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Levemir vs Humalog
Introduction
For patients with diabetes, insulin-based medications like Levemir and Humalog can help manage blood sugar levels. These two drugs are both types of insulin but they work differently in the body and have different dosing schedules to control hyperglycemia (high blood sugar). Levemir is a long-acting basal insulin that provides consistent glucose level control for up to 24 hours, mimicking the function of naturally-produced background insulin. On the other hand, Humalog is a fast-acting or 'bolus' insulin designed to be taken at meal times to handle the rapid rise in blood glucose associated with meals. It begins working within 15 minutes after injection, peaks approximately one hour later, and continues working for two to four hours.
Levemir vs Humalog Side By Side
| Attribute | Levemir | Humalog |
|---|---|---|
| Brand Name | Levemir | Humalog |
| Contraindications | Should not be used if allergic to any of its ingredients or if you have episodes of hypoglycemia without awareness. Beta-blockers can mask symptoms of hypoglycemia. Thiazolidinediones (TZDs) used with Levemir could increase the risk of serious heart failure. | Should not be used if allergic to any of its ingredients or if you have episodes of hypoglycemia without awareness. Careful monitoring needed as it can lower blood glucose substantially within just half an hour. |
| Cost | Averages around $300 for a 10 mL vial (1000 units) | Averages around $350 for a 10 mL vial |
| Generic Name | Insulin detemir | Insulin lispro |
| Most Serious Side Effect | Severe hypoglycemia, allergic reactions, breathing problems, sudden weight gain, swelling of the ankles, feet, unusually weak or tired | Signs of an allergic response, low potassium levels (hypokalemia), severe hypoglycemia, hyperglycemia if not enough insulin is used |
| Severe Drug Interactions | Beta-blockers, Thiazolidinediones (TZDs) | Not specifically mentioned, but similar precautions as Levemir regarding beta-blockers and TZDs may apply |
| Typical Dose | Common starting dose for adults may range from 10-20 units per day, adjusted based on blood sugar levels | Dosage adjusted according to blood glucose measurements, usually administered before meals |
What is Levemir?
Insulin detemir (the generic name for Levemir) belongs to the class of long-acting insulins, which marked a significant advancement after the discovery of rapid-acting insulins like insulin lispro, represented by Humalog. The FDA first approved Insulin detemir in 2005. Levemir works by mimicking the basal secretion of insulin from our bodies, providing a low level of continuous action that can last up to 24 hours. It is prescribed for both type 1 and type 2 diabetes as part of a regimen that may include mealtime insulin or other diabetes medications. Unlike Humalog, which acts quickly to manage blood sugar spikes associated with meals but wears off after several hours, Levemir has a slow onset and longer duration of action without pronounced peaks in its glucose-lowering profile making it less likely than some other insulins to cause hypoglycemia.
What conditions is Levemir approved to treat?
Levemir is approved for the management of blood sugar levels in patients with diabetes:
- Type 1 diabetes, where it can be used in adults and children as young as two years old
- Type 2 diabetes, where it can be used in adults when diet and exercise alone does not result in adequate glycemic control.
On the other hand, Humalog is also approved to treat both types of diabetes but works more rapidly than Levemir:
- It's used to improve glycemic control in adults and children with type 1 or type 2 diabetes.
How does Levemir help with these illnesses?
Levemir helps to manage diabetes by mimicking the function of insulin, a hormone that enables cells to absorb glucose and use it for energy. Unlike regular insulin, Levemir is designed to provide a slow, steady release of insulin over 24 hours. It does this by binding with albumin in the bloodstream and gradually detaching throughout the day or night. Glucose is a simple sugar that provides energy for the body, but too much glucose can damage organs over time. Therefore, managing blood sugar levels is crucial in individuals with diabetes.
On the other hand, Humalog acts faster than Levemir and its primary role is to control blood sugar levels during meals or snacks and upon administration will start working within minutes which lasts up to few hours. Both serve significant roles in maintaining balanced blood sugar levels for individuals living with type 1 or type 2 diabetes but are used at different times depending on immediate versus long-term needs.
What is Humalog?
