Thoughts please on Lantus V Levemir, I need help!

[lauraw1983]

Ok to cut a long story short, I am on Lantus basal and Humalog.

I have 2 stone left to lose, and NOTHING is shifting it since I went onto insulin. I was losing weight before I did as they had me on Byetta and Victoza briefly.🙄

I am well aware that losing this last 2 stone will improve my diabetes, and of course make me happier! Having 2 babies in the last 6 years I guess the weight creeps on, sure some of you know the score!

I was doing a very low carb diet and even after weeks on that NOTHING was shifting. I was on tiny doses Humalog and therefore can only put it down to Lantus??

I have emailed my DSN who has said that yes Novo Nordisk to claim the weight effect is less on Levemir but of course they will push their product, she says in the clinics they really don't see much difference at all between them and of course Levemir needs given twice a day and people usually need bigger doses of it too?? I am currently on 13u Lantus at bedtime. Is this correct for Levemir - bigger doses??

She's said it's entirely up to me, she can write to my GP to prescribe Levemir if I want but now I am confused as to what's better to do! How to people usually time their Levemir doses to split it?

I am suffering badly with DP too it seems, particularly charming was waking up to 16.8 this morning 😱 Highest it has ever been in the morning, it's normally in the 8-9's even though I go to bed with it 5-6 usually. sigh.

Help oh wise ones, I am getting myself more and more confused!! Much appreciated.

 

[Flutterby]

I can't comment about the weight effects of either Lantus or Levemir, have been on both but not noticed any real effect in that sense. I do wonder though if you might be better having a split dose of whatever basal insulin you end up on. It is easier then to adjust if for example you are getting highs in the morning as you can adjust the evening dose accordingly and it might help a bit. I have my morning levemir at 7.30am and my evening at 8pm - it just works best for me that way. As long as the split is roughly 12 hours apart and at the same time each day it's fine. As for higher doses I think everyone is different. I started off splitting the old lantus dose equally between the 2 levemir ones but have tweaked it to suit. I now have 12u in the morning and 6 at night - it's just whatever works best. Good luck with your decision and do consider that you might get some benefit from the split dose.

 

[everydayupsanddowns]

Can't comment from personal experience (was only ever on Lantus and had no weight gain with it), but if you *are* getting severe DP then 2x basal injections may well help - ie you can have more active overnight.

Esp if you are able to take part of the split near enough supper time as the 'onset' hour (or whatever) would mean less basal active during the typical cortisol/adrenaline dip in the early hours. Of course that *might* not work if you need to take the next 12 hours apart (10am maybe?) but you'll never know without trying.

In your shoes I may well give it a go. If your GP/DSN know what you want to achieve with it and that you think it's worth 'trialling' for 6 months or so - then if it doesn't work you could always switch back - or push for a pump!

 

[robofski]

I split my 24u of levimer into 16u at around 7am and 8u around 11pm, seems to be working for me 🙂

 

[DeusXM]

The important thing to remember is that insulin doesn't cause you to gain weight, technically speaking. It's poor matching of insulin to blood sugar that does.

If your Lantus dose is matched to your basal output from your liver, you shouldn't gain weight - all it's doing is processing what's in you. It's not like Insulatard, where you have to specifically eat more.

The issue then is probably more complicated - let's leave aside your DP for the moment.

If you want to lose weight while low-carbing, you need to put your body into ketosis. Many people misjudge how low they actually need to go with this - I think there is a rule somewhere that your carb intake needs to be no more than 12g for one meal and no more than 6g for two other meals. Therefore, even just two sausages would put you over the threshold. Not knowing what you were defining as 'low-carb', it's hard to say whether this was an issue, although I would also point out that low-carbers have a tendency to overstate the weight-loss they get from the diet.

You also will need to look at your calorie intake. As a rule, everyone eats more than they think they do. I thought I didn't really eat a lot but a week of rigorously filling in the Carbs and Cals app on my phone showed me that my carb intake was much higher than I thought and I was overeating if I wanted to lose weight.

Finally....where's the exercise? Most people can't lose weight on diet alone.

 

[brett]

Hi Laraw, i have recently switched to levemir from lantus, main reason was that if i had enough lantus for a good morning reading i had too much lantus in the day having regular hypos without even using nova rapid. I got to about six units of lantus pm for a morning reading of around 6.5 but poor control throughout the day. Since swapping and tweaking i have alot better and predictable control. I inject 7 units of levemir am and 4 units pm. Split dose and more units than lantus but working alot better. Also i do feel less bloated and have no muscle spasms/headaches which i used to on lantus. Just think my body had a bad reaction to lantus.

