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Can You Mix Levemir?

Mixing Long And Short Acting Insulins In Same Syringe Does Not Compromise Long-t

Mixing Long And Short Acting Insulins In Same Syringe Does Not Compromise Long-t

Mixing Lantus and rapid-acting insulins as Humalog or Novolog does not compromise glycemic control. Similar to what has been shown in short-term studies, rapid-acting insulin analogues (RAI) can be mixed with insulin glargine without compromising long-term glycemic control in children with type 1 diabetes, new research shows. The ability to give RAIs and insulin glargine in the same syringe has the potential to decrease the number of daily injections and increase use of insulin glargine, lead author Dr. Rosanna Fiallo-Scharer, from the University of Colorado in Denver, and colleagues note. As reported in the Journal of Pediatrics for April, the researchers compared glycemic control in 55 children who mixed insulin glargine and a RAI with that seen in 55 children who took separate injections. The ability to give rapid-acting insulin analogues (such as Apidra, NovoRapid) and long-acting insulin glargine (Lantus) in the same syringe has the potential to decrease the number of daily injections and increase use of insulin glargine, Dr. Rosanna Fiallo-Scharer, from the University of Colorado in Denver, and colleagues note in the Journal of Pediatrics The researchers compared blood sugar control in 55 children who mixed insulin glargine and a rapid-acting insulin analog with that seen in 55 children who took separate injections. Low and high blood sugar complications were uncommon and occurred with similar frequency in each group, the report indicates. After 6 months, HbA1c levels were nearly the same in each group, at 8.54 and 8.61. Likewise, the groups were comparable in terms of the percentages of blood glucose values that fell outside the target range. Hypoglycemic events and diabetic ketoacidosis events were uncommon and occurred with similar frequency in each group, the Continue reading >>

High-alert Medications - Levemir (insulin Detemir)

High-alert Medications - Levemir (insulin Detemir)

The leaflets are FREELY available for download and can be reproduced for free distribution to consumers. Or, if you are a facility or organization, you can order professional pre-printed leaflets shipped directly to you. Extra care is needed because Levemir is a high-alert medicine. High-alert medicines have been proven to be safe and effective. But these medicines can cause serious injury if a mistake happens while taking them. This means that it is very important for you to know about this medicine and take it exactly as directed. Top 10 List of Safety Tips for Levemir When taking your medicine 1. Know your insulin. Levemir is a long-acting insulin that should be injected below the skin once or twice daily. (When taken in smaller doses, Levemir may be considered an intermediate-acting insulin.) When Levemir is taken once daily, inject the insulin with the evening meal or at bedtime. When taken twice daily, the evening dose should be taken with the evening meal, at bedtime, or 12 hours following the morning dose. 2. Prepare your insulin. A rapid- or short-acting insulin is often prescribed with Levemir. However, Levemir should never be mixed in the same syringe with other insulins before injection. Do not vigorously shake insulin before use. 3. Don't reuse or recycle. Discard used syringes/needles, pens, and lancets in a sealable hard plastic or metal container (e.g., empty detergent bottle, sharps container from your pharmacy). When the container is full, seal the lid before placing it in the trash. Don't reuse or recycle syringes, needles, or lancets. 4. Don't share. Even if you change the needle, sharing an insulin pen or syringe may spread diseases carried in the blood, including hepatitis and HIV. To avoid serious side effects 5. t Avoid mix-ups. If you use more t Continue reading >>

Mixing Insulin Aspart With Detemir Does Not Affect Glucose Excursion In Children With Type 1 Diabetes

Mixing Insulin Aspart With Detemir Does Not Affect Glucose Excursion In Children With Type 1 Diabetes

