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Levemir To Lantus Conversion Calculator

Calculating Insulin Dose

Calculating Insulin Dose

You'll need to calculate some of your insulin doses. You'll also need to know some basic things about insulin. For example, 40-50% of the total daily insulin dose is to replace insulin overnight. Your provider will prescribe an insulin dose regimen for you; however, you still need to calculate some of your insulin doses. Your insulin dose regimen provides formulas that allow you to calculate how much bolus insulin to take at meals and snacks, or to correct high blood sugars. In this section, you will find: First, some basic things to know about insulin: Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals. This is called background or basal insulin replacement. The basal or background insulin dose usually is constant from day to day. The other 50-60% of the total daily insulin dose is for carbohydrate coverage (food) and high blood sugar correction. This is called the bolus insulin replacement. Bolus – Carbohydrate coverage The bolus dose for food coverage is prescribed as an insulin to carbohydrate ratio. The insulin to carbohydrate ratio represents how many grams of carbohydrate are covered or disposed of by 1 unit of insulin. Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. This range can vary from 6-30 grams or more of carbohydrate depending on an individual’s sensitivity to insulin. Insulin sensitivity can vary according to the time of day, from person to person, and is affected by physical activity and stress. Bolus – High blood sugar correction (also known as insulin sensitivity factor) The bolus dose for high blood sugar correction is defined as how much one unit of rapid-acting insulin will drop the blood sugar. Generally, to correct a high bloo Continue reading >>

Selected Important Safety Information

Selected Important Safety Information

Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients Never Share a Tresiba® FlexTouch® Pen Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens Monitor blood glucose in all patients treated with insulin. Changes in insulin may affect glycemic control. These changes should be made cautiously and under medical supervision. Adjustments in concomitant oral anti-diabetic treatment may be needed Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening Tresiba® (insulin degludec injection) is indicated to improve glycemic control in patients 1 year of age and older with diabetes mellitus. Tresiba® is not recommended for treating diabetic ketoacidosis or for pediatric patients requiring less than 5 units of Tresiba®. Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients Never Share a Tresiba® FlexTouch® Pen Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens Monitor blood glucose in all patients treated with insulin. Changes in insulin may affect glycemic control. These changes should be made cautiously and under medical supervision. Adjustments in concomitant oral anti-diabetic treatment may be needed Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening. Increase monitoring with changes to: insulin dose, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with hypoglycemia unawareness or renal or hepatic impairment Accidental mix-ups betwe Continue reading >>

100/33 (insulin Glargine And Lixisenatide Injection) 100 Units/ml And 33 Mcg/ml

100/33 (insulin Glargine And Lixisenatide Injection) 100 Units/ml And 33 Mcg/ml

Important Safety Information for SOLIQUA® 100/33 (insulin glargine and lixisenatide injection) 100 Units/mL and 33 mcg/mL Contraindications During episodes of hypoglycemia. In patients with known hypersensitivity to the active substance(s) or to any of the product components. Warnings and Precautions Anaphylaxis and Serious Hypersensitivity Reactions: In clinical trials of lixisenatide, there have been cases of anaphylaxis and other serious hypersensitivity reactions including angioedema. Severe, life-threatening, generalized allergic reactions, including anaphylaxis and angioedema, can occur with insulins, including insulin glargine. If hypersensitivity reactions occur, discontinue SOLIQUA 100/33. Use caution in patients with a history of anaphylaxis or angioedema with another GLP-1 RA because it is unknown whether such patients will be predisposed to anaphylaxis. Pancreatitis: Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with GLP-1 RAs. Cases of pancreatitis were reported in clinical trials of lixisenatide. After initiation of SOLIQUA 100/33, observe patients for signs and symptoms of pancreatitis (e.g., persistent severe abdominal pain, sometimes radiating to the back and which may be accompanied by vomiting). If pancreatitis is suspected, SOLIQUA 100/33 should promptly be discontinued. If pancreatitis is confirmed, restarting SOLIQUA 100/33 is not recommended and other antidiabetic therapies should be considered. Never Share a SOLIQUA 100/33 SoloStar® Pen between Patients: Pen-sharing poses a risk for transmission of blood-borne pathogens, even if the needle is changed. Do not withdraw SOLIQUA 100/33 from the pen with a syringe. Hyperglycemia or Hypoglycemia with Changes in Insulin Continue reading >>

