info on levemir?

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i'm recieving 2 levemir pens tomorow about 3 in the mail....is this an insulin i want to refrigerate? i've heard different things.
that would be the very first thing i need to know.
thanks.
 
thanks sienne for the link. i thought i'd heard that lev can be kept unrefrigerated but i will be refrigerating mine.
i cannot IMAGINE drawing out 1u on those tiny u100's and getting it right without excess!!!! even with the u40's and pro zinc i always draw too much and work my way back down. i think i'll practice on an old bottle of pzi than i'm not using anymore.
 
Lori

There's a chance you won't use it all anyway before it goes kaput. I always draw a couple units more and then slowly (and I can't overemphasize that word) eek it down to my desired dose.
 
:lol: Marjorie...but not into the pen right?
I don't want to waste it...I need it to last me like a year!!!
 
people say different things, like one pen has 300 units and will last until i use it up...potentially if all goes well (which it won't) that is 150 days!
 
I think some people get longer usage out of their pens than others. I think there is a similarity in use in lantus/lev and I know some of the folks here toss their
pens at the 28 day mark where others use them longer. You'll just have to play it by ear and see how long it's good for. I'd pay alot of attention to the storage info.
 
oh yeah I will, its like starting all over as a newbie! Levemir is still a foreign language to me, I feel like I know more about Lantus than Lev but I was told Lev was more forgiving of scheduling and such. Hope I find a nice coach. I could not possibly do what you guys do...no BOS and I can't pull those all nighters :lol:
 
unlike lantus with a 28 day unrefrigerated shelf life(according to the manufacturer) levemir has a 42 day unrefrigerated shelf life so there is no reason to pitch it after 28 days.besides if yu keep the pens in the frdge when yu dont use them they should last longer.everyone has different experiences about how long their levemir lasts.if after 42 days yu see what were once consistent numbers getting crappy them yu know its time to open a new pen.
 
I don't know of anyone here who gets 150 days from Lev. Also, it is no more forgiving than Lantus when it comes to a 12/12 shot schedule. The differences between Lantus and Lev are pharmacological and do not effect the way the way the insulin is administered. Lev is more forgiving in the sense that it is not as fragile of an insulin as Lantus, although I would not recommend that your cat treat the pen like a hockey puck.

And no, do not inject insulin or air back into the pen.
 
Yep, refridgerate your lev, both opened and unopened pens for longer life. I have used my pens way longer then 45 days, as a matter of fact, I believe that the cart I have now I've been using since 10/20/10 and it's still going strong. I have used other carts for up to 4 months. There have been times that Spot's numbers looked really bad and I thought it may be the insulin and opened up a new pen and there was no change, other times there was a difference. So, you just have to be more aware of things.
 
thanks for all the tips. i will be handling my lev with great care. hopefully can gain the most bang for the buck. any lev users here that want to pm me for contacts in coaching me please feel free, of course we'll coach on board so as not to 'give off board advice' but just want to get familiar with a few users.
thanks everyone,
lori
 
Glad you got some good info on lev; the other big difference between lev and lantus is the nadir....it's usually around +8 instead of +6 BUT ECID :lol: :lol: When I've asked others about lev, that has been what was indicated as the biggest difference so you'll still need to do that monitoring!! I've never been in the lev forum but there really are a lot of lev users here so hang out...hope to see you posting here daily!

Glad Sienne told you not to inject into the pen...I thought you were joking so didn't answer :lol: :lol:
 
Steve and Jock were, to the best of my knowledge, the first to put his cat on Lev. He is one of the administrators on the Diabetes in Pets Wikia. Therefore, I would guess that info in the Lev article on the Wikia is reliable.

Some of my experience with 4+ years with Ennis on Lev.

1. With Ennis, a pen lasts to the end.
2. Yes, do refrigerate (I do this with any insulin). Do not roll Lev (or any clear insulin), as you have rolled PZI.
3. You can shoot Levemir back into the pen/vial (unlike with Lantus, thank you Martha and AlleyCat for that knowledge 5+ years ago about Lantus).
4. Dosage and timing between shots is not as strict as with Lantus. However, it's best to stick with/close to the Lantus protocol until you have Tom well- or pretty well-regulated.