Go to: RESEARCH DESIGN AND METHODS The protocol was approved by the institutional review board of the Baylor College of Medicine. The study was designed to detect a 20% difference in mean area under the curve (AUC) for blood glucose values in the 72-h study period. We assumed the r > 0.7 between repeated measures and that the SD for our excursion measure AUC was ∼30%. With these specifications and assuming a 45% drop-out rate, we required 20 subjects to achieve the final necessary sample size of 11 subjects. Eighteen pediatric subjects with type 1 diabetes (11 males and 7 females) were recruited for this 20-day, randomized, crossover, and open-labeled study. These subjects were aged 14.75 ± 2.69 years and had A1C of 7.7 ± 0.7%. The first four subjects were aged 16 years and older as required by the U.S. Food and Drug Administration. The subjects were randomly assigned to either Study A (mixed insulins) or Study B (separate insulins) for the first 10 days. They were then crossed over for the last 10 days. Each subject underwent 72 h of continuous glucose monitoring (CGM) using CGMS iPro (Medtronics, Minneapolis, MN) on the last 72 h of Study A and Study B. Data of 48 h from midnight of the 1st day to midnight of the 3rd day of the 72-h CGM were used for analysis to ensure the same starting and ending times of monitoring for all subjects. The relative frequency of mild hypoglycemic episodes was calculated as the number of glucose values between 40 and 60 mg/dl divided by the total number of glucose values generated during the chosen 48 h of CGM. Sustained glucose values over time were calculated as AUC, index of blood glucose control as M-value, and glucose excursion as mean amplitude of glucose excursion (MAGE). The 48-h M-value for each treatment of each subject was Continue reading >>

Levemir

Levemir

LEVEMIR® (insulin detemir [rDNA origin]) Injection DESCRIPTION LEVEMIR® (insulin detemir [rDNA origin] injection) is a sterile solution of insulin detemir for use as a subcutaneous injection. Insulin detemir is a long-acting (up to 24-hour duration of action) recombinant human insulin analog. LEVEMIR® is produced by a process that includes expression of recombinant DNA in Saccharomyces cerevisiae followed by chemical modification. Insulin detemir differs from human insulin in that the amino acid threonine in position B30 has been omitted, and a C14 fatty acid chain has been attached to the amino acid B29. Insulin detemir has a molecular formula of C267H402O76N64S6 and a molecular weight of 5916.9. It has the following structure: Figure 1: Structural Formula of insulin detemir LEVEMIR® is a clear, colorless, aqueous, neutral sterile solution. Each milliliter of LEVEMIR® contains 100 units (14.2 mg/mL) insulin detemir, 65.4 mcg zinc, 2.06 mg m-cresol, 16.0 mg glycerol, 1.80 mg phenol, 0.89 mg disodium phosphate dihydrate, 1.17 mg sodium chloride, and water for injection. Hydrochloric acid and/or sodium hydroxide may be added to adjust pH. LEVEMIR® has a pH of approximately 7.4. Continue reading >>

Insulin Types

Insulin Types

What Are the Different Insulin Types? Insulin Types are hormones normally made in the pancreas that stimulates the flow of sugar – glucose – from the blood into the cells of the body. Glucose provides the cells with the energy they need to function. There are two main groups of insulins used in the treatment of diabetes: human insulins and analog insulins, made by recombinant DNA technology. The concentration of most insulins available in the United States is 100 units per milliliter. A milliliter is equal to a cubic centimeter. All insulin syringes are graduated to match this insulin concentration. There are four categories of insulins depending on how quickly they start to work in the body after injection: Very rapid acting insulin, Regular, or Rapid acting insulins, Intermediate acting insulins, Long acting insulin. In addition, some insulins are marketed mixed together in different proportions to provide both rapid and long acting effects. Certain insulins can also be mixed together in the same syringe immediately prior to injection. Rapid Acting Insulins A very rapid acting form of insulin called Lispro insulin is marketed under the trade name of Humalog. A second form of very rapid acting insulin is called Aspart and is marketed under the trade name Novolog. Humalog and Novolog are clear liquids that begin to work 10 minutes after injection and peak at 1 hour after injection, lasting for 3-4 hours in the body. However, most patients also need a longer-acting insulin to maintain good control of their blood sugar. Humalog and Novolog can be mixed with NPH insulin and are used as “bolus” insulins to be given 15 minutes before a meal. Note: Check blood sugar level before giving Humalog or Novalog. Your doctor or diabetes educator will instruct you in determini Continue reading >>

Levemir Vs. Lantus: Similarities And Differences

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 >>

Long-acting Insulins

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 >>

Lantus And Levemir: What’s The Difference?