Specific Insulin Info & Dosing Scales

Specific Insulin Info & Dosing Scales

There are many kinds of insulin available to use for our FD cats. Some perform much better than others and each has its idiosyncrasies. Sometimes we will have a choice when it comes to which insulin is prescribed by our vets; sometimes we won't. Whatever insulin, all insulin types have been proven to work with TR. The insulin types addressed in this sticky are PZI (compounded, ProZinc and Hypurin), Lantus, Levemir, NPH (Humulin N), Caninsulin/Vetsulin, please scroll down to for information on the specific insulin. It is advised to start TR / Insulin when you are available to monitor your cat’s BG frequently by performing frequent testing and/or curves for the first few days until you know how your cat processes their insulin. One of the important premises TR is built on is maintaining overlap between doses – meaning that the remnants of the prior shot are still working to keep the BG from rising very high, while the next shot approaches onset (when the insulin starts to work). Different insulin types have different durations -experienced members on forum will help guide you through the process of understanding the nuances of the insulin you are using to get maximum results. Insulin should be stored in the fridge at all times, in a protected spot on a less-used shelf, in a sturdy, padded container where it will not get knocked over. Do not store insulin on the door of your fridge to avoid excess jostling. Practicing TR we handle our insulin more often than when dosing twice a day. Handling your insulin gently and with care will prolong potency considerably. Dr. Hodgkins' Tight Regulation protocol was developed for use with bovine based PZI insulin but it has been proven over time that many insulin types work very well with TR. Please scroll down this page for explana Continue reading >>

Multiple Dose Insulin In Type 2 Diabetes

Multiple Dose Insulin In Type 2 Diabetes

Introduction Levemir (Detemir) & Lantus (Glargine) & quick-acting insulin before meals This page is aimed at people with type 2 diabetes needing multiple dose insulin (basal bolus). If you have a fair amount of insulin from your pancreas still, you will not need this intensive insulin regime, and may just need tablets or once daily insulin as opposite. If your type 2 diabetes is quite severe, and you have very little remaining insulin, then your diabetic control is similar to type 1 diabetes. This page discusses intensive insulin control, and this is taken further in the insulin dose adjustment pages above. You naturally need to speak to your diabetes nurse and doctor for individual advice. If you have no or very little remaining insulin from you pancreas, and are prone to hypos, then your diabetes is nearly equivalent to the type 1 diabetes patient, and you may benefit from the same intensive insulin 'regime'. This is discussed on this page below and the adjusting insulin dose pages taken from the DAFNE Program. Complex insulin regimes do lead to better glucose control, fewer hypos, and better weight control than twice daily insulin (NEJM 2009). Controversies First The two long acting insulins are Levemir (detemir) or Lantus (glargine). Levemir is shorter acting, with a peak 9-12 hours. Lantus generally has no peak in the first 24 hours, and its action may take 3 days to complete. Therefore anyone with a slightly irregular lifestyle in theory will be better off using twice daily Levemir rather than once daily Lantus. At present, this decision is usually made by diabetes doctors and nurses. If you do use once daily Lantus, and your glucose levels fluctuate, then you should consider twice daily Levemir instead. Second Another controversy is the use of analogue insulins s Continue reading >>

Conversion Chart For Humulin R U-500 Insulin Dose

Conversion Chart For Humulin R U-500 Insulin Dose

When using a U-100 insulin syringe or a tuberculin syringe, use this handy U-500 Conversion Chart. Humulin U-500 Conversion Chart Mar 2011 Continue reading >>

Is There A Maximum Insulin Glargine (lantus) Dose?

Is There A Maximum Insulin Glargine (lantus) Dose?

Is there a maximum insulin glargine (Lantus) single-injection dose? Anecdotally, I have heard that patients receiving more than 50 units should split the dose from daily dosing to twice-daily. What’s the evidence? The question of a maximum insulin glargine dose is not straightforward because it encompasses several issues: How long does insulin glargine last? Does it ever need to be given twice-daily? Is there a difference in efficacy between daily and twice-daily insulin glargine dosing? Can you administer more than 50 units of insulin glargine as one single injection? Pharmacodynamics and Duration of Insulin Glargine In theory, insulin glargine should last a full 24 hours without a significant peak effect. Glargine forms a depot effect because it is only soluble at an acidic pH.1 In the vial (pH 4), the drug is completely soluble. Once injected, the solution is neutralized to biologic pH (7.4), which causes the insulin molecules to precipitate. These microprecipitates slowly dissolve over a 24-hour period. This slow dissolution results in a slower onset and a lack of a peak effect compared to other insulins, as shown below: Efficacy of Daily versus Twice-Daily Lantus Administration Although insulin glargine should last a full 24 hours, there is some evidence that its duration of action may be reduced to 20-23 hours, particularly following injection due to its delayed onset of activity of about 3-5 hours.2 Currently, the best estimate is that 15-30% of type-I diabetics will have pre-injection hyperglycemia and may benefit from twice-daily dosing. The idea of twice-daily dosing was explored in an 8-week, open-label crossover trial of 20 patients with type-I diabetes.2 Patients received either 100% of a pre-determined dose daily (dinner) or 50% twice-daily (breakfast an Continue reading >>

