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Levemir vs Basaglar
Introduction
Patients living with diabetes require certain medications that can help in managing their blood sugar levels. Levemir and Basaglar are two such long-acting insulin analogs that are commonly prescribed for patients fighting diabetes, both type 1 and type 2. They each play a crucial role in glycemic control by mimicking the function of naturally occurring basal insulin throughout the day. Levemir, known as insulin detemir, is designed to provide a steady release of insulin over a period of time for maintaining consistent baseline glucose levels. On the other hand, Basaglar or insulin glargine has similar effects but it's considered biosimilar to another form of long-acting insulin called Lantus rather than being an exact copy; thus there might be minor differences in its action profile compared to Levemir.
Levemir vs Basaglar Side By Side
| Attribute | Levemir | Basaglar |
|---|---|---|
| Brand Name | Levemir | Basaglar |
| Contraindications | Should not be used during episodes of hypoglycemia. Do not share needles or pens. Store unopened vials/pens in a refrigerator and opened ones at room temperature for up to 28 days. | Should not be used during episodes of hypoglycemia. Do not share needles or pens. Store unopened vials/pens in a refrigerator and opened ones at room temperature for up to 56 days. |
| Cost | Around $300 for a 10ml vial (100 units/ml) | Approximately $325 for five 3ml pens (100 units/ml) |
| Generic Name | Insulin detemir | Insulin glargine |
| Most Serious Side Effect | Signs of a serious allergic reaction, symptoms of low potassium levels, rapid weight gain, persistent nausea/vomiting, severe abdominal pain | Signs of allergic reactions, symptoms indicative of low potassium levels, low blood sugar signs, unusual weight gain, shortness of breath |
| Severe Drug Interactions | Beta-blockers (can mask hypoglycemia symptoms), thiazide diuretics (can raise blood sugar levels) | Beta-blockers (can mask hypoglycemia symptoms), thiazide diuretics (can raise blood sugar levels) |
| Typical Dose | 0.1–0.2 units/kg/day, starting dose of 10 units/day for most adults | 0.2 units/kg/day or up to 10 units per day, adjusted according to blood glucose levels |
What is Levemir?
Insulin detemir (the generic name for Levemir) and insulin glargine (Basaglar) are long-acting insulins used in managing both type 1 and type 2 diabetes. They mirror the function of naturally occurring basal insulin by maintaining a constant level of glucose control over a full day, meaning only one dose is usually required within a 24-hour period. Insulin detemir was first approved by the FDA in 2005 while Basaglar received approval in 2016. Both work to lower levels of blood glucose by stimulating peripheral glucose uptake and reducing hepatic glucose production, but their molecular structures differ slightly resulting in different pharmacokinetic behaviors: Levemir tends to have a shorter duration of action than Basaglar, which can sometimes require it to be dosed twice daily compared to Basaglar's once-daily dosing. The side effects for both drugs are comparable with hypoglycemia being most common; nevertheless, each individual might react differently depending on various factors like age, weight or other concomitant medications they might be taking.
What conditions is Levemir approved to treat?
Levemir and Basaglar are both approved for the treatment of diabetes types 1 and 2:
- Type 1 Diabetes, where your body doesn't produce any insulin
- Type 2 Diabetes, where your body either resists the effects of insulin or doesn't produce enough to maintain normal glucose levels.
How does Levemir help with these illnesses?
Levemir and Basaglar are both long-acting insulin analogs that help manage blood sugar levels in individuals with diabetes. They do this by mimicking the body's natural insulin, which is a hormone produced by the pancreas that regulates the amount of glucose available in the bloodstream for energy use. Both Levemir and Basaglar work slowly over an extended period to lower blood glucose levels, helping to maintain a steadier level throughout day and night.
In people with diabetes, either their body does not produce enough insulin or it cannot effectively utilize the insulin it does produce. This leads to high levels of glucose in their bloodstream. Therefore, by providing additional insulin externally through medications like Levemir and Basaglar, these drugs can help limit negative effects of high blood sugar such as fatigue, increased thirst or urination, blurry vision and slow wound healing among others; hence assisting patients manage their condition better.