PS--It seems that my advice differs from others here. My advice is based on my experience. Ennis's AMPS, at +23, was 102.

And, Lori, I told you I would give you the link to Bastian's SS. The only numbers there are the ones when he was fostering here. He's been with Stefani for some time now and, like Ennis, Bastian now stays between 80 and 140 most of the time. Unlike Ennis, Bastian is on BID.

Venita
 
lori, you will hear different things about the longevity of lev because many of us have had different experiences using it. one of my flexpens lasted only 34 days... another lasted 37 days before seeing floaties (less than the manufacturer's suggested 42 day use). however, the flexpen i'm currently using was opened on 09-10-2010... almost 4 months old and still going strong. go figure. i've handled all of them the same.

some have had to toss a flexpen when the little disc inside the pen reaches about the 12 mark. others have been able to use a lev flexpen down to the last drop. my advice is to visually inspect the pen often. toss it when you see floaties or it becomes discolored or if it has frozen. if there's no possible explanation for an unexpected rise in numbers... you might want to try a new pen.

as far as shooting excess levemir back into the flexpen or vial... many do it. i'm probably one of the few who would not shoot any insulin whether it's levemir, lantus, or pzi back into the pen/vial because of the silicone oil which has been sprayed on the inside of the barrels of disposable syringes: http://www.henkesasswolf.de/fileadmin/pdf/Latex_and_Silicone_Oil_Report_on_HSW_NORM-JECT_R_.pdf.

human diabetics are known to build up a small amount of silicone oil under their skin from injections. i don't see any reason to possibly push silicone oil back into the pen/vial only to draw it up again the next time i pull an insulin dose. i'm sure the amount of silicone is minute, but why do it if i don't have to? like i said, i'm probably one of the few who is concerned not necessarily about the efficacy of the insulin itself when shooting excess insulin back into the vial/pen, but rather have an increased concern stemming from the injection of something other than insulin into my cat's body. different strokes for different folks.

most lantus and levemirs will tell you it's best to stick to a 12/12 schedule whenever possible. ideally, it's the best way to go. however, life isn't always ideal. contrary to popular belief, there have been BOTH lantus and levemir users who have had to become (out of necessity) somewhat creative concerning shot times and dosing. it's not easy, but it can be done. lev AND lantus kitties who are tightly controlled are more forgiving when it comes to being off schedule.... so much so that my own tightly controlled cat rarely misses a beat in the event of a skipped shot.

good luck with the switch to lev! i think you'll grow to like it.
 
I am one of those that, so far, have been able to use my pen down to the last drop. jojo and I had a difference of opinion on how long I use a pen but after finally opening a new cart, (after mine is empty) wheezers numbers were no different. he gets anywhere from 0.05u-.2.
refrigerate used and unused
 
sooooooooo. things i learned that i did not know.

no rolling the insulin!

i'm not shooting back in just for the sake of longevity, dian...do you shoot back in? and what about those darn air bubble, do you shoot those back in?

check for floaties often, especially after 28 days.

refrigerate unopened and opened pens.

expect a later nadir.

the shed thing is kind of iffy, various opinions on that. this is only very important to me becuase tom is running VERY HIGH and i am loath to let him build a shed while sitting in the 5-600's. i have also heard that i can expect to see results day 1 so that would indicate no real shed time. you can see my concern. we don't have much wiggle room.

and as Marjorie said....'slowly' export any insulin i pulled into syringe, she cannot overempathize this....s l o w l y :lol:

so tomorow i start at 1u, no matter the super high # i wake up to? is everyone in agreement with that?
currently shooting 2.2 u pro zinc into 5-600's and usually hang in 200's but today came down to 116 at +4.5 YAY!
 
well, with Lev, I do shoot back in and have never had a problem. I have used one unexpired cartridge for 9 month.
one thing is. lev has a hard time working with high numbers. a few give some R when that high at same time they give lev so that numbers come down into a more workable range for lev.
I know Dyana does this and a few others but names escape me
 
hey u welcome to LL!

quick questions, will u be adding your december (PZI) numbers to your SS?
and one other question, I think I saw on another thread over in health, that you don't test in the evening cycles, how flexible are you with this?
if it's not possible for you (evening checks), you may want to add that to your signature so we don't bug ya about it.

good luck with the Lev!
 