Insulin: Compare Common Options For Insulin Therapy

Insulin: Compare Common Options For Insulin Therapy

Insulin therapy is a critical part of treatment for people with type 1 diabetes and also for many with type 2 diabetes. The goal of insulin therapy is to maintain blood sugar levels within your target range. Insulin is usually administered in the fat under your skin using a syringe, insulin pen or insulin pump. Which insulin regimen is best for you depends on factors such as the type of diabetes you have, how much your blood sugar fluctuates throughout the day and your lifestyle. Each insulin type is characterized by: How long it takes to begin working (onset) When it's working the hardest (peak) How long it lasts, ranging from about 3 to 26 hours Many types of insulin are available. Here's how they compare. Keep in mind that your doctor may prescribe a mixture of insulin types to use throughout the day and night. Insulin type and name Onset Peak How long it lasts Rapid-acting Insulin aspart (NovoLog) Insulin glulisine (Apidra) Insulin lispro (Humalog) 5-15 min. 45-75 min. 3-4 hours Short-acting Insulin regular (Humulin R, Novolin R) 30-45 min. 2-4 hours 6-8 hours Intermediate-acting Insulin NPH (Humulin N, Novolin N) 2 hours 4-12 hours 16-24 hours Long-acting Insulin glargine (Lantus/ Toujeo) Insulin detemir (Levemir) 2 hours No clear peak 14-24 hours In some cases, premixed insulin — a combination of specific proportions of intermediate-acting and short- or rapid-acting insulin in one bottle or insulin pen — may be an option. Continue reading >>

Levemir® Flextouch® Is Ready To Use In Just A Few Steps

Levemir® Flextouch® Is Ready To Use In Just A Few Steps

Levemir® FlexTouch®, a prefilled insulin pen with no push-button extension, requires low force to inject at all doses and is ready to use in just a few steps.a In fact, Levemir® FlexTouch® has up to 77% less injection force than Lantus® SoloSTAR®. From the makers of the world’s #1-selling prefilled insulin pen,b Levemir® FlexTouch® is: Accurate—Accurate dosing from 1 to 80 units Prefilled—Each pen is prefilled with 300 units of Levemir® Discreet—Fits in your pocket, purse, or nightstand On the go—Take it with you almost anywherec aPlease see the Patient Information for complete Instructions For Use. cOnce in use, Levemir® FlexTouch® must be kept at room temperature below 86°F for up to 42 days. Injecting with Levemir® FlexTouch® You may have concerns about using an injectable medicine for type 2 diabetes. But it’s important to realize the positive effect it may have on the management of your diabetes. And once you gain a little practice in giving injections on your own, Levemir® injections will become part of your daily routine. If you were given instructions from your health care provider on how to use Levemir® FlexTouch® and you have read the Instructions for Use in the Patient Information, you may be ready for your first injection. Your health care provider will tell you what dose of Levemir® is right for you and how many times to take it each day. Your dose may be adjusted based on your blood sugar. Please consult your health care provider prior to adjusting your dose. No compatible source was found for this video. Levemir® can be injected in the thigh, abdomen, or upper arm. It’s important to change the injection site within your injection area each time you inject and not inject into the exact same spot each time. Rotating where yo Continue reading >>

Toujeo, A More Concentrated Version Of Lantus Is Now Available

Toujeo, A More Concentrated Version Of Lantus Is Now Available

As most of you may know, Lantus, the most commonly prescribed basal insulin, saw its patent protection expire in February of this year. Several new competitors in the basal insulin niche are waiting in the wings, hoping to siphon off some of the $9 billion a year the French firm Sanofi has been earning from Lantus. Two brand new basal insulins currently on deck are Novo Nordisk's Tresiba and a peglispro, from Lilly. Tresiba has been already available in Europe since 2013 but is not approved in the U.S.. It achieves similar blood sugar results as Lantus while claiming to produce fewer nighttime hypos. Peglispro is not yet approved anywhere yet, and its approval appears to be getting delayed due to some troubling signs found in clinical trial data that suggest it may harm the liver and that it may cause more severe hypos than existing basal insulins. Besides these new analog insulins, there is another kind of competitor ready to take away Lantus' market share: biosimilars. These are protein molecules that claim to be similar in action, though not identical in structure, to another drug. They are as close as we can get to a generic product with hormones like insulin. Lilly, in partnership with Boehringer Ingelheim, has already received approval to market its biosimilar insulin glargine, Basaglar in Europe and has tentative FDA approval to market it in the U.S. though because of a patent dispute with Sanofi, it can't bring Basaglar to market in the U.S. until mid 2016. . What is Toujeo? To defend itself against this dramatic ramp up in competition, Sanofi has come out with its own "new" basal insulin, which it is calling Toujeo. However, Toujeo is not really a new insulin, as it uses the same molecule, insulin glargine, as Lantus. All that is different is that it now comes Continue reading >>