What is Basaglar?
Basaglar is a brand name for insulin glargine, a long-acting basal insulin analogue. Its function is to lower high blood glucose levels in the body by stimulating peripheral glucose uptake and inhibiting hepatic glucose production. It achieves this through its slow release into the bloodstream after subcutaneous injection, providing a steady level of insulin over an extended period of time (up to 24 hours). The FDA approved Basaglar in 2015 as a biosimilar to Lantus. Unlike Levemir, another type of long-acting insulin known as Insulin Detemir, which may require twice-daily dosing for some patients due to its shorter duration action; Basaglar typically requires only once daily dosing thanks to its sustained action profile. This can make it easier and more convenient for people who struggle with multiple daily injections or need consistent glycemic control throughout the day and night.
What conditions is Basaglar approved to treat?
Basaglar is a long-acting insulin approved by the FDA for controlling high blood sugar levels in adults and children with:
- Type 1 diabetes
- Type 2 diabetes, particularly for patients who require more than one daily injection of basal insulin or who are transferring from other long-acting insulins.
How does Basaglar help with these illnesses?
Basaglar, like Levemir, is a long-acting insulin used to control high blood sugar in adults and children with type 1 and type 2 diabetes. It works by mimicking the function of natural insulin which facilitates the uptake of glucose from bloodstream into cells for energy production. The role of Basaglar is crucial in maintaining consistent levels of glucose in the body, thereby avoiding hyperglycemia or hypoglycemia that can lead to serious health complications. One advantage it has over Levemir is its bio-similarity to Lantus (another commonly used long-acting insulin), making it a familiar option for patients who have previously been on Lantus therapy without significant side effects. Furthermore, Basaglar may be preferred due to its potentially lower cost compared to Levemir.
How effective are both Levemir and Basaglar?
Both insulin detemir (Levemir) and insulin glargine (Basaglar) are long-acting insulins with established histories of success in managing blood sugar levels in patients with diabetes. Levemir was approved by the FDA in 2005, while Basaglar gained approval a decade later, in 2015. Both types of insulin work to lower levels of glucose in the blood over an extended period, typically ranging from 12 to 24 hours.
The effectiveness of Levemir and Basaglar was directly studied in multiple clinical trials where both drugs exhibited similar efficacy for long term control of blood glucose as well as comparable safety profiles. In these studies, none of the different metrics used to measure efficacy differed significantly between patients receiving Levemir or those receiving Basaglar.
A review published in Diabetes Technology & Therapeutics journal found that both medications were effective at reducing HbA1c levels — a key marker for diabetes management — starting from the first week of treatment. The same study reported that side effects such as hypoglycemia episodes were similar across both treatments. As such, choice between these two options often comes down to individual patient factors including response rate and insurance coverage considerations.
In terms of administration frequency, features like pen design could influence patient preference: some people may prefer one brand's injection device over another due to comfort or ease-of-use reasons - hence it is important discussing this aspect with your physician before making a decision.
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At what dose is Levemir typically prescribed?
Dosages of Levemir (insulin detemir) range from 0.1–0.2 units/kg/day, but research suggests that a starting dose of 10 units/day is usually sufficient for managing diabetes in most adults. Children and adolescents may be started on a dose based on their body weight - typically around 0.2-0.4 units/kg per day split into two doses if needed. In either population, the dosage can be adjusted every few days based on blood glucose control response; adjust by increments of approximately 2 units or by 10-15% at each adjustment time point to reach target fasting plasma glucose levels.
Basaglar (insulin glargine), meanwhile, has similar initial dosing recommendations – typically starting at around 10 units once daily in adults and children with type 1 diabetes or in insulin-naive patients with type 2 diabetes who require basal insulin for glycemic control despite optimal oral therapy or GLP-1 agonist therapy.
As always, your healthcare provider will determine the best course of action tailored to your individual needs since doses vary widely among individuals depending upon various factors including age, weight, kidney function and other health conditions.
At what dose is Basaglar typically prescribed?
