Levemir binds to the albumin of the blood which prevents it from being rapidly used. In theory, you could inject Levemir directly into a vein and it would not be used all at once.
Lantus was always predictable for me. I used it many years. But I think Levemir is more predictable.
I understand the concern. Have you ever used a pump? I think the slower basal release of things like Lantus, Levemir, or Tresiba are actually more predictable than the things that happen with a pump - which are subject to absorption and site issues, different sites, time since the pump infusion. All kinds of things.
The drawback for me for Tresiba is the longer than 1 day duration, which makes ramping it down more difficult.
At my dosing, Levemir is ideal since its duration is 12 hours. That letās me do adjustments for different days, and also different amounts for night and day. 12 hours is a pretty good duration for a basal insulin for my needs.
But if someone took a higher dose, then Levemir gets into the 16-18 hour range, or even up to 23 hours, and that might be less ideal.
I had a one month trial of the omnipod. The podās lowest dosage was too much for me. For some reason, more effective absorption, shorter needleā¦etc. led to a significantly lower TDD. My TDD on the omnipod was only about a fraction of my MDI. I had to repeatedly suspend my podā¦so the long and short of it is that the omni pod pump did not work for me. In truth, I feel more āfreeā with MDI than on the omnipod.
Before switching to Tresiba, I did use Levemir for awhile (after a few disastrous scary lows from Lantus). But at the time, I was not yet enlightened by this group of very well informed PWD. Therefore, if I were achieving less than optimal BG control, I cannot attribute it to Levemir. I would probably be willing to return to Levemir to try it out. I still have a small supply of Levemir.
The trick with Levemir (which you may not have been told!) is to do it twice a day. That also allows you to vary your daytime and nighttime basal amounts which can be super helpful.
Here is an excerpt on the mechanism of slowing Levemir:
The duration of action of LEVEMIR is mediated by slowed systemic absorption of insulin detemir molecules from the injection site due to self-association of the drug molecules. In addition, the distribution of insulin detemir to peripheral target tissues is slowed because of binding to albumin.
And here is the info on the duration of Levemir.
RESULTS:
Duration of action for insulin detemir was dose dependent and varied from 5.7, to 12.1, to 19.9, to 22.7, to 23.2 h for 0.1, 0.2, 0.4, 0.8, and 1.6 units/kg, respectively.
That sentence is horribly written and would make my 2nd grade teacher roll in her grave, but the idea is the amount in units per kg and duration are like this: