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Lantus or Levemir - Which is Better?

PaulTex
PaulTex
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PaulTex is Helpful RN in San Antonio, Texas
56, Type 2 since 40. COPD - smoker 30 yrs. RN in home health

I am an RN and worked in Psychiatric hospitals for 18 years then...

03/03/09
PaulTex
Topics:LantusLevemirWeightgainlossedema

Lantus or Levemir? Which is Better?

 

Levomir vs Lantus
PaulTex
Tuesday, March 03, 2009 at 02:39 PM

I am a Type 2 Diabetic.  After taking Lantus for the last 3 years with good results (I always proclaimed it as my "Miracle" drug) my doctor became concerned with my slow but steady weight gain.  I was switched two months ago to Levemir at the same dose (I'm a big guy and the dose is large compared to most).  Now after the switch I have two observations.  First, I have indeed lost about 8 pounds!  My pants keep falling down.  lol.  This is good, however the other observation is that (and don't laugh) my head seems to swell in the evenings particularly.  Some of the adverse reactions listed for Levemir is CV: Edema, Metabolic: Sodium Retention, weight gain (Lantus does not show either of these).  How do I know my head swells?  My glasses get so tight that I get headaches (and this even after I had them adjusted and loosened).  As far as control of my glucose - I'm not too sure yet - it seems about the same - it's too early for an A1C.   I suspect that the Lantus was perhaps just a little more effective as I have been surprised by a few high glucometer readings lately that I didn't seem to get with the Lantus - particularly in the late evenings (I take my Levemir around midnight).  I have been adjusting the dose of my Humalog Regular at HS snack (midnight) upward just a bit.  The edema I seem to be experiencing is probably global but I just notice it in my head because of my glasses.  I have NO pedal edema at all.  The other question I have is if my shortness of breath is worse?  I am a long term COPD (due to smoking) and I am thinking now that perhaps I have been more tired and struggling a bit more with SOB.  I have had to use my Albuterol inhaler and Advair more frequently and that is for sure.  So which is better?  Lantus or Levemir?   Well, it would be worth a little edema to see weight continue to come off.  There is a noticeable difference in that I am just not as hungry as I used to be.  I tend to eat twice a day a tv dinner of Lean Cuisine or Healthy Choice brand and whereas I used to snack in-between I no longer do.  I don't buy sweets and try to stay away from carbohydrates and White things.  What is confusing is that Levemir shows "Weight Gain" as an adverse reaction (in Nursing 2008 Drug Handbook) (I am an RN) whereas the Lantus makes no mention about weight whatsoever.  I believe some of the studies show that there is less weight gain with Levemir but I cannot cite sources for this. 

 

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frankenduf
frankenduf
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frankenduf is Frank Duffy
nutritionist

I am a nutritionist at Temple University Hospital in North Philly,...

Tuesday, March 03, 2009

well, i'd say you covered all bases in your comparison! :)

my only comment would be about the fluid retention- if you have increased SOB, it may be fluid in the lungs, so cutting back on sodium and H20 might improve the symptoms

the weight gain comparison is interesting- i think the "adverse reaction" listing is for acute response, not chronic- so, if a drug causes water retention, this is an adverse weight gain, whereas chronic weight gain (from all insulin types) is not considered acute/adverse/dangerous- avandia had a similar side effect of weight gain from fluid, as opposed to anabolism

my advice is to go with the levemir, if you are happier with the body type- happiness is, after all, the bottom line- however if you or anyone in your family has a history of cardiac disease, the edema may be worrisome- in the end, more exercise + lantus may be a better tolerated combo, but as we all know, exercise ain't no miracle :)

 

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