 

[trophywench]

I did a lot better on Lev than I ever did on Lan. An extra jab made no difference to me cos I'd tried splitting Lantus for 6 months before I said to doc - I've had enough of this. Let's try Levemir - dunno if it will make a difference; but let's have a try of it. I did 12 hours apart as suggested and it was still carp during the night/early hours. Then they said move it, in the evening to nearer bedtime, and if you are high after dinner, increase your morning dose. I was ceptical .... I landed up with 14u am and 4u pm , no night time etc hypos good FBG and an A1c (once they'd a-hem - sharpened up my carb counting skills - well - mine dated from 1972 and the 2007/8 method was a tad different LOL) of 7.2 !

The main things I liked about Levemir other than the obvious were a) didn't sting when I injected it and b) any time you fiddled with the dosage, you saw the results more or less straight away. Marvellous in comparison to having to wait 3 flipping days every time - this meant I could keep my eye on the ball FAR easier and didn't lose the impetus I'd had originally when I decided to make the change .....

 

[Vicsetter]

A bit surprise they had a T1 on Byetta or Victoza. Can't speak about Lantus, but from what I have read the split dose of Levemir gives you mor control, especially of the overnight performance. My doses where obviously much greater than a T1 at 80 and 60 units 7am and 5pm, and now I am on Levemir am at 65 and Victoza pm (no evening levemir now).

As far as losing weight is concerned, low carbing will not guarantee weight loss you need to reduce your total food intake. Energy consumed (from food) must be less than energy expended. So either eat less or exercise more or both. If you have lost weight (which I presume you have) and then stalled, you have reached equality in energy in and out and need to examine how you can reduce any high calorie items.

 

[Clarkey]

I've recently moved from Lantus to Levemir. I used to take 20u of Lantus. Now I have split it to 10u of Levemir at 8am and 10u at 8pm. I have generally found my BG to be higher than it was before.

I only moved over on Monday so it's only been a few days. But right now i have no idea which to increase or if I increase both the same amount.

 

[DeusXM]

A bit surprise they had a T1 on Byetta or Victoza.

That'sa bloody good point. I've been trying to get a script for Byetta for ages but keep getting told it's not suitable for T1s - despite the fact it's proven to regrow beta cells AND has been proven to entirely reverse T1 when used in conjunction with lisofylline. Laura - how did you get on Byetta? I'm desperate to get this stuff!

 

[pgcity]

Hiya. I have split lantus and levermir but didn't notice any difference in my weight. I ended up splitting 10 and 5 on lantus at 7am and 7pm but still had very variable fasting readings. Levermir was just the same but the dose was 12 and 8.

What might be useful to you is trying levermir anyway as you will be able to show you have tried everything to control your levels on mdi if you are thinking about pushing for a pump.

Hope this helps

 

[lauraw1983]

The important thing to remember is that insulin doesn't cause you to gain weight, technically speaking. It's poor matching of insulin to blood sugar that does.

If your Lantus dose is matched to your basal output from your liver, you shouldn't gain weight - all it's doing is processing what's in you. It's not like Insulatard, where you have to specifically eat more.

The issue then is probably more complicated - let's leave aside your DP for the moment.

If you want to lose weight while low-carbing, you need to put your body into ketosis. Many people misjudge how low they actually need to go with this - I think there is a rule somewhere that your carb intake needs to be no more than 12g for one meal and no more than 6g for two other meals. Therefore, even just two sausages would put you over the threshold. Not knowing what you were defining as 'low-carb', it's hard to say whether this was an issue, although I would also point out that low-carbers have a tendency to overstate the weight-loss they get from the diet.

You also will need to look at your calorie intake. As a rule, everyone eats more than they think they do. I thought I didn't really eat a lot but a week of rigorously filling in the Carbs and Cals app on my phone showed me that my carb intake was much higher than I thought and I was overeating if I wanted to lose weight.

Finally....where's the exercise? Most people can't lose weight on diet alone.

Sorry I am just getting back here to answer these posts - thank you all!

Yes I was in ketosis - I bought ketostix to check this specifically, I was usually having 20-30g carbs a day, trying to stay nearer 20 than 30 if possible. I know people in real life on the same diet who HAVE had incredible losses though, so I know for a fact it works for some! So disappointed it didn't for me for some reason.

I also log everything on MFP app on my phone - believe me I am aware of people always understimating their food intake, I think they say by about 20% a day in general! Having done WW in the past, i know how important it is to log everything.

Exercise - well I am having huge problems with hypos when I exercise, I seem unable to balance my insulin and also having 2 small children (one also on summer holidays now) and a partner who works long shifts don't always make for lots of spare time to nip out for a run! i try to do my DVD's from home and have been considering buying a fitness bike again - we had one years ago that became a clothes horse so sold it on - but I'm thinking it may be useful to have one again! I know I have to improve overall fitness though too, you are right with that.