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 >>

Compare Novolog Vs. Levemir

Compare Novolog Vs. Levemir

When used correctly, this medication will l lower blood sugar every time you use it and prevent the harmful, long-term effects of high sugar levels on your organs and blood vessels. You can easily change the dose of Novolog (insulin aspart) to fit your individual needs. Starting insulin early in the treatment of Type 2 diabetes can maintain your body's insulin-producing cells and slow down disease progression. Can use Novolog (insulin aspart) even if you have liver or kidney problems, unlike many other blood sugar-lowering medicines. 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. 177 reviews so far Have you used Novolog (insulin aspart)? Leave a review 130 reviews so far Have you used Levemir (insulin detemir)? Leave a review The Novolog (insulin aspart) FDA package insert doesn’t have numbers about how common side effects are. Insulin dose too high Use of other blood sugar lowering medicines Poor injection techniques Changes in meal pattern or exercise Kidney problems Liver problems Continue reading >>

Can You Mix Levimir With Humalog In One Syringe ?

Can You Mix Levimir With Humalog In One Syringe ?

Can you Mix Levimir with Humalog in one syringe ? Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Can you Mix Levimir with Humalog in one syringe ? According to Gary Scheiner " Think Like a Pancreas " (2004 edition) Detimir ( Levemir ) can be mixed with a fast acting insulin. However most other sources state that you can not mix them. Has anyone tried mixing Levemir and Humalog with success ? You can't mix them in the same syringe. What Scheiner means is you can take them at the same time - you just do two injections in different parts of your body. I'd defer to the manufacturers with this, who state explicitly not to mix. AFAIK mixing won't make the world explode but studies suggest it may change the profile of one or both, an x factor you could do without. " Lantus must be given in it's own syring (it can not be mixed with other insulins, meaning that a lot of injections will be necessary. Detemir may be mixed with fast acting insulin." I'm pretty sure that means that Scheiner is saying mixing in the same syringe. ( Not 2 injections in different parts of body) From the Levemir pharmaceutical notes: ( ) If LEVEMIR is mixed with other insulin preparations, the profile of action of one or both individual components may change. Mixing LEVEMIR with insulin aspart, a rapid acting insulin analog, resulted in about 40% reduction in AUC(0-2h) and Cmax for insulin aspart compared to separate injections when the ratio of insulin aspart to Assuming your quote is correct, I don't know why Gary Scheiner recommends this. Potentially mucking around with the onset of insulin is just bad news. The quote form Schiener's book is from 2004. Maybe at the time Continue reading >>

Proper Use

Proper Use

Drug information provided by: Micromedex Make sure you have the type (beef and pork, pork, or human) and the strength of insulin that your doctor ordered for you. You may find that keeping an insulin label with you is helpful when buying insulin supplies. The concentration (strength) of insulin is measured in USP Insulin Units and USP Insulin Human Units and is usually expressed in terms such as U-100 insulin. Insulin doses are measured and injected with specially marked insulin syringes. The appropriate syringe is chosen based on your insulin dose to make measuring the dose easy to read. This helps you measure your dose accurately. These syringes come in three sizes: 3/10 cubic centimeters (cc) measuring up to 30 USP Units of insulin, ½ cc measuring up to 50 USP Units of insulin, and 1 cc measuring up to 100 USP Units of insulin. It is important to follow any instructions from your doctor about the careful selection and rotation of injection sites on your body. There are several important steps that will help you successfully prepare your insulin injection. To draw the insulin up into the syringe correctly, you need to follow these steps: Wash your hands with soap and water. If your insulin contains zinc or isophane (normally cloudy), be sure that it is completely mixed. Mix the insulin by slowly rolling the bottle between your hands or gently tipping the bottle over a few times. Never shake the bottle vigorously (hard). Do not use the insulin if it looks lumpy or grainy, seems unusually thick, sticks to the bottle, or seems to be even a little discolored. Do not use the insulin if it contains crystals or if the bottle looks frosted. Regular insulin (short-acting) should be used only if it is clear and colorless. Remove the colored protective cap on the bottle. Do not Continue reading >>