Tilly's Diabetes Homepage

Tilly's Diabetes Homepage

Home Story 6 important factors Blood glucose values The future? Links Guestbook About this site Disclaimer • see your vet and get his or her approval of this protocol before you start!!! • talk to your vet regularly about your cat's progress • see your vet immediately if your cat develops additional problems (e.g. ketones, hypoglycemia, vomiting, fever, bladder infections, etc) Read this first • this protocol was developed by lay people, including myself, who are members of the German Diabetes-Katzen Forum. It has since been published in the Journal of Feline Medicine and Surgery. • the majority of cats do very well on this protocol, some cats do not (generally these are hard-to-regulate cats) • it is more time-consuming than most other protocols, but still definitely doable if you work a regular full-time work week • it is more expensive than most other protocols, but costs can be reduced by e.g. buying glucose test strips from online pharmacies or reputable sellers at eBay • members of the German Diabetes-Katzen Forum buy 3 ml Lantus/Levemir cartridges, refrigerate them after opening and routinely use them for 6 months or more - when refrigerated, opened cartridges of these insulins are extraordinarily stable • you will need to test the blood glucose levels of your cat multiple times per day • you will need to know about hypoglycemia and be prepared to deal with it • you will need to test for ketones regularly to start with and know about ketoacidosis, but be aware that ketones don't occur once a cat is (and remains) properly regulated • you will need a brand-name glucometer made for human diabetics that measures whole blood (not plasma-equivalent) and which uses 0.6 µL of blood per test or less • you will need to use syringes which allow yo Continue reading >>

Key Facts About Basaglar: A Less Expensive Long-acting Insulin

Key Facts About Basaglar: A Less Expensive Long-acting Insulin

If you’ve been using a long-acting insulin like Lantus, you might have heard about a friendly competitor called Basaglar which is coming soon to pharmacies. Basaglar is insulin glargine known as a biosimilar (also called a follow-on biologic). Because of the manufacturing process it isn’t considered a generic, but there are no differences from Lantus in regard to safety, purity and potency. To get to know Basaglar better, here are some details you’ll want to be aware of. What is the difference between a biosimilar and a generic? Generic drugs are copies of a brand name drug, and their manufacturing process can be replicated exactly through chemical reactions. Biologics are made using manufacturing processes and living organisms that are unique to each manufacturer. Therefore, it is not really possible to make an exact copy of a biologic. For an in-depth look at the definition of biosimilar, see here. Is Basaglar less expensive than Lantus? The cost of Basaglar is estimated to be about 20% cheaper than Lantus. It is manufactured by Eli Lilly as a KwikPen. Basaglar won’t be sold in a vial form. Will my insurance switch me to Basaglar? In some cases, yes. CVS Health has announced that Basaglar will be on formulary in place of Lantus. Is it really equivalent to Lantus? Yes, the onset, peak and duration of action are almost identical. Will my dose be the same as the insulin I’m currently taking? Your healthcare provider will tell you exactly how to make the switch. In general, Lantus and Basaglar can be interchanged unit for unit. If you were on Levemir, the conversion will also be unit for unit. If you were taking Levemir twice a day, the total number of units will likely be given as one Basaglar injection. If you are switching from Toujeo or NPH, your dose might Continue reading >>

