Insulin Glargine: Lantus vs. Levemir

When two new drugs hit the market, it can be hard to decipher the differences and make an educated decision on which is right for you. Levemir and Lantus solostar are an example of this conundrum. 

If you are one of the thirty million Americans with diabetes, insulin is far from a new concept for you. For everyone else, here is a little catch-up; insulin is a hormone that regulates the blood sugar in the body. It is naturally created by the pancreas and works to move sugar from the blood to cells where it is turned into energy. People with diabetes are not able to control their blood sugar, either because the pancreas does not produce insulin or their body just cannot process sugar. Insulin can be monitored with diet and exercise, but sometimes people with diabetes need to take insulin to help keep things running smoothly.

With medical advances, there are now more insulin options available. Specifically, let’s talk long-acting insulins. Long-acting insulins, aka basal insulin, provide a similar effect as the insulin produced naturally by the pancreas. This is due to a slower release time. There are two new basal insulins available: Levemir and Lantus solostar.

Levemir and Lantus are popular right now so here is everything you should know about Levemir and Lantus when considering them as insulin options.  

What are the similarities between Levemir and Lantus?

Levemir and Lantus are similar. Both Levemir and Lantus are insulin analogues. Insulin analogues are called such because they are engineered to be analogous to (aka. mimic) human insulin. They are man-made insulins that are injected into the subcutaneous tissue. This is the layer of fat underneath the skin. Levemir and Lantus are both preferred over NPH insulin as they last longer, have less peak and less risk of hypoglycemia. Peak refers to moments of high blood sugar and hypoglycemia refers to moments of low blood sugar. Nobody wants their blood sugar on a rollercoaster ride all day. People with diabetes want things to stay as the middle of the road as possible with few ups and downs. This is why basal insulins are frequently prescribed. Levemir and Lantus are used for both Type 1 and Type 2 diabetes.

NOTE: Levemir and Lantus are both clear liquids that should never be frozen. Discard them if they appear cloudy or were potentially too cold. Keep them out of direct sunlight.

Which is more effective; Levemir or Lantus?

The similarities continue. Studies have shown that Levemir and Lantus are both effective in regulating blood sugar throughout the day. They both do the job.

How are Levemir and Lantus absorbed?

On a molecular level, they are engineered differently. Lantus is an insulin glargine, meaning it is created with human insulin that is genetically modified. Levemir is an insulin detemir created by genetically engineered insulin. They both have unexpected beginnings; Lantus with E.Coli and Levemir with baker’s yeast. Science has a way of turning lemons into lemonade. There are definitely more specifics in their molecular differences but what it all comes down to is how each is absorbed by the body.

A huge difference between Levemir and Lantus is how they are engineered to release into the bloodstream. Levemir releases slowly because when the solution is injected, it undergoes a reaction at the injection site that makes it a neutral pH. At a neutral pH, Levemir becomes non-soluble, keeping it from being absorbed into the bloodstream. As Levemir slowly returns to the correct pH, it becomes soluble again. It reaches a max concentration in the blood about 6 to 8 hours after injection.

Upon injection, Lantus solostar sticks to itself in the fat of the injection spot. From here, Lantus solostar is slowly absorbed. But it does not go straight to the bloodstream. It attaches to proteins called albumin. It is here that the Lantus slowly detaches from the protein to enter the bloodstream. This allows Lantus to absorb more steadily than Levemir, so there is not that same moment of peak concentration.

What are the different side effects of Levemir and Lantus?

Lantus and Levemir are similar in effectiveness. So when deciding between Lantus and Levemir, it is best to consider their side effects. Levemir has greater chances of skin reactions at the injection site. Lantus solostar has a slightly higher chance of weight gain, the risk of a peak, and hypoglycemia at nighttime. Both have risks of allergic reactions.

Do Levemir and Lantus cost the same?

Usually, health insurance companies will only cover either Lantus or Levemir, not both at the same time.  So being in the position to decide between the two based on price is rare. While costs can vary, generally Levemir is more expensive than Lantus. Levemir is about $29 per ml while Lantus is about $13.54 per ml. Again, prices can vary.

Is there any other difference between Levemir and Lantus?

Lantus is administered once a day and can be taken by people over six years old. Levemir can be taken once or twice a day and can be taken by people over the age of two. While it is possible to take Levemir twice in a day be sure to space it out, with a preferred twelve hours difference between dosing.

Always consult a doctor when switching medications and follow dosing instructions carefully. If you can choose between these basal insulins, consider the price and the side effects.