Insulin: How To Give A Mixed Dose

Insulin: How To Give A Mixed Dose

Many people with diabetes need to take insulin to keep their blood glucose in a good range. This can be scary for some people, especially for the first time. The truth is that insulin shots are not painful because the needles are short and thin and the insulin shots are placed into fatty tissue below the skin. This is called a subcutaneous (sub-kyu-TAY-nee-us) injection. In some cases, the doctor prescribes a mixed dose of insulin. This means taking more than one type of insulin at the same time. A mixed dose allows you to have the benefits of both short-acting insulin along with a longer acting insulin — without having to give 2 separate shots. Usually, one of the insulins will be cloudy and the other clear. Some insulins cannot be mixed in the same syringe. For instance, never mix Lantus or Levemir with any other solution. Be sure to check with your doctor, pharmacist, or diabetes educator before mixing. These instructions explain how to mix two different types of insulin into one shot. If you are giving or getting just one type of insulin, refer to the patient education sheet Insulin: How to Give a Shot. What You Will Need Bottles of insulin Alcohol swab, or cotton ball moistened with alcohol Syringe with needle (You will need a prescription to buy syringes from a pharmacy. Check with your pharmacist to be sure the syringe size you are using is correct for your total dose of insulin.) Hard plastic or metal container with a screw-on or tightly-secured lid Parts of a Syringe and Needle You will use a syringe and needle to give the shot. The parts are labeled below. Wash the work area (where you will set the insulin and syringe) well with soap and water. Wash your hands. Check the drug labels to be sure they are what your doctor prescribed. Check the expiration date o Continue reading >>

The Effects Of Mixing Different Insulin Analogues

The Effects Of Mixing Different Insulin Analogues

The effects of mixing different insulin analogues Poole Hospital NHS Foundation Trust, Dorset, UK Poole Hospital NHS Foundation Trust, Dorset, UK Poole Hospital NHS Foundation Trust, Dorset, UK Poole Hospital NHS Foundation Trust, Dorset, UK Please review our Terms and Conditions of Use and check box below to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. Frequently doctors, specialist nurses and patients are unaware of the interaction between different insulins. We reviewed a needle phobic patient using a subcutaneous cannula device. The patient was using insulin glargine (Lantus) and insulin aspart (Novorapid). He had been advised to use two separate devices to keep the insulins apart. However, he was using the one device to give both insulin types and had experienced no problems. Unlike most other insulins which are soluble at a neutral pH, insulin glargine is soluble at a pH of 4. The slightly acidic nature of glargine is the reason it can sting when injected. The manufacturer (SanofiAventis) advises that it is never diluted or mixed with other insulins and that it should only be used if it is clear and colourless with no particles visible. We demonstrate the effects of mixing insulin glargine with short acting insulin analogues. In each of six 1ml syringes we mixed 50 units of a long acting insulin analogue, either glargine (Lantus) or detemir (Levemir), with 50 units of a short acting analogue: aspart (Novorapid), lispro (Humalog) or glulisine (Apidra). All of the short acting insulins mixed with insulin glargine immediately formed a cloudy white precipitate which gradually settled at the b Continue reading >>

Can Humulin R Be Taken With Levemir. Not At The Same Time But Can Humulin R Be Taken At Meal Time And Levemir For Basal???

Can Humulin R Be Taken With Levemir. Not At The Same Time But Can Humulin R Be Taken At Meal Time And Levemir For Basal???

Question Originally asked by Community Member fl98girl Can Humulin R Be Taken With Levemir. Not At The Same Time But Can Humulin R Be Taken At Meal Time And Levemir For Basal??? Answer Humulin regular can be used as a bolus insulin at meal time with Levemir as a basal. However, it is not recommended (or FDA approved) to be mixed together. Some health care providers use NPH/Regular at breakfast, regular at dinner and Levemir at bedtime to avoid the potential for lows overnight. Some also my use Levemir at Breakfast, regular at breakfast (separate shot), regular at dinner and Levemir at bedtime. Hope this helps. Dr.Cogen You should know Answers to your question are meant to provide general health information but should not replace medical advice you receive from a doctor. No answers should be viewed as a diagnosis or recommended treatment for a condition. Continue reading >>

Product Important Safety Information

Product Important Safety Information

Selected Important Safety Information WARNING: RISK OF THYROID C-CELL TUMORS Liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Victoza® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined. Victoza® is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of Victoza® and inform them of symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Victoza®. Selected Important Safety Information Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients Levemir® is contraindicated in patients with hypersensitivity to Levemir® or any of its excipients NovoLog® and NovoLog® Mix 70/30 are contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin aspart or any of the excipients Warnings and Precautions Never Share a Tresiba® FlexTouch®; Levemir® FlexTouch®, NovoLog® FlexPen, NovoLog®FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device; or NovoLog®Mix 70/30 FlexPen® Between Patients, even if the needle is changed. Patients using vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens Hypoglyc Continue reading >>

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