My other thought is my thyroid results were a bit out at my last clinic tests and I think i need to see my GP about that, I have a suspicioun maybe something is up there! 😡

And I agree taking insulin itself isn't what MAKES people gain weight, I'm not GAINING weight, just not able to shift a damn pound and a quick search on google finds LOTS of posts from people who have discovered similar. The stuff we inject is never going to match what we are meant to product naturally so I think there is something in that surely? and let's not forget it's not always as simple as matching the insulin correctly, if it was we wouldn't swing about from high to low numbers who no bl**dy explanation at times!! 😉

 

[lauraw1983]

I did a lot better on Lev than I ever did on Lan. An extra jab made no difference to me cos I'd tried splitting Lantus for 6 months before I said to doc - I've had enough of this. Let's try Levemir - dunno if it will make a difference; but let's have a try of it. I did 12 hours apart as suggested and it was still carp during the night/early hours. Then they said move it, in the evening to nearer bedtime, and if you are high after dinner, increase your morning dose. I was ceptical .... I landed up with 14u am and 4u pm , no night time etc hypos good FBG and an A1c (once they'd a-hem - sharpened up my carb counting skills - well - mine dated from 1972 and the 2007/8 method was a tad different LOL) of 7.2 !

The main things I liked about Levemir other than the obvious were a) didn't sting when I injected it and b) any time you fiddled with the dosage, you saw the results more or less straight away. Marvellous in comparison to having to wait 3 flipping days every time - this meant I could keep my eye on the ball FAR easier and didn't lose the impetus I'd had originally when I decided to make the change .....

The last part of your post is what is making me think it might be a good change too....I have to get back to my nurse today about what I want to do. I figure it might be better, and figure if not then I can always go back to Lantus?

I'm a bit confused by how they split Levemir and think I will need guidance with it - we go on holiday in a few weeks so would probably rather not mess about with it until we get back anyway and then reassess?

Argh confusing!!! Thank you for posting though x

 

[lauraw1983]

A bit surprise they had a T1 on Byetta or Victoza. Can't speak about Lantus, but from what I have read the split dose of Levemir gives you mor control, especially of the overnight performance. My doses where obviously much greater than a T1 at 80 and 60 units 7am and 5pm, and now I am on Levemir am at 65 and Victoza pm (no evening levemir now).

As far as losing weight is concerned, low carbing will not guarantee weight loss you need to reduce your total food intake. Energy consumed (from food) must be less than energy expended. So either eat less or exercise more or both. If you have lost weight (which I presume you have) and then stalled, you have reached equality in energy in and out and need to examine how you can reduce any high calorie items.

Sorry for a while after diagnosis while I was waiting for the results of the c-peptide and anti-GAD tests (took ages to come back!!), they had me down as Type 2.....😡 I knew all along it was nonsense but there we go. Hence being on metformin, then Byetta, then Victoza.....until suddenly they got the results and saw LOTS of nasty antibodies and I was swiftly put on insulin!!!

 

[lauraw1983]

That'sa bloody good point. I've been trying to get a script for Byetta for ages but keep getting told it's not suitable for T1s - despite the fact it's proven to regrow beta cells AND has been proven to entirely reverse T1 when used in conjunction with lisofylline. Laura - how did you get on Byetta? I'm desperate to get this stuff!

Sorry just answered this above too.

I had NO idea that had been proven - do you have an links to that so I can have a read? I can't believe it has been proven to reverse Type 1?!?! 😱 Is that only if it used near the time of diagnosis?

 

[lauraw1983]

Once again I just want to say thank you for all the replies, sorry it took me so long to get back on to reply to them, but never fails to amaze me that people have taken the time to reply to me here. I'm still not entirely sure what to do but will discuss with my nurse today again. xxx

 

[DeusXM]

Exercise - well I am having huge problems with hypos when I exercise, I seem unable to balance my insulin

This is probably the hardest thing about T1 - exercise completely changes your basal requirement and insulin ratios. Different kinds of exercise also have different kinds of effects - for instance, some people find certain exercises actually raise their blood sugar. The only thing you can do is test, test, test and adjust your insulin. It's worth noting though that the less insulin you take, the less fat-storing hormone you have circulating.

However, you should also get your thyroid checked out as well as you've hinted something may be up there - hypothyroidism can make it hard to lose weight.

I had NO idea that had been proven - do you have an links to that so I can have a read? I can't believe it has been proven to reverse Type 1?!?!

As with all these things, it's been proven in mice. University of Virginia combined Exendin-4 (AKA Exenatide, AKA Byetta) with Lisofylline. The Lisofylline is an extremely specific immunosuppressant that blocks beta cell destruction in the pancreas, while Byetta stimulates beta cell growth. Both drugs have been independently approved for use in humans but haven't been approved for combined use. The more scientifically minded would also note this isn't quite a cure - as long as your immune system remains the same, you would need to still regularly take at least the Lisofylline to prevent the autoimmune reaction repeating itself for the rest of your life. However, I still think this would be preferably to having to manually manage your blood sugar.

http://oscar.virginia.edu/researchnews/x7701.xml