Levemir Vs Lantus: What's The Difference?
Levemir and Lantus are both long-acting forms of insulin that work for most of the day. Levemir Vs Lantus: Both human insulin analogs Levemir is a brand name for insulin detemir. Levemir takes at least one hour to start working (some sources state up to three hours), and its effects are dependent on the initial dosage given. Dosages of 0.1 units per kg may last only six hours whereas dosages equal to or greater than 0.8 units/kg last approximately 22 to 24 hours. Levemir has a relatively peakless profile but may be more slowly absorbed from the thigh compared to the deltoid (arm) and the abdomen after subcutaneous administration. Lantus is the brand name for insulin glargine. Lantus takes approximately an hour to start working and lasts for an average of 24 hours; however, there is some variability and in some people, it may only act for just over 10 hours, whereas for others it may last longer than 24 hours. Lantus releases consistently, so doesn't really have a peak effect. Levemir Vs Lantus: Differences in formulation account for some differences in action Both Levemir and Lantus are made by modifying human insulin. Both should be clear solutions before they are injected (discard if cloudy). Insulin glargine (Lantus) tends to be absorbed more slowly and for longer than detemir ( Levemir) because it is not as soluble once injected just under the skin. This means it has a longer duration of action and an insignificant peak effect - instead, it delivers consistent blood levels of insulin. Insulin detemir (Levemir) remains soluble after injection but is able to bind to protein in the tissue and bond to itself which gives it a prolonged action. How do Levemir and Lantus compare to NPH insulin? Both Levemir and Lantus were created to improve on NPH insulin, and to better m Continue reading >>
Fda Approves Pregnancy Category Change For Insulin Detemir Injection
FDA has approved insulin detemir [rDNA origin] injection (Levemir, Novo Nordisk) pregnancy Category B classification. The new classification indicates that Levemir, when used in pregnant women with diabetes, did not increase the risk of harm to the unborn baby. Previously, Levemir was relegated to pregnancy category C, meaning animal reproductive studies have shown an adverse effect on the fetus and adequate and well-controlled studies in humans were not available. According to Novo Nordisk, Levemir is the only basal insulin analog to achieve the category B classification. “This approval provides patients with a long-acting insulin analog option that can help them manage their blood sugar,” said Lois Jovanovic, MD, chief science officer for the Sansum Diabetes Research Institute in Santa Barbara, Calif. FDA changed Levemir’s status after receiving a new randomized, controlled trial of 310 pregnant women with type 1 diabetes. The study compared the safety and efficacy of Levemir against NPH insulin and found that patients taking Levemir had similar A1C reduction at gestational week 36 and lower fasting plasma glucose levels at gestational weeks 24 and 36, compared with NPH. “The study found no differences in the overall safety profile during pregnancy, on pregnancy outcomes, or the health of the fetus and newborn,” according to a statement from Novo Nordisk. To view the new labeling and packaging insert, click here. Continue reading >>
Taking Insulin During Pregnancy
When your blood glucose levels stay raised despite meal planning and physical activity, insulin must be added to your management plan to keep you and your baby healthy. Pregnancy requires that your body produce extra amounts of insulin. Insulin is a hormone that is made by the pancreas. If your pancreas does not make enough insulin, injections can help you meet the need. Your health care provider and diabetes educator will teach you how to inject insulin safely and comfortably. Determining the right insulin and dosage Tip Keep a record of the type and amount of insulin you take. It is important that you know and remember your insulin type every time you speak with a health