Levemir vs. Lantus insulin?

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kwkelley

kwkelley

Member Since 2022
My Kiki has been diabetic since November 2021. Originally, she was on Lantus insulin but went into remission when we were able to stop the prednisolone she was taking for IBD. Unfortunately, she had to resume the steroid a few months later and her blood sugar has been hard to control ever since that time. She is currently on Lantus 3u BID but still runs in the 300-400s. I'm wondering if she might do better with a switch to Levemir insulin. Can someone help me understand the difference between these two depot insulins in cats? Thank you!
 
Do you have any data on your kitty's blood sugar to share with us? There might be another reason she is presenting in higher numbers all the time. Levemir may not be the solution to whatever the issue is.

My girl was on Lantus and then I switched to Levemir. There are a few reasons people might switch insulins. First of all, the insulin you want to give is the one that works for your cats. Sometimes you just need to change, but we typically suggest people give the first insulin around 6 months to see how it does. It can take a cat's body a while to adjust to the new hormone (insulin). Second reason people switch is if their cat is responding to the Lantus in a negative way. Lantus has an acid base, that some cats find stings, especially if in higher doses. This link has a little more on what is happening behind the scenes: Lantus and Levemir: What’s the Difference?

Some people find that Levemir gives a bit better duration, resulting in flatter cycles, but again ECID each cat is different. In general, the onset and nadir are later with Levemir. Lantus onset is typically 2-3 hours after the shot, Levemir around 4 hours (my girl it was 5 hours). Nadir are typically a couple hours later as well, with Levemir it's not uncommon to have nadirs around the following shot time.

And finally, which steroid is she on now? My girl was on budesonide instead of prednisolone (which she couldn't take due to her heart condition), and the budesonide did not impact her blood sugars.
 
The downside of Levemir is cost. Compared with generic/biosimilar glargine (Lantus is one brand name), Levemir is more expensive, like twice or so.
 
Wendy&Neko said:
And finally, which steroid is she on now? My girl was on budesonide instead of prednisolone (which she couldn't take due to her heart condition), and the budesonide did not impact her blood sugars.
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Sorry for the offtopic question: How did you give budesonide to the cat? Pills? Aerosols?
 
Thank you for the answers! I see that there are only tablets or aerosols - for human use. There would be another option in case ciclosporin does not work.
 
My cat Neko started with pills, but we switched to compounded in liquid with fish flavour at the local compounding pharmacy. And it was easier to reduce her dose when she went down to 0.75 mg.

Larry and Kitties said:
Compared with generic/biosimilar glargine (Lantus is one brand name), Levemir is more expensive, like twice or so.
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That may be true for the US, but not true in many other countries, so depends where you live. In Canada they are very close in price.
 
kwkelley said:
My Kiki has been diabetic since November 2021. Originally, she was on Lantus insulin but went into remission when we were able to stop the prednisolone she was taking for IBD. Unfortunately, she had to resume the steroid a few months later and her blood sugar has been hard to control ever since that time. She is currently on Lantus 3u BID but still runs in the 300-400s. I'm wondering if she might do better with a switch to Levemir insulin. Can someone help me understand the difference between these two depot insulins in cats? Thank you!
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So you cat went into remission after you stopped the steroid? Our cat was recently diagnosed with diabetes (only 7), but he has taken a steroid for IBD for three years. We think that's what may have caused it.
 
In Canada they sell Semglee (as of recently) and Basaglar, but they aren't much cheaper than real Lantus, which again is just a bit cheaper than Levemir. Don't go by the prices on the Marks Marine website. Although cheaper for Americans, it's a markup from what we pay in our local pharmacies. Most of the US Levemir users here buy from Marks Marine, which is cheaper than buying local in the US.
 
waterlily said:
So you cat went into remission after you stopped the steroid? Our cat was recently diagnosed with diabetes (only 7), but he has taken a steroid for IBD for three years. We think that's what may have caused it.
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I had Rico who got FD from pred but he was on it a short time and I caught it right away......after we switched to budesonide I dosed him very carefully and he went into remission in a month,
 
waterlily said:
So you cat went into remission after you stopped the steroid? Our cat was recently diagnosed with diabetes (only 7), but he has taken a steroid for IBD for three years. We think that's what may have caused it.
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You should consider switching to budesonide instead, which is a localized steroid and rarely affect a the bg. Minnie was on it for her IBD
 
Kiki tried a switch to Budesonide but unfortunately in her case it still spiked her blood sugars. We are now using Cerenia tabs 6mg. orally daily to control the vomiting and it's working very well. However, she is still diabetic and running high so I was hoping a switch to Levemir might help lower and level out her numbers a bit.
 
Without seeing some blood sugar numbers for KiKi, it’s hard to say if Levemir would help, or if you just need a different dose of Lantus. Cats usually need similar doses of Levemir as Lantus. Though new do start on a somewhat lower dose to start, as some cats react strongly to the switch at first.
 
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