Conversion Back Onto Insulin Injections

Conversion Back Onto Insulin Injections

Thanks for our wonderful support group, GNO, and Sharon Roberson, here is a great guide for converting back to insulin shots from being on an insulin pump. This comes from a British site called Salford Diabetes Care (www.salforddiabetescare.co.uk) Why would you want to switch from a pump to injections? In an emergency situation, such as a pump failure, it may be necessary for you to convert back onto insulin injections. In case you are unable to recall information from your pump it is recommended that you should always keep a written record of your current basal rate and average total daily insulin usage. You are going on vacation and don’t want to be sporting an insulin pump at the beach or while scuba diving. You are just plain TIRED of managing the insulin pump. Your skin is sore, needs a break or you are simply running out of skin geography. How to Calculate Your Starting Dose Calculate using your average total daily dose (TTD) of insulin. TTD is all the insulin you have i.e. the basal and every bolus. Obtain this information by: Accessing the history of daily insulin totals in the memory of the pump or: From your records add together the daily set basal rate and the bolus doses together. Add 20% onto your average daily total of insulin then divide this in two equal parts. 50% is now your background insulin eg Lantus or Levemir. You should continue with your usual insulin to CHO ratio at mealtimes and give your usual correction dose. This formula provide a starting dose, further adjustments may be necessary depending on your blood sugar results Working example Daily average insulin total via the insulin pump = 36 units Add on 20% (36 x 20% extra insulin = 7 units) 36 units + 7 units= 43 units Divide into two equal parts = 43 units/2 = 22 units You would administer Continue reading >>

Glycemic Control In Hospitalized Patients Not In Intensive Care: Beyond Sliding-scale Insulin

Glycemic Control In Hospitalized Patients Not In Intensive Care: Beyond Sliding-scale Insulin

Glycemic control in hospitalized patients who are not in intensive care remains unsatisfactory. Despite persistent expert recommendations urging its abandonment, the use of sliding-scale insulin remains pervasive in U.S. hospitals. Evidence for the effectiveness of sliding-scale insulin is lacking after more than 40 years of use. New physiologic subcutaneous insulin protocols use basal, nutritional, and correctional insulin. The initial total daily dose of subcutaneous insulin is calculated using a factor of 0.3 to 0.6 units per kg body weight, with one half given as long-acting insulin (the basal insulin dose), and the other one half divided daily over three meals as short-acting insulin doses (nutritional insulin doses). A correctional insulin dose provides a final insulin adjustment based on the preprandial glucose value. This correctional dose resembles a sliding scale, but is only a small fine-tuning of therapy, as opposed to traditional sliding-scale insulin alone. Insulin sensitivity, nutritional intake, and total daily dosing review can alter the physiologic insulin-dosing schedule. Prospective trials have demonstrated reductions in hyperglycemic measurements, hypoglycemia, and adjusted hospital length of stay when physiologic subcutaneous insulin protocols are used. Transitions in care require special considerations and attention to glycemic control medications. Changing the sliding-scale insulin culture requires a multidisciplinary effort to improve patient safety and outcomes. In the United States, the prevalence of diabetes mellitus is now 10.8 percent of adults 20 years and older, and 23.1 percent of adults 60 years and older.1 An estimated one in five U.S. health care dollars is spent caring for someone with diabetes.2 Over the past 10 years, the Agency fo Continue reading >>

Levemir Cartridge 100 Units/ml - Penfill, Levemir Pre-filled Pen 100 Units/ml - Flexpen And Innolet

Levemir Cartridge 100 Units/ml - Penfill, Levemir Pre-filled Pen 100 Units/ml - Flexpen And Innolet

Levemir Penfill 100 units/ml solution for injection in cartridge. Levemir FlexPen 100 units/ml solution for injection in pre-filled pen. Levemir InnoLet 100 units/ml solution for injection in pre-filled pen. Levemir Penfill 1 ml of the solution contains 100 units insulin detemir* (equivalent to 14.2 mg). 1 cartridge contains 3 ml equivalent to 300 units. Levemir FlexPen/Levemir InnoLet 1 ml of the solution contains 100 units insulin detemir* (equivalent to 14.2 mg). 1 pre-filled pen contains 3 ml equivalent to 300 units. *Insulin detemir is produced in Saccharomyces cerevisiae by recombinant DNA technology. For the full list of excipients, see section 6.1. Levemir is indicated for treatment of diabetes mellitus in adults, adolescents and children aged 1 year and above. Posology The potency of insulin analogues, including insulin detemir, is expressed in units, whereas the potency of human insulin is expressed in international units. 1 unit insulin detemir corresponds to 1 international unit of human insulin. Levemir can be used alone as the basal insulin or in combination with bolus insulin. It can also be used in combination with oral antidiabetic medicinal products and/or GLP-1 receptor agonists. When Levemir is used in combination with oral antidiabetic medicinal products or when added to GLP-1 receptor agonists it is recommended to use Levemir once daily, initially at a dose of 0.1–0.2 units/kg or of 10 units in adult patients. The dose of Levemir should be titrated based on the individual patient's needs. When a GLP-1 receptor agonist is added to Levemir, it is recommended to reduce the dose of Levemir by 20% to minimise the risk of hypoglycaemia. Subsequently, dosage should be adjusted individually. For individual dose adjustments, the following two titration gu Continue reading >>

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