care provider. Your health care provider will decide what kind of insulin is right for you, how much to use and when you should take it, based on: your weight (which changes weekly) how far along your pregnancy is your meal plan your most recent blood glucose levels Sometimes, you may need more than one type of insulin. Different types of insulin work at different speeds, and your health care provider may combine insulins to achieve the best results for you. Time-action of different insulins Insulins Starts working Peaks Stops working Rapid acting: Humalog® (lispro) NovoLog® (aspart) Apidra® (glulisine) 5 to 15 minutes 1 to 2 hours 2 to 4 hours Intermediate acting: NPH (N) 2 to 4 hours 4 to 8 hours 10 to 16 hours Basal*: Lantus® (glargine) Levemir® (detemir) 2 hours No peak 24 hours *Lantus® and Levemir® cannot be mixed with any other insulin. How to help insulin work best Take your insulin at the same times each day as directed. Talk with your health care provider if you feel sick. Follow any instructions your health care provider gives you. Don't change your meal plan, physical activity, pres Continue reading >>
Long-acting Insulins
Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Drug UPDATES: TRESIBA ®- insulin degludec injection [Drug information / PDF] Click link for the latest monograph Dosing: Click (+) next to Dosage and Administration section (drug info link) Initial U.S. Approval: 2015 Mechanism of Action: The primary activity of insulin, including TRESIBA, is regulation of glucose metabolism. Insulin and its analogs lower blood glucose by stimulating peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin also inhibits lipolysis and proteolysis, and enhances protein synthesis. TRESIBA forms multi-hexamers when injected into the subcutaneous tissue resulting in a subcutaneous insulin degludec depot. The protracted time action profile of TRESIBA is predominantly due to delayed absorption of insulin degludec from the subcutaneous tissue to the systemic circulation and to a lesser extent due to binding of insulin-degludec to circulating albumin. INDICATIONS AND USAGE: TRESIBA is indicated to improve glycemic control in adults with diabetes mellitus. Limitations of Use TRESIBA is not recommended for the treatment of diabetic ketoacidosis. Dosing: Individualize dose based on type of diabetes, metabolic needs, blood glucose monitoring results and glycemic control goal. Rotate injection sites to reduce the risk of lipodystrophy. Do not dilute or mix with any other insulin or solution. Administer subcutaneously once daily at any time of day. Do NOT perform dose conversion when using the TRESIBA U-100 or U-200 FlexTouch pens. The TRESIBA U-100 and U-200 FlexTouch pens dose window shows the number of insulin units to be delivered and NO conversion is needed. HOW SUPPLIE Continue reading >>
Levemir Vs. Lantus: Similarities And Differences
Levemir and Lantus are both long-acting injectable insulins that can be used for long-term management of diabetes. Insulin is a hormone that is naturally produced in the body by the pancreas. It helps convert the glucose (sugar) in your bloodstream into energy. This energy is then distributed to cells throughout your body. With diabetes, your pancreas produces little or no insulin or your body is unable to use the insulin correctly. Without insulin, your body can’t use the sugars in your blood and can become starved for energy. The excess sugar in your blood can also damage different parts of your body, including your blood vessels and kidneys. Everyone with type 1 diabetes and many people with type 2 diabetes must use insulin to maintain healthy blood sugar levels. Levemir is a solution of insulin detemir, and Lantus is a solution of insulin glargine. Both are basal insulin formulas. That means that they work slowly to lower your blood sugar levels. They’re both absorbed into your body over a 24-hour period. They keep blood sugar levels lowered for longer than short-acting insulins do. Although the formulations are slightly different, Levemir and Lantus are very similar drugs. There are only a few differences between them. Children and adults can use both Levemir and Lantus. Specifically, Levemir can be used by people who are 2 years or older. Lantus can be used by people who are 6 years or older. Levemir or Lantus can help with daily management of diabetes. However, you may still need to use short-acting insulin to treat spikes in your blood sugar levels and diabetic ketoacidosis (a dangerous buildup of acids in your blood). Learn more: All about diabetic ketoacidosis » Administration Both Levemir and Lantus are given through injection in the same way. You can gi Continue reading >>
