How Much Levemir Is Too Much?

Many of you will be familiar with words like diabetes, hypoglycemia, insulin, etc. But have you ever thought how these terms relate to each other? Diabetes is a condition in which your pancreas fails to produce enough insulin.

Do you know what insulin is? Insulin is a hormone that maintains the normal sugar level of your blood. People that cannot produce sufficient insulin take it from an external source. This insulin is provided with the help of microorganisms artificially. Insulin for human use comes in many brands and is produced by many pharmaceutical industries. E.g., Levemir.

But as we know that drugs and medications should be taken carefully. So we should know some basic things like how much Levemir is too much? Can lactating mothers use it? Is it safe to use during pregnancy? In this article, we will try to sort out these things and many more.

What is Levemir?

Levemir is a colorless, aqueous, and sterile solution of insulin detemir. It is long-lasting insulin. Hence it works for 24 hours after injection.

Composition:

Generally, the composition of each milliliter of LEVEMIR is 100 units of insulin detemir, 65 mg zinc, 16 mg glycerol, 2 mg m-cresol, and 1.8 mg phenol. It also contains 1.17 mg sodium chloride, 0.89 mg disodium phosphate dehydrate, and water. Moreover, to adjust pH 7.4, sodium hydroxide or hydrochloric acid is also added.

Types of diabetes:

There are three main types of diabetes. Types of diabetes depend on the causes. The main types of diabetes are as follows.

• Type I diabetes:

Type I diabetes is common in children and adolescents but can develop at any age. If you have type I diabetes means your pancreas is not producing enough insulin. So you need routine insulin injections to maintain normal blood sugar.

• Type II diabetes:

About 90% of all diabetes cases involve type II diabetes. It is common in adults and older people. Here although your body is producing insulin but of no use. Due to certain reasons, your body cells fail to respond to this insulin. So glucose uptake by cells is very low. At the same time, glucose concentration in the blood is higher than normal, which we call diabetes.

People with type II diabetes are also recommended to use oral drugs and insulin. Moreover, exercise and an active lifestyle are also important to maintain good health.

Possible reasons for type II diabetes:

It may be due to many reasons e.g.

• Genetic factors
• Sedentary lifestyle
• Obesity
• Aging
• Hypertension
• Poor nutrition
• Gestational diabetes can also turn into type II diabetes if ignored

So you should be more careful if you have a family history of diabetes. A balanced and healthy lifestyle keeps you away from diabetes.

• Gestational diabetes:

As gestation means pregnancy, so gestational diabetes means diabetes during pregnancy. It occurs in pregnant women due to hormonal imbalances during pregnancy. Here the mother’s body is unable to produce and use sufficient insulin.

Mostly it disappears after delivery, but It should be treated carefully. However, it can occur at any stage but is more frequent during the last trimester of pregnancy. Diabetic women mostly use insulin to keep normal sugar levels.

What is insulin?

Now you are familiar with diabetes. Do you know what insulin is? Insulin is a hormone; your pancreas release to control blood sugar. In particular, insulin helps to remove glucose from our blood and make it available to cells. Consequently, cells need this glucose to obtain energy.

Well, this is all about natural insulin. Nowadays, many companies are making insulin in laboratories. So there are many types and many brands of human-made insulin.

Types of insulin:

There are five types of insulin, according to the time it is taken for action.

• Short-acting insulin
• Rapid-acting insulin
• Intermediate-acting insulin
• Long-acting insulin
• Mixed insulin

1. Short-acting insulin:

Short-acting insulin starts working within 30 minutes. So you should have to inject this insulin 30 minutes before your meal. E.g Humulin® R is a short-acting insulin.

2. Rapid-acting insulin:

It starts working faster than short-acting insulin. It’s action starts within 2.5-25 minutes. At the same time, it’s effectiveness is maximum for 1-3 hours. Nonetheless, it is effective for 5 hours. An example of rapid-acting insulin is Humalog® (insulin lispro).

3. Intermediate-acting insulin:

The appearance of intermediate-acing insulin is cloudy, so it needs mixing. These start working within 60-90 minutes after injection. Humulin® NPH (human isophane insulin) is such insulin.

4. Mixed insulin:

Mixed insulins are a combination of either rapid-acting or short-acting insulins with intermediate-acting insulin. E.g Mixtard® 50/50 (50% short, 50% intermediate Protaphane).

5. Long-acting insulin:

Long-acting insulins are effective for a long time and are long-lasting. These are mostly clear and do not need mixing. An example of such insulin is Levemir® (detemir insulin). About which we will discuss in more detail.

How Do scientists produce insulin?

Are you curious to know about the synthesis of insulin in industries? Yes! So let me explain the process in simple words.

• First of all, scientists manufacture the gene of human insulin.
• Then, scientists insert this gene in bacteria through plasmid. Now they are recombinant bacteria.
• Then, these bacteria are put in large fermentation tanks.
• Here, the bacteria will produce insulin using the gene.
• Finally, scientists collect prepared insulin for human use.

Does that mean insulin detemir?

We said LEVEMIR is insulin detemir. Then what is insulin detemir? Insulin detemir is long-lasting, human-made insulin. It is available in liquid form( as a solution) to inject under skin.

However, insulin detemir slightly differs from human insulin in the overall structure. Actually, in insulin detemir, an amino acid threonine is absent from a single position. And with previous amino acid, a C14 fatty acid chain is attached. Its molecular formula is  C₂₆₇H₄₀₂O₇₆N₆₄S₆ and molecular weight is 5916.9.

When should you use Levemir?

