised that you just injected Levemir once a day and that you have been switched to Humulin I. If you were injecting Levemir twice a day, then I could understand moving to Humulin, but if you can manage your diabetes well with just a single dose then I would have thought you would be switched to one of the newer basal insulins like Tresiba.

When I was on MDI, I used Lantus which is a once a day basal and the idea of Tresiba, an insulin that takes 3 to 4 days for a change of dose to take effect, scares the bejeebers out of me.
My day-night basal needs are not that different. However, the flexibility of Levemir (or even Lantus) is not just the ability to have different doses night and day but also to have different doses today, tomorrow and the next day. As someone who exercises regularly but not every day, this is very important.
There are many other reasons for day to day basal flexibility such as periods and illness and shift work or different basal workdays and non-workdays.

I really hope the default replacement for Levemir is not Tresiba with no discussion.

 

[Hobbit]

Presumably it’s Humulin i you’ve been given @Hobbit ? That’s an isophane basal insulin and a perfectly good one 🙂 I use an isophane basal insulin when I take a break from my pump but I take it twice a day. Your nurse should have told you how often to take it. Are you also taking a bolus/fast/meal insulin?

What pen have you been given for your Humulin?

ETA if it’s the Savvio pen, then that doesn’t click when you depress the button. It just goes down like pressing the end of a syringe. You still need to do airshots the same and dial your dose, but when you inject you won’t hear any clicks.

I have Novorapid with my meals. The label on the pen says it's a Lilly Humulin Kwikpen.

 

[Hobbit]

Quite surprised that you just injected Levemir once a day and that you have been switched to Humulin I. If you were injecting Levemir twice a day, then I could understand moving to Humulin, but if you can manage your diabetes well with just a single dose then I would have thought you would be switched to one of the newer basal insulins like Tresiba.

I will be interested to hear how you get on as I currently use Levemir and my consultant has agreed I can stay on it until supplies run out next year as I absolutely love the flexibility of it in taking it twice a day and being able to adjust day and night doses independently of each other and get more or less real time results, but if you don't do that then I suppose your experience with Humulin will be different.

Sorry I can't answer your question. In your situation I would either clarify with my clinic via the helpline where I can ring and leave a message and they ring me back within a couple of days or go with the same dose but make sure to set my low alarm a bit higher in case it is slightly more potent. Unfortunately some clinics don't have a helpline but the hospital switchboard should be able to tell you if they do or put you through.

There is always a question of how any individual body will respond to a change, so it is a bit of try it and see, but making sure to keep yourself safe by taking extra precautions to prevent possible hypos.

I personally couldn't get away with taking such a large dose of Levemir at night. I need a large dose in the morning but just a small one or sometimes none at all at bedtime, but we are all different.

Do let us know how you get on with Humulin I as there are a few of us here who will be hoping to get that option when Levemir runs out.

I only take it once at night because that's how the nurse told me I should take it when I first had to start using insulin in 2007. I suppose it must be doing ok as they've never suggested taking it differently. My diabetes is generally well controlled but I do have to be careful to avoid hypos in my sleep, which is annoying because I have to go to bed with blood sugar readings a bit higher than I'd like but if I don't I'll wake up with a hypo.

What do you mean by setting your low alarm?

I called my GP this morning to speak to a diabetic nurse but nobody called me back. I'll ring them again tomorrow. I'll have to start taking the Humulin in a few days so I need to know what to do.

 

[mashedupmatt]

What do you mean by setting your low alarm?

Do you have a CGM? It's an alarm that lets you know if you are going low on your phone (or reader) so you can act to treat it (if necessary) - you can change the alarm to suit - I am on Levemir too and am concerned about the the upcoming discontinuation so am also very interested how the change to Humulin I goes - I take my Levemir twice daily and often change my night time dose depending on what I've been up to (have only done 2 units tonight instead of my usual 4 due to exercising tonight) - please let us know how you get on, but sorry I can't answer your question directly - and you shouldn't have been forced to change your insulin now if it is working for you as it hasn't been discontinued yet (that is in the guidelines) so if it doesn't work, get them to change it back

 

[Hobbit]

Do you have a CGM? It's an alarm that lets you know if you are going low on your phone (or reader) so you can act to treat it (if necessary) - you can change the alarm to suit - I am on Levemir too and am concerned about the the upcoming discontinuation so am also very interested how the change to Humulin I goes - I take my Levemir twice daily and often change my night time dose depending on what I've been up to (have only done 2 units tonight instead of my usual 4 due to exercising tonight) - please let us know how you get on, but sorry I can't answer your question

Never heard of a CGM before! Doesn't it feel uncomfortable having something stuck in you all the time? It would be nice not to have to keep pricking my fingers, the whole process of doing that gets tiresome.

 

[mashedupmatt]

Never heard of a CGM before! Doesn't it feel uncomfortable having something stuck in you all the time

Not at all, it's much nicer than finger-pricking, although you still need to do that from time to time - if you are on insulin (basal/bolus regime) you should definitely ask about one, particularly if you are worried about having nocturnal hypos, and are waking up low

 

[Bruce Stephens]

Doesn't it feel uncomfortable having something stuck in you all the time?

No. The first Libre sensors (at least, the first ones most of us had) needed to be scanned using a reader each time you wanted a reading. All of us occasionally scanned the wrong arm (normally you apply the next sensor on the opposite arm), proving that not only is it not uncomfortable, we don't notice it at all (generally, anyway).