Compare Levemir Vs. Lantus
Insulin is the most effective blood sugar lowering medication, as it lowers A1c (average blood sugar over time) up to 2 or 3%. When used correctly, it'll prevent the harmful effects of high blood sugar levels on your organs and blood vessels. Levemir (insulin detemir) is a long lasting insulin that provides consistent, all-day blood sugar control with less risk of low blood sugar. Doses can be easily adjusted to make a customized regimen that's tailored to your body's needs. Starting insulin early in the treatment of type 2 diabetes can maintain your body's insulin producing cells and slow down disease progression. Levemir (insulin detemir) can be used in people with liver or kidney problems. Insulin is one of the most effective blood sugar-lowering medication and can lower your A1c (average blood sugar over time) by up to 2-3%. Lantus (insulin glargine) is a long-lasting insulin that provides consistent, all-day sugar control with just once or twice daily dosing. Dose can be easily adjusted to make a customized regimen that's tailored to your body's needs. Lantus (insulin glargine) can be used with liver or kidney problems. 130 reviews so far Have you used Levemir (insulin detemir)? Leave a review 584 reviews so far Have you used Lantus (insulin glargine)? Leave a review Continue reading >>
Insulin Detemir (levemir) For Diabetes Mellitus
SAFETY Insulin detemir has the same safety concerns as other insulins, with hypoglycemia being the most serious. Most safety trials compare insulin detemir with neutral protamine Hagedorn (NPH) insulin in patients with type 1 or 2 diabetes. When comparing patients with type 1 diabetes who are receiving mealtime insulin aspart with those receiving NPH insulin, insulin detemir caused slightly fewer episodes of minor hypoglycemia (i.e., approximately one fewer episode of nocturnal hypoglycemia every three months). There was no difference in the number of major hypoglycemic events.1,2 In another study,3 patients with type 2 diabetes receiving insulin detemir or NPH insulin had similar occurrences of minor and major hypoglycemic events. Insulin detemir is pregnancy category C,4 as are insulins glargine, aspart, and aspart protamine/aspart. Other insulins are category B. The effect of insulin detemir on morbidity or mortality in patients with diabetes has not been evaluated. TOLERABILITY Insulin detemir is tolerated to the same degree as other insulins. Unlike NPH insulin, the use of insulin detemir has not been associated with weight gain in short-term studies.1–3 EFFECTIVENESS Insulin detemir, as well as other long-acting insulins, is used to provide continuous low blood levels of insulin and is augmented with immediate-acting insulins to produce an insulin response more likely to mimic normal physiology. This approach has been attempted with older long-acting insulins. Detemir produces reductions in A1C levels similar to NPH insulin when both are used in combination with short-acting bolus insulin in patients with type 1 and 2 diabetes.1–3,5 There are no clinical trials comparing insulin detemir to insulin glargine. Insulin detemir is available in a vial and prefilled Continue reading >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Diabetes Mellitus: Part III – Monitoring & Insulin Handling
- Effects of Insulin Plus Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs) in Treating Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Lantus And Levemir: What’s The Difference?
