Lantus vs Lev

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jayla-n-Drevon

Member Since 2015
Anyone interested in sharing experience with lantus vs lev?
My cat has a early nadir (rapid drop) so I am wondering if he would do better on a even longer lasting insulin that releases slower (in theory) I know ECID- I am currently using food to try and manipulate the curve.
Not sure if I am jumping the gun but don't want to wait too long either....
Thank you!
 
Hi Jayla,
I used Lantus for about a year I think before I swapped to Levemir. Actually I swapped to levemir then it didn't work out, so I went back to lantus, then about 6 months later I tried again and I prefer it now. I think the first time I wasn't giving enough insulin and the BSLs were too high. It was before I joined the forum and my vet didn't know anything about levemir so I was doing it alone.
I find the nadir for Sheba is later on the levemir than on the lantus. I think she used to nadir about +4 or +5 on lantus but now she often nadirs at +9 on the levemir.
I find the onset is later as well. Sheba's onset is about +3.
I also felt when Sheba swapped to levemir, her mood was better........I can't put my finger on anything ...but it is just the impression I got.
Sheba has rapid drops on the levemir so if you are just swapping because of hoping the drop will be more gentle...you may be disappointed. But ECID of course.
Personally I like the levemir. I like the later nadir. It fits I with my lifestyle better and when Sheba has an active cycle I find the numbers stay lower for longer.
Hope that has helped, and not confused you.
Good luck with whatever you choose to do.
Bron
 
Thank you for the responses--we are still on the fence but your experiences help .... the fast drops and not staying low very long is 1 reason but he also feels the sting sometimes. Thank you again.
 
Max was on lantus when first diagnosed, we got up to 7 units twice daily, and vet wanted to switch to lev. We made the switch, and still got up to 7 units before he started to respond, and we could come down. The lev seemed to have a later onset and later nadir than the lantus, so once we got under control, we had to get used to shooting on pretty low numbers. The nadir was often right at the next preshot time.

My cat has hyperestesia and frequent partial seizures (born that way), and the other thing we noticed once we switched is that the twitching and seizures were reduced on the Lev. I think this had a lot to do with the stinging that can happen in lantus, which can probably last for hours after the shot is given. He was on a pretty high dose, and the stinging is probably worse at high doses.
 
We didn't really notice a difference with Lev for Smokey. We switched because at the time Lev was new and much cheaper. Neither seemed to sting any more/less than the other. She'd ACT like it sometimes. But then sometimes I'd pretend to give her the shot and she'd still act like it hurt, other times she wouldn't bother getting out of bed - drama queen she was :rolleyes:
 
Jayla.....Lantus is said to sting a bit but apparently Levemir does not.
I have been reading that--
He doesn't always flinch and he is on a small dose but it seems to have to do with hydration (if he had fluids within 12ish hours and certain spots-
80% of the time there is no reaction. If we become long term I will switch but we are still hoping for remission....
I have tried vetsulin ..very hard on him/depressed big time
Pro Zinc -- back to him self but he metabolizes this stuff so fast I was dosing every 8 hours (sometimes 6)
with lantus it seems he hits nadir about +3ish and then rises steadily, I feel like he is above renal threshold for way too long. -- I was thinking maybe if he still had a early onset (even +5) maybe it would last much longer as it is 1x a day (I think)
I realize I will need to get a whole bunch of new data if we switch-still pondering.....
 
If you decide to swap and you are not happy, you can always go back to the Lantus
But I would give it a few weeks for Dre to settle into the new insulin. I did not give it long enough the first time around.
 
FYI, for lantus and levemir, the nadirs are dose dependent. That is, the larger the dose, the later the nadir can be. It has to do with the way each insulin time release mechanism works.
 
Though it's for human diabetics, here is the technical stuff from https://www.diabeteshealth.com/lantus-and-levemir-whats-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 (glargine) is a clear formula made with glargine, a genetically modified form of human insulin, dissolved in a special solution. The modifications make glargine soluble at an acidic pH (about 4pH.), but much less soluble at the neutral pH that’s found in the body. 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 into solution over time and then to the bloodstream. The acidic nature of Lantus can sometimes cause stinging at the injection site, especially at higher doses.

Levemir is also a clear formula, but it contains dissolved detemir, a different form of genetically modified insulin. Unlike glargine, detemir does not form a precipitate upon injection. Instead, detemir’s action is extended because its altered form makes it stick to itself in the subcutaneous depot (the injection site), so it’s slowly absorbed. Once the detemir molecules dissociate from each other, they readily enter the blood circulation, but there the added fatty acid binds to albumin. More than 98 percent of detemir in the bloodstream is bound to albumin. With the albumin stuck to it, the insulin cannot function. Because it slowly dissociates from the albumin, it is available to the body over an extended period.
 
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