There are many kinds of insulin, and finding the right insulin and dosage is no easy feat. Unfortunately, for us in the United States, there is one less option now. Novo Nordisk is discontinuing Levemir in the U.S. Let’s explore what that may mean and what replacement insulin may work.
Levemir’s Discontinuation: A Closer Look
The discontinuation of Levemir, available in both vial and FlexPen forms, stems from factors like global manufacturing constraints. FlexPen users must consider alternatives now, with supply disruptions having begun in mid-January 2024 and a complete stop by April 1, 2024. Levemir will be available in vials for a little more time, up to the end of 2024.
Considering Your Options
In our search for alternatives, there are several long-acting insulins available:
- Insulin Glargine (Basaglar, Lantus, Toujeo): It’s effective over 20-24 hours but comes with its risks. My research uncovered a risk called “Lantus lows” – unexpected hypoglycemia episodes – which makes me hesitant to recommend it. Also see the article titled Lantus: Lethal or Lifesaver? which explains why this risk happens with Insulin Glargine but not Insulin Detemir or Degludec. This rare but serious issue is something to discuss with your healthcare provider if you are considering this insulin type for your long-acting insulin.
- Insulin Detemir (Levemir): This is the type being phased out and will be unavailable by the end of the year. It lasts up to 24 hours.
- Insulin Degludec (Tresiba): A popular recommendation in our community, it has a long-lasting effect (up to 42 hours) and allows flexible dosing. However, its extended duration means that getting the right dose is crucial to avoid hypoglycemia, especially on active days or during hormonal fluctuations. (Novo Nordisk makes Tresiba too; some articles about this Levemir discontinuation suggest that it will help boost their profits as people switch to the more expensive Tresiba.)
The Tresiba Transition
Transitioning to Tresiba involves careful planning. Working with your doctor to adjust the dosage can mitigate the risks of prolonged action. According to professional guidelines, the starting dose of Tresiba should be around 20% less than your Levemir dose. This is just a starting point; your personal needs might require further adjustments. Work with your doctor to adjust dosage and watch your blood glucose closely when making this change.
Empathy in Times of Change
I understand that this transition isn’t just about switching medications; it’s about coping with the uncertainties it brings. It’s okay to feel stressed or anxious about these changes. Managing diabetes is already a journey filled with constant adjustments, and this adds another layer of complexity. Know that it’s alright to seek support and express your concerns. We’re all navigating this together, and sharing our experiences can make the journey less daunting.
Your Experiences Matter
As we all embark on this transition, I encourage you to share your experiences with long-acting insulins, especially if you’ve previously used Levemir or are currently considering Tresiba or other alternatives. Your insights are invaluable to our community. Have you faced challenges in adjusting dosages? Found a routine that works well for you? Every story shared is a potential guidepost for someone else on a similar path. Let’s use our collective knowledge and experiences to support each other through this change.
Stay connected, stay informed, and most importantly, share your journey. Each comment, each shared experience, enriches our understanding and strengthens our community. Looking forward to reading your stories and learning together.