Lantus and Levemir have a lot in common. Both are basal insulin formulas, which means that they last for a long time in the body and act as background insulin, with a slow feed that mimics the constant low output of insulin produced by a healthy pancreas. Both are insulin analogues, which means that their insulin molecules are analogous to human insulin, but engineered, or recombined, with slight differences that slow their absorption. Lantus is a clear formula made with glargine, a genetically modified form of human insulin, dissolved in a special solution. Levemir is also a clear formula, but it contains dissolved detemir, a different form of genetically modified insulin. Human insulin is made of two amino acid chains, called A and B, that have two disulfide bonds between them. In glargine, one amino acid has been switched out, and two extra amino acids have been added to one end of the B chain. The modifications make glargine soluble at an acidic pH, but much less soluble at the neutral pH that’s found in the body To make Lantus, first the glargine is produced by a vat of E. coli bacteria. Then it’s purified and added to a watery solution containing a little zinc and some glycerol; a dash of hydrochloric acid is also added to make it acidic, bringing its pH down to about 4. At that degree of acidity, glargine completely dissolves into the watery solution, which is why the vial is clear. After you inject it into your subcutaneous tissue, the acidic solution is neutralized by your body to a neutral pH. Because glargine is not soluble at a neutral pH, it precipitates out into a form that’s not soluble in subcutaneous fat, and there forms a relatively insoluble depot. From that pool, or depot, of precipitated glargine in the tissues, small amounts slowly move back Continue reading >>
Levemir® — The First Basal Insulin Analog With Pregnancy Category B Classification.1
Levemir® is the first FDA-approved basal insulin analog with Pregnancy Category B classification. In a randomized, controlled clinical trial1: Pregnant women with type 1 diabetes (n=310) were treated with either Levemir® (n=152) or NPH insulin (n=158) in a basal-bolus regimena Women were randomized either as pregnant or planning pregnancy; those who where randomized as pregnant were between weeks 8 and 12 of gestationb Approximately one-half of the study participants in each arm were randomized as pregnant and were exposed to NPH insulin or other insulins prior to conception and in the first 8 weeks of gestation According to pretrial insulin regimen: Levemir® was administered once or twice daily NPH was administered once, twice, or 3 times a day An open-label, randomized, parallel-group, multinational study in women with type 1 diabetes who were on insulin for at least 12 months before randomization and who were planning to become pregnant or already pregnant at gestational weeks (GWs) 8 to 12. Patients could enroll in the study with intention to become pregnant. Patients were withdrawn from the trial if they did not become pregnant within 1 year. Patients were separated at randomization as pregnant and nonpregnant and all were required to have A1C ≤8% at confirmation of pregnancy. Patients were randomized 1:1 to Levemir® (n=152) or NPH insulin (n=158). Both groups used NovoLog® (insulin aspart injection) 100 U/mL as mealtime insulin. Approximately 50% of the women also received Levemir® or NPH insulin prior to conception and in the first 8 weeks of gestation. Regimen was followed from randomization until termination/6 weeks postdelivery.2 Adapted from Mathiesen et al, 2012.2 aBoth groups used NovoLog® (insulin aspart injection) 100 U/mL as mealtime insulin. bP Continue reading >>
Levemir And Getting Pregnant
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community I have Type 1 for 19yrs already and I'm planning getting pregnant. I take Humalog and Levemir and my diabetologist doesn't want to change Levemir for other shorter acting insulin. Has anyone been taking Levemir being pregnant (as it is not clinically tested on pregnant women and studies on animals show embryo malformations)?? What are your views on this? Hi, this is a very good question. I was taken off novorapid and put on to humalog when I got pregnant 9 years ago. Still worry about it, as I no longer trust any synthetic insulin. I'm quite sure it's also not recommended to take Lantus in pregnancy. Purified animal insulins has been tried and tested for years and years, synthetic 'human' insulins only came about in the 80s, and the analogues in last 10 years or so. I know what I would trust, and in retrospect I would much rather have been educated about what I was taking for my diabetes. I just trusted the doctors. I was on synthetic insulins for 19 years until, due to ill health and poor blood sugar control, I changed to hypurin porcine insulin a year ago. Life has improved for me beyond belief! You should do some internet research on synthetic and purified animal insulins. Not just for the sake of a safe pregnancy but for your own health. The truth is because these 'analogue' insulins suchas Novorapid, Humalog, Lantus, and Levemir have only been available for a limited time, no-one really knows the long-term effects on us, let alone our children. You are obviously concerned and wise to be so, and not to take your doctor's word. Can u tell me where you got info bout the embryo malformation? I was swapped from apidra to novorapid (but i was told that Continue reading >>