Humalog is a brand name for insulin lispro, which is a rapid-acting human insulin analog. It works by lowering levels of glucose (sugar) in the blood, and it's typically used to control high blood sugar in adults and children with diabetes. Humalog functions similarly to natural insulin produced by the pancreas but has a quicker onset and shorter duration of action compared to regular human insulin.
Unlike Levemir, an intermediate or long-acting basal insulin that provides consistent glucose-lowering effect with less risk for hypoglycemia, Humalog acts quickly after injection to regulate post-meal spikes in blood sugar. It was first approved by the FDA in 1996.
One distinguishing feature about Humalog is its ability to act rapidly while not persisting too long in the body preventing extended periods of low blood sugars which can be dangerous - these attributes make it ideal for use around meal times when swift yet temporary adjustments are necessary. This unique property makes it quite different from other types like Levemir where steady glucose control over a protracted period is required rather than immediate impact.
What conditions is Humalog approved to treat?
Humalog is a fast-acting insulin approved for use in treating both type 1 and type 2 diabetes. It can be used to control high blood sugar levels in the following conditions:
- Type 1 Diabetes, where the body does not produce insulin
- Type 2 Diabetes, where either the body does not make enough insulin or cannot efficiently utilize it
How does Humalog help with these illnesses?
Insulin is a hormone that regulates the amount of glucose (sugar) in the blood and is required for cells to function normally. Humalog, a rapid-acting insulin, works by mimicking the body's natural response to meals and quickly lowers blood sugar levels. It starts working within 15 minutes after injection, peaks approximately one hour later, and continues to work for two to four hours. This makes it particularly useful for controlling blood sugar levels during meals or snacks and correcting high blood sugars. On the other hand, Levemir is a long-acting insulin used primarily to control blood sugar levels between meals and throughout the night. Unlike Humalog which has an immediate effect on glucose metabolism, Levemir provides stable baseline coverage over 24 hours with less risk of hypoglycemia but doesn't cover insulin needs arising from food intake as effectively as Humalog does.
How effective are both Levemir and Humalog?
Insulin detemir (Levemir) and insulin lispro (Humalog) both have strong track records in managing blood glucose levels for patients with diabetes, receiving FDA approval only a few years apart. They act on different aspects of the body's insulin needs, so they may be prescribed under different circumstances. Levemir is a long-acting basal insulin used to control blood sugar throughout the day, while Humalog is a rapid-acting bolus insulin taken at meal times to prevent postprandial hyperglycemia.
A 2008 clinical trial directly compared Levemir and another long-acting insulin analog against mealtime use of Humalog. The study found that Levemir had similar efficacy in controlling fasting plasma glucose levels as other basal insulins but was associated with less nocturnal hypoglycemia.
A 2012 review noted that Levemir reduces fasting plasma glucose effectively starting from the first week of treatment, has a good safety profile relative to other long-acting insulins, and can be safely used across various populations including elderly and pregnant women. In this same report it was stated that since its introduction into the market as one of the newer generation basal insulins, there has been significant study proving its effectiveness in maintaining glycemic control over 24 hours.
On the other hand, studies support Humalog being more effective than regular human insulin in reducing post-meal spikes in blood sugars due to its rapid onset action after administration just before meals. However, it is usually given together with longer acting insulins or oral diabetic medications for complete daily glycemic management as it does not provide basal coverage.
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At what dose is Levemir typically prescribed?
Dosages of Levemir, an insulin medication used to control blood sugar in people with diabetes, can vary widely depending on the individual's needs. However, a common starting dose for adults may range from 10-20 units per day. It can be adjusted every few days based on the patient's blood sugar levels. Children and adolescents' dosage should always be determined by their healthcare provider based on their specific requirements.
On the other hand, Humalog is a fast-acting insulin often taken before meals. The dosage depends heavily on food intake and physical activity but usually starts at around 4-6 units per meal for adults. Similar to Levemir, children and adolescents should have their dosages determined by a healthcare professional familiar with their case.
In both medications, no maximum dosage limit applies universally as it highly depends upon individual response and need; however one must always adhere strictly to the prescribed amount due to potential risks associated with incorrect insulin usage.
At what dose is Humalog typically prescribed?