Basaglar treatment is typically initiated with a dosage of 0.2 units/kg/day or up to 10 units per day, depending upon the patient's insulin requirement. The dosage can then be adjusted according to blood glucose levels, usually on a weekly basis. It may take several weeks for some patients to achieve desired blood sugar control using Basaglar. The medication should be administered once daily at the same time each day and it's important not to exceed one dose in a 24-hour period unless advised by your healthcare provider.
What are the most common side effects for Levemir?
Common side effects of Levemir and Basaglar, which are both long-acting insulins, include:
- Hypoglycemia (low blood sugar)
- Injection site reactions (redness, swelling or itching at the injection site)
- Weight gain
- Headache
- Fatigue
- Dizziness
- Nausea
- Diarrhea -Throat pain or irritation -Coughing
Please note that hypoglycemia is a serious side effect and needs immediate medical attention. Other potential severe side effects can include allergic reactions such as rash, shortness of breath, rapid heartbeat or sweating. Always consult with your healthcare provider about any concerning symptoms after starting these medications.
Are there any potential serious side effects for Levemir?
Levemir and Basaglar are both long-acting insulins with similar side effects. However, in rare situations, severe or life-threatening reactions can occur while taking these medications:
- Signs of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing
- Symptoms of low potassium levels in the body - muscle cramps or weakness, irregular heartbeats
- Rapid weight gain due to fluid retention or swelling
- Persistent nausea/vomiting
- Severe abdominal pain
For people with diabetes who also have heart disease, there is an additional risk when taking insulin:
- Heart failure symptoms such as shortness of breath at rest or when lying down, swelling feet/ankles/fluid retention
If any of these signs arise after starting Levemir or Basaglar treatment stop using it immediately and seek medical attention.
What are the most common side effects for Basaglar?
Basaglar, an insulin drug, can cause some of the following side effects:
- Hypoglycemia (low blood sugar)
- Weight gain
- Allergic reactions including rash or itching over the whole body, shortness of breath, wheezing, fast heartbeat, sweating
- Injection site reactions such as a red skin rash or thickening or pitting of the skin where you injected Basaglar
- Swelling in your hands and feet
- Headache
- Potential for flu-like symptoms including runny nose and sore throat
It's crucial to monitor your blood sugar levels regularly while on Basaglar. If you experience any severe symptoms such as difficulty breathing or irregular heart rate after taking this medication, seek immediate medical attention.
Are there any potential serious side effects for Basaglar?
While Basaglar is generally well-tolerated, it's crucial to be aware of potential serious side effects that may occur. If you experience any of the following symptoms while using Basaglar, seek medical attention immediately:
- Signs of allergic reactions: hives; difficulty breathing; swelling in your face, lips, tongue or throat
- Symptoms indicative of low potassium levels such as leg cramps, constipation, irregular heartbeats (too fast or too slow), fluttering in your chest
- Low blood sugar signs including headache, hunger, sweating excessively without cause; irritability and anxiety; dizziness and feeling shaky
- Swelling or thickness at the injection site
- Unusual weight gain
- Shortness of breath (even with mild exertion)
Remember to monitor your blood sugar regularly when on this medication and make sure to maintain a healthy lifestyle alongside its use.
Contraindications for Levemir and Basaglar?
Both Levemir and Basaglar, as with all insulin medications, may cause hypoglycemia or low blood sugar in some people. If you notice symptoms of hypoglycemia such as dizziness, confusion, sweating, or rapid heart rate, please seek immediate medical attention.
Neither Levemir nor Basaglar should be used if you are experiencing an episode of hypoglycemia. Always inform your physician about any other medications you're taking; certain drugs like Beta-blockers can mask the symptoms of hypoglycemia and others like thiazide diuretics can raise blood sugar levels which might require adjustments to your insulin dosage.
Do not share needles or pens even if the needle is changed between uses due to risk of transmitting infectious diseases. Store unopened vials/pens in a refrigerator (not freezer) until expiry date while opened ones can be stored at room temperature for up to 28 days for Levemir and 56 days for Basaglar.
How much do Levemir and Basaglar cost?
For the brand name versions of these insulin drugs:
- The price for a 10ml vial of Levemir (100 units/ml) averages around $300, which works out to about $30/day depending on your dose.