Levemir Side Effects Center
Levemir (insulin detemir [rDNA origin] injection) is a man-made form of a hormone that is produced in the body used to treat diabetes in adults and children. Common side effects of Levemir include: injection site reactions (e.g., pain, redness, irritation), swelling of the hands/feet, thickening of the skin where you inject Levemir, weight gain, headache, back pain, stomach pain, flu symptoms, or cold symptoms such as stuffy nose, sneezing, sore throat. Tell your doctor if you experience serious side effects of Levemir including: signs of low potassium level in the blood (such as muscle cramps, weakness, or irregular heartbeat). Levemir is for once- or twice-daily subcutaneous (under the skin) administration. Patients treated with Levemir once-daily should administer the dose with the evening meal or at bedtime. Patients requiring twice-daily dosing can administer the evening dose with the evening meal, at bedtime, or 12 hours after the morning dose. Levemir may interact with albuterol, clonidine, reserpine, guanethidine, or beta-blockers. Other medicines can increase or decrease the effects of insulin Levemir on lowering your blood sugar. Tell your doctor all prescription and over-the-counter medications you use. Tell your doctor if you are pregnant before using Levemir. Discuss a plan for managing your blood sugars with your doctor before you become pregnant. Your doctor may switch the type of insulin you use during pregnancy. It is not known if this medication passes into breast milk. Consult your doctor before breastfeeding. Insulin needs may change while breastfeeding. Our Levemir (insulin detemir [rDNA origin] injection) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. T Continue reading >>
Using Insulin In Pregnancy: Fda Approves Levemir
Novo Nordisk’s Levemir (insulin detemir) has been classified as Category B for pregnant women. “This is the most thrilling news since the discovery of insulin,” says Dr. Lois Jovanovic, CEO and Chief Scientific Officer of the Sansum Diabetes Research Institute and world-renowned expert in diabetes and pregnancy. “I am thrilled.” Given that Dr. Jovanovic is so unequivocally positive, the news deserves a bit more explanation for those of us who aren’t experts and aren’t pregnant. Levemir is the first long-acting insulin other than NPH to be classified as Category B. But what exactly does that mean? And why are we so worried about insulin in pregnancy anyway? The FDA, Dr. Jovanovic explains, needs to make sure drugs taken by women during pregnancy are safe for the baby, and not going to cause any birth defects or abnormalities. The FDA therefore assigns drugs to a category that indicates how they should be used in pregnancy. Category A drugs are things like vitamins—not just okay to use, but actually good for the pregnant woman and the fetus. Category B drugs are not necessarily positive for pregnancy, but all animal and human studies must indicate that the drug is safe for the mother and the baby. Category C drugs are not known to cause birth defects, but have not been sufficiently tested in humans to really be certainly safe. Up until now, untested insulin analogues, and all long-acting insulin analogues other than NPH, fell into Category C—not known to be harmful, but not known to be safe either. Now, normal, non-diabetic women produce their own insulin, and that insulin is obviously safe for fetuses. What, then, makes insulin analogues different and riskier? The answer is that insulin analogues may behave similarly to human insulin in the body, but th Continue reading >>
Insulin Glargine Safety In Pregnancy
