hello pzi'ers! i couldn't help but notice this thread. as a user of both lantus and levemir, i hope you don't mind me sharing some thoughts on a few of the points that were brought up. switching insulins is scary and a difficult decision to make. it might help hearing from someone who has used both lantus and levemir.
imho,
both of these insulins are great! one is not better than the other. it saddens me to read anyone learned on this board that levemir is better. actually, research has shown lantus has a slight edge over levemir as far as the success rate in getting newly diagnosed kitties OTJ (lantus 84% vs levemir 82%). although, imho, a 2% difference is negligible at best. the BEST insulin is
the one that works for YOUR cat... no matter which insulin it is! we've seen many, many kitties thrive and some go OTJ on every one of the insulins currently available.
as to the Ls...
pricing:
when switching to either of these insulins, i strongly urge you to call the pharmacies
where you live to get the best prices. prices vary... and sometimes a lot. i was shocked to see the price range within 5 miles of my home! many of our lantus and lev users get the best prices from costco (you don't have to be a member to use their pharmacy), BUT that's not always the case. and you can't count on the big box pharmacies charging the same from one area to the next. for instance, one member i know who lives in another state gets the best price for lantus at target. where i live, target is one of the most expensive places to buy insulin. go figure.
a few pharmacies will break up a box of lantus solostar or levemir flexpens and sell you one or two at a time if you don't have the cash available to purchase an entire box at once. we've found pharmacies make these kinds of decisions on an individual basis. you have to ask.
longevity:
yep. the manufacturer of lantus says to discard open lantus after 28 days. the manufacturer of levemir says to discard open levemir after 42 days. what we've found (and so have lantus and levemir users on the german-katzen message board, who incidentally have been using both of the Ls for in most cases years before the Ls were available to most of us) is both lantus and levemir can be used long past these days if
refrigerated and handled properly. the important thing is to visually inspect regularly. if the insulin is discolored or you see floaties (tiny crystals), discard the insulin. if your insulin freezes, discard it. please refer to the
STICKY: LANTUS & LEVEMIR - INFO, PROPER HANDLING, & STORAGE for detailed information.
speaking from personal experience, i've been able to use some to the last drop and there have also been occasions when i've had to discard a vial/pen before the manufacturer's suggested amount of days. overall, i've been able to use the Ls long past the manufacturer's suggestion... which has brought down my insulin cost to approximately $20 - $23 per month. your mileage will vary depending on the amount of kitty's dose.
flexibility:
early and late shots... heck, these are a concern to anyone who has a life outside feline diabetes. :lol:
as we all know, the Ls are meant to be shot on a 12/12 schedule. if only our lives were that simple! i'll tell it to you straight... until you learn YOUR cat's response after switching to one of the Ls, shooting as close to a 12/12 schedule will offer you the best opportunity to learn how your cat responds. however, once you know how your cat responds you'll find there is some flexibility
because of the Ls being
depot insulins as well as the
overlap and
carryover involved. you might find
this post i recently wrote about early and late shots helpful.
bouncers/divers and the L insulins:
we've had more levemir users in what's now called the lantus TR forum than there have ever been in the levemir forum since i joined the fdmb... it's just not obvious because TR forum posters do not differentiate between lantus and levemir. i gotta tell you folks... i wish i could say one or the other of the Ls is better for bouncers/divers, but it just wouldn't be so. kitties bounce with both lantus and lev. some kitties bounce more on lantus. some kitties bounce more on levemir. they bounce... until they don't.
what IS different is the approach used for bouncers/divers in the lev and lantus TR groups. the lantus TR group advocates following the TR Protocol (the only researched and published approach) until it's time to fine tune based on the individual cat's needs... if needed or as necessary. from what i've read and seen, the lev group may often follow the TR guidelines, but has a tendency to lower doses based on bouncing.
neither approach is wrong. as a TR advocate, i bet some of you are surprised to hear me say that. :mrgreen: neither approach is wrong because ECID is not just a slogan. every cat IS truly different and different approaches work for different cats. however, there's one thing i have observed after studying many spreadsheets of kitties whose doses have been lowered to prevent a cat from bouncing... in almost every case (not all), weeks or even months later the caregiver eventually ends up taking the dose back up until they're right back where they started or they have to surpass that dose if
glucose toxicity has set in. just looks like a whole lot of wasted time and effort to me. according to research, there's a golden opportunity to get newly diagnosed kitties OTJ when their BG numbers are brought down into the normal range as quickly as possible... allowing their pancreas' to heal before more damage is done from remaining in unnecessary and unhealthy hyperglycemia. if that's the case, it just kind of makes sense to work towards tight regulation and ignore the fluctuations caused by bouncing, but that's just a personal opinion.
anyway, there's my 2 cents. that and a buck won't even buy a decent cup of coffee these days.
fwiw, just a few thoughts and observations for you...
) and they have it cheaper than what I paid at the vet, so called my vet to call in a prescription. The assistant just called me to say Costco told her they don't carry ProZinc and my vet wants to know if we want to switch to Lantus, Levemir or Humilin N. Well - I KNOW not Humilin N...I feel nervous about the thought of starting all over with a new insulin...and think he's doing pretty good on ProZinc...but, could he do better on something else??? And, at least 1 person has switched from ProZinc to Levemir recently and had their cat go into remission...but ECID...