Levemir is effective in both type I and type II diabetes ( but after a prescription from a doctor). In both cases, it is used as an injection under the skin. It solves the problem that causes diabetes. It works in place of the natural insulin of your body because it helps move glucose from your blood to your tissues so that your muscles can get the required glucose.

The optimum dose of Levemir

Now we will discuss how much Levemir is too much. Like we will discuss suitable dosage for patients of different age groups.

So starting dose for insulin- naive type II diabetes patients is ten units once daily. In other words, we can also say that 0.1-0.2 units/kg daily.  While for type I diabetes patients initial dose should be 0.2-0.4 units/kg daily.

If a person is already on glargine insulin, then change will be on the same unit to a unit basis. While if the conversion is from NPH to Levemir, then some type II diabetes patients need more Levemir than NPH.

Levemir is used as long term treatment. However, the dose may be changed from time to time. Your doctor will also set your dose to reach your FPG goals. FPG sand for fasting blood sugar.

Frequency:

You can take Levemir once or twice a day. However, if you are taking twice, there should be 12 hours between the two doses. Once or twice, it depends on the ability of your body to remove drugs.

Absorption:

The rate of absorption depends on the concentration of the dose. Moreover, it also depends on the frequency of taking a dose. Generally, Levemir’s peak in your blood is after 6-8 hours.

Effectiveness:

It is highly effective in both types I and II diabetes. However, if you feel low blood sugar, you should readily consult your doctor.

Forms in which Levemir is available:

As we have discussed, Levemir comes in many forms and brands. So it is available as Levemir flex touch pen and Levemir 10ml vials. With the help of a flex touch pen, you can take a maximum dose of 80 units. In 10ml bottles, each 1ml contains 100 units of insulin.

How should Levemir be used?

Preferably Levemir should be used at night. A question arises in mind why Levemir take at night?  Because insulin need is maximum at night and early morning so. Moreover, you should also follow insulin dosing guidelines by your medical specialist.

Use during pregnancy

During studies, Levemir is found safe for pregnant women. But it should be used after the doctor’s advice.

Use during lactation

Although insulin is present in human milk, Levemir passes into breast milk is not known yet. So lactating mothers should talk to their doctor before starting Levemir.

Side-effects of Levemir:

Many side effects of Levemir have been observed. Some common are:

1. Hypoglycemia:

Means a low blood sugar level. Common symptoms include

• Cold sweating
• Feeling faint
• Not able to speak
• Convulsions
• Loss of consciousness
• Confusion
• Hunger

These symptoms can be reversed by eating something. However, if the condition persists long immediately consult your doctor.

2. Allergic reactions:

Sometimes you may experience common allergic reactions. That include

• Skin rash
• Itching
• Redness of the skin

While signs of severe allergy include:

• Swelling of hands, eyelids or lips, etc
• Difficulty in breathing

You should consult a doctor if you face any allergy.

3. Weight gain:

You may also gain weight if using Levemir. Although this weight gain is less as compared to other insulin. But if you are much concerned about your weight gain, then you should consult some doctor nearby. People using insulin NPH gain more weight than those using Levemir.

Interaction of Levemir with other drugs:

Levemir can be used with other drugs like metformin to control blood sugar levels. It can also be taken with mealtime insulins to control blood sugar quickly. However, with certain other drugs, it can cause serious consequences.

For example, Levemir with thiazolidinedione can affect your heart and cause a heart attack. Similarly, taking Levemir with certain other diabetic drugs may cause hypoglycemia. These include Glucotrol and Symlin etc.

Levemir vs. Lantus:

Do you know the difference between Levemir and Lantus? No! Let me tell you about some common variations. Levemir and Lantus are brand names of insulin detemir and insulin glargine.

Levemir and Lantus are both injectible and long-lasting insulins. Levemir contains a solution of insulin detemir, while Lantus includes a resolution of insulin glargine. Both have slightly different formulas.

Besides this, there is some difference in their side effects. Levemir causes less weight gain than Lantus. At the same time, Lantus has fewer skin reactions than Levemir.

Lantus may have more serious effects on mitochondria.

Levemir can stay for 42 days if open, but Lantus can stay only for 28 days.

What is the difference btw insulin detemir and insulin glargine?

Although there is no significant difference between insulin detemir and insulin glargine, some differences still exist. Do you know what that difference is? Really no?? Insulin glargine absorbs more slowly than insulin detemir. It is so because insulin glargine is less soluble under the skin as compared to insulin detemir.

Further information

Remember that the dosage of any insulin depends on the following factors

• Your weight and age
• Condition of your blood sugar levels
• You’re other medical complications if you have any.

Some key points:

While using any insulin, keep some key points in mind.

• You should have an insulin dosing chart by your doctor.
• You should know how much Levemir is too much
• Never inject insulin directly into a vein or any blood vessel.
• Use insulin after rubbing between your hands.
• Do not freeze insulin. Just keep it in some cold place.
• Keep insulin away from direct sunlight.
• Do not use Levemir or Lantus if it is not clear and appears foggy.

FAQs

What is the difference between type I and type II diabetes?

Both types I and type II diabetes differ in the cause. Type I diabetes is caused when your pancreas stops producing insulin. But in Type II diabetes, insulin is produced, but your cells cannot use it. Moreover, Type I diabetes is common in children and adolescents. But type II diabetes is common in older people.

Can Levemir be used as a replacement for Lantus?

No. Although both Levemir and Lantus are almost similar drugs. But you cannot use them as an alternative. Furthermore, you cannot use them together. But you should use any one of them at a time. Using Levemir needs a doctor’s guidance.

Which is the best time to take Levemir?

The best time to take Levemir is at night. Because at night and in the early morning, your insulin needs are high.

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