Go to: Abstract Insulin glargine (Lantus) is an extended-action insulin analog with greater stability and duration of action than regular human insulin. The long duration of action and decreased incidence of hypoglycemia provide potential advantages for its use in pregnancy. However, the placental pharmacokinetics of insulin glargine have not been studied. Therefore, the objective of this study was to determine whether insulin glargine crosses the human placenta using the human perfused placental lobule technique. Placentae were obtained with informed consent after elective cesarean section delivery of noncomplicated term pregnancies. Insulin glargine, at a therapeutic concentration of 150 pmol/l (20 μU/ml) was added to the maternal circulation. Additional experiments were carried out at insulin glargine concentrations 1,000-fold higher than therapeutic levels (150, 225, and 300 nmol/l). A subsequent perfusion for which the maternal circuit remained open and insulin glargine was continuously infused at 150 pmol/l was completed for further confirmation of findings. The appearance of insulin glargine in the fetal circulation was analyzed by a chemiluminescence immunoassay. Results from perfusions carried out at therapeutic concentrations (150 pmol/l) of insulin glargine showed no detectable insulin glargine in the fetal circuit. After perfusion with very high insulin glargine concentrations of 150, 225, and 300 nmol/l, the rate of transfer remained low at 0.079 ± 0.01, 0.14, and 0.064 pmol · min−1 · g tissue−1, respectively. Maternal to fetal transport of insulin glargine Experiment no. Maternal concentration (pmol/l) Lobule weight (g) Fetal concentration (pmol/l) Rate of transfer (pmol · min−1 · g tissue−1) 1 150 15.17 Below LOQ — 2 150 9.8 Below LOQ — Continue reading >>
Safety Of Insulin Glargine Use In Pregnancy
The study was done to compare the safety of using Glargine in place of NPH insulin…. The prevalence of diabetes in women of childbearing age is increasing. As such, the number of pregnancies complicated by diabetes will inevitably increase. New insulin analogues such as the long-acting analogue insulin glargine may represent beneficial treatment options in pregnancy by ensuring that patients achieve excellent glycemic control without risk of maternal hypoglycemia. The study was done to determine the fetal safety of insulin glargine use in the treatment of diabetes in pregnancy compared with NPH insulin therapy. A systematic review and meta-analysis was performed of all original human studies that reported neonatal outcomes among women with pregestational or gestational diabetes who were managed with either insulin glargine or NPH insulin during pregnancy. A systematic literature search was conducted from 1980 to June 1, 2010. Outcomes included large size for gestational age, macrosomia, neonatal hypoglycemia, neonatal intensive care unit admissions, birth trauma, congenital anomalies, preterm delivery, perinatal mortality, respiratory distress, and hyperbilirubinemia. Relative risk ratios and weighted mean differences were computed with 95% confidence intervals. Eight studies reporting on a total of 702 women with pregestational or gestational diabetes in pregnancy treated with either insulin glargine (n = 331) or NPH insulin (n = 371) met the inclusion criteria. There were no statistically significant differences in the occurrence of fetal outcomes studied with the use of insulin glargine compared to NPH insulin. Several new insulin analogues have become available during the past decade, yet data on the fetal safety of insulin glargine are scarce. By avoiding high pe Continue reading >>
Diabetes Management Guidelines
Endocrine Society Guideline on Diabetes and Pregnancy Source: Blumer I, Hadar E, Hadden DR, et al. Diabetes and pregnancy: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(11):4227-4249. Available here. Refer to source document for full recommendations, including strength of recommendations and quality of evidence. Jump to a topic or click back/next at the bottom of each page Antihyperglycemic Therapy During Pregnancy Insulin therapy Long-acting insulin detemir Initiate during pregnancy in women who require insulin therapy and for whom appropriate doses of NPH insulin have caused/may cause hypoglycemia* Continue if used successfully prior to pregnancy* Insulin glargine Continue if used successfully prior to pregnancy† Rapid-acting insulin lispro and aspart Use in preference to regular soluble insulin‡ Continuous SC insulin infusion Recommended when treatment has been prior to pregnancy§ Do not initiate during pregnancy unless other insulin strategies – including multiple daily doses of insulin – tried and unsuccessful† Insulin glargine is classified as FDA Pregnancy Category C and should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus *Less strong recommendation, very high quality evidence †Less strong recommendation, low quality evidence ‡Less strong recommendation, moderate quality evidence §Strong recommendation, moderate quality evidence Noninsulin therapy Glyburide May be used as alternative to insulin in women with GDM who do not achieve sufficient glycemic control after 1-week trial of medical nutrition therapy and exercise* Exceptions, in which case insulin is preferred therapy:* Diagnosis of GDM before 25 weeks FPG >110 mg/dL (6.1 mmol/L) Metformin Use only for wo Continue reading >>