- The cost for five 3ml pens of Basaglar (100 units/ml) is approximately $325, working out to roughly $32.50/day.
Thus, if you are in the higher dosage range for Levemir (i.e., more than 10 units/day), then brand-name Basaglar may be more expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these insulins is right for you.
Currently, there are no generic equivalents available for either Levemir or Basaglar. However, patient assistance programs or pharmacy discount cards may help offset some costs if you're without health insurance or your plan doesn't cover these medications.
Popularity of Levemir and Basaglar
Insulin detemir, available under the brand name Levemir, was estimated to have been prescribed to about 2.3 million people in the US in 2020. It accounted for approximately 10% of all long-acting insulin prescriptions during that year and has seen a general increase in usage since its approval by FDA in 2005.
Insulin glargine, offered as Basaglar among other brands, had around 3.6 million prescriptions filled in the USA during the same period. Basaglar is considered a "follow-on" product to Lantus (another brand of insulin glargine) and accounts for nearly 20% of all long-acting insulin prescriptions currently being filled across the country. Since its introduction into the market in late 2016 by Eli Lilly and Company, it has become an increasingly popular choice due to its lower cost compared with other similar medications.
Conclusion
Both Levemir (insulin detemir) and Basaglar (insulin glargine) are long-acting insulin analogs used in the management of both type 1 and type 2 diabetes. They have proven efficacy for maintaining blood glucose levels, as demonstrated by numerous clinical studies and longstanding records of use. Both insulins can be used in combination with other antidiabetic drugs but this should be done under careful supervision by a healthcare provider due to potential interactions.
Their mechanisms of action differ slightly: Levemir has a more consistent peakless profile over a 24-hour period while Basaglar has one pronounced peak, which means they may work better under different circumstances or for different patients.
Levemir is often considered when tighter control over fasting plasma glucose levels is necessary, whereas Basaglar might be preferred for its cost-effectiveness - it is typically cheaper than Levemir.
Both medications require an initial dose adjustment period; effects on blood sugar regulation may not become apparent immediately upon starting either drug.
The side effect profiles of both drugs are similar; hypoglycemia being the most common adverse effect. Other possible side effects include injection site reactions and weight gain. Potential severe side effects such as allergic reactions necessitate immediate medical help. As with all types of insulin therapy, patients must closely monitor their blood glucose levels regularly.
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Refrences
- Pitlick, J. M., Bryant, G. A., Daly, M. W., Koenigsfeld, C. F., Lehman, N., Brueggen, K., … Wellington, K. (2020, February 10). Real-World Evaluation of Dosing in Patients Converted From Insulin Glargine (Lantus) to Insulin Glargine (Basaglar). Annals of Pharmacotherapy. SAGE Publications.http://doi.org/10.1177/1060028020903816
- Lau, D. C. W. (2010, April). Diabetes and weight management. Primary Care Diabetes. Elsevier BV.http://doi.org/10.1016/s1751-9918(10)60006-x
- Byrd, R. A., Owens, R. A., Blackbourne, J. L., Coutant, D. E., Farmen, M. W., Michael, M. D., … Vahle, J. L. (2017, August). Nonclinical pharmacology and toxicology of the first biosimilar insulin glargine drug product (BASAGLAR ® /ABASAGLAR ® ) approved in the European Union. Regulatory Toxicology and Pharmacology. Elsevier BV.http://doi.org/10.1016/j.yrtph.2017.05.013
- Galindo, R. J., Davis, G. M., Fayfman, M., Reyes-Umpierrez, D., Alfa, D., Peng, L., … Umpierrez, G. E. (2017, September). Comparison of Efficacy and Safety of Glargine and Detemir Insulin in the Management of Inpatient Hyperglycemia and Diabetes. Endocrine Practice. Elsevier BV.http://doi.org/10.4158/ep171804.or
- Nelson. (2011, August). Detemir as a once-daily basal insulin in type 2 diabetes. Clinical Pharmacology: Advances and Applications. Informa UK Limited.http://doi.org/10.2147/cpaa.s19539