Humalog treatment is typically initiated with a dosage that matches the individual's needs, which can vary widely from person to person. The dose of Humalog should be adjusted according to blood glucose measurements. It is usually administered before meals due to its rapid onset of action. The maximum daily dose will depend on your individual insulin requirements; however, it should not exceed more than 60 units per injection site or 200 units in total per day. If there is no response to treatment after a few weeks, further medical evaluation and adjustment may be necessary. Always remember that Humalog dosages need careful monitoring as they can lower blood glucose substantially within just half an hour.
What are the most common side effects for Levemir?
Common side effects of Levemir (insulin detemir) may include:
- Hypoglycemia (low blood sugar)
- Allergic reactions
- Injection site reactions (redness, swelling, itching at the injection site)
- Weight gain
- Headache
On the other hand, Humalog (insulin lispro) shares some similar side effects but can also cause:
- Lipodystrophy (fat redistribution or accumulation in certain parts of your body)
- Hypokalemia (low potassium levels)
- Swelling of extremities Remember to consult a healthcare provider if you experience any adverse effects from these medications.
Are there any potential serious side effects for Levemir?
Levemir and Humalog are both insulin medications, but they affect the body in slightly different ways and can have different side effects. Serious potential side effects of Levemir include:
- Severe hypoglycemia or low blood sugar symptoms: shaking, fast heartbeat, sweating, blurred vision, dizziness or fainting spells
- Signs of an allergic reaction such as skin rash; itching or hives; swelling of the face, lips or tongue
- Breathing problems
- Sudden weight gain
- Swelling of the ankles, feet
- Unusually weak or tired
On the other hand, serious potential side effects for Humalog may include:
- Symptoms related to a drop in your potassium level like muscle cramps or weakness, irregular heartbeats, feeling dizzy, severe stomach pain or confusion.
If you experience any above mentioned symptoms while taking either Levemir or Humalog you should seek medical attention immediately.
What are the most common side effects for Humalog?
Humalog, a fast-acting insulin, can lead to some side effects. These may include:
- Hypoglycemia (low blood sugar)
- Weight gain
- Mild rash or itching at the injection site
- Headache and dizziness
- Muscle pain or weakness
- Swelling in your hands or feet due to fluid retention
- Changes in vision
- Increased heart rate and feeling jittery or anxious. In rare cases, Humalog might cause serious allergic reactions. Always consult with your healthcare provider for any concerns about side effects.
Are there any potential serious side effects for Humalog?
While Humalog is generally safe and effective, it can occasionally cause serious side effects. These may include:
- Signs of an allergic response: hives, itching, difficulty breathing or swallowing; swelling in your face, lips or throat
- Low potassium levels (hypokalemia), leading to muscle cramps, weakness or irregular heartbeats
- Hypoglycemia (low blood sugar) with symptoms such as dizziness, sweating, confusion and rapid heartbeat
- Hyperglycemia (high blood sugar) if not enough insulin is used – this may lead to frequent urination, increased thirst and hunger.
- Swelling in your hands and feet -Sudden mood changes
If you notice any of these signs while using Humalog, it's important that you seek medical attention immediately.
Contraindications for Levemir and Humalog?
Both Levemir and Humalog, as with most other insulin medications, may cause hypoglycemia (low blood sugar) in some individuals. If you notice symptoms of low blood sugar such as sudden sweating, nervousness, hunger, weakness or dizziness please seek immediate medical attention.
Neither Levemir nor Humalog should be used if you are allergic to any of its ingredients or if you have episodes of hypoglycemia without awareness. Furthermore, it's important to always inform your physician about all the medications you're currently taking; certain drugs can interact negatively with both Levemir and Humalog requiring potential dosage adjustments for safety.
For example, beta-blockers can mask the symptoms of hypoglycemia while thiazolidinediones (TZDs), which are used in combination with insulin therapy including Levemir and Humalog could increase the risk of serious heart failure. Always communicate openly with your doctor about all medication use for optimal diabetes management.
How much do Levemir and Humalog cost?
For the brand name versions of these insulin medications:
- The price of a 10 mL vial (1000 units) of Levemir averages around $300, which works out to about $9-$30/day based on an average daily dose range from 10 to 35 units.
- The price for a similar quantity (10 mL vial) of Humalog is slightly higher, averaging around $350