SWEET!!! Best of luck on the switch, you two!

and tho i said it in a pm...now it's goin' public...
i can't thank you enough for how you welcomed us when we came to the board and your support and kindness since...

you & Senor Tomas ROCK!!!

celi & binks
 
Lori & Tom said:
the shed thing is kind of iffy, various opinions on that. this is only very important to me becuase tom is running VERY HIGH and i am loath to let him build a shed while sitting in the 5-600's. i have also heard that i can expect to see results day 1 so that would indicate no real shed time. you can see my concern. we don't have much wiggle room.
Click to expand...

Both Lantus and Lev have a shed. You need to keep in mind that with both Lantus and Lev, it is likely that it may take a while to bring high numbers down. The Ls do better at latching on to lower numbers and producing a flat curve. If you take a look at the Tilly protocol, it states:
Tilly Protocol said:
When selecting a starting dose, it is important to know that while Lantus and Levemir have a longer duration than other insulins, they also have a lower potency in most cats.
Click to expand...
Thus, you are unlikely to see an immediate response that pulls high numbers down quickly. Some of the folks here who have switched from Lantus to Lev do see a response to the first dose. Then things level out as the shed is rebuilding. Just be aware that this is a long acting insulin and a fast response, while technically possible, is unlikely.

Lori & Tom said:
any lev users here that want to pm me for contacts in coaching me please feel free, of course we'll coach on board so as not to 'give off board advice' but just want to get familiar with a few users."
Click to expand...
While I realize that conventions may be different on the PZI board, "coaching," whether it be by phone or backchannel, is not normative in LL.

One other point, and I may be reading more into how you're presenting information, but we treat Lantus and Lev identically here. If you want a purely Lev focus, you may want to post on the Lev board. I'm not suggesting you go over there, just that we don't treat the two types of insulin differently. There is enough similarity between how the two types of insulin work that we do not differentiate in LL. All of the versions of the tight regulation protocol we use make no distinction between Lantus and Lev. What we state for one, largely applies to the other.
 
Hi Lori,
Here is my technique for avoiding bubbles in the syringe. 1) Work the plunger back and forth a few times. 2) Depress the plunger fully and FORCEFULLY and hold it there while you insert the needle into the cartridge. 3) SLOWLY draw out a little more insulin than you need. 4) Slowly TWIST the plunger while holding the syringe over a paper towel to expel the excess insulin and arrive at your dose (twisting is much more precise than pushing the plunger).

Hope this helps.

I used Lantus with Stu(GA), but Rusty was already on Levemir, so I have kept him on it. ECID, but I don't do anything differently. I'm still on my first cartridge (begun 28 November).

Ella & Rusty
 
Awwww, thanks Celi. I thought you were fun from your very first post and hoped I'd see alot more of you.

And Ronnie, it's true I don't test thru the night. I sleep really heavy and so does tom. I have to carry him to bed from the living room when he falls asleep there....and he sleeps right thru it. I lay him down and he snuggles up and snores. It would not be part of my plan to test thru the night..I could maybe get a + 2 is all.
Sorry about the Dec. ss, I have been dealing with a flooded house, tearing out carpets, moving furniture and such.
I'll fill it in...I'll say this...it got way ugly. Those #'s were just getting scarier and scarier, I'm relieved my baby boy is on ab's now and starting Lev.

We will shoot either tomorow morning or the next morning as tomorow at 8am the carpet people are coming and I might not have time in the morning to try getting that dose perfect on the u100's, pilling, feeding and testing.

Sienne I hope to be able to post here..but I don't want to upset the apple cart if I'm not one to test at night and not comfortable with extremely tight regulation. I've always enjoyed the extrodinary support system you all have here. I want to gather info from lev users and just do the best I can for my Tomtom. I can test maybe 4 times a day. Is that too little. Of course at first I may test more since he is on ab's and there are a few different variable's at work. I've considered waiting until he is off ab's before the switch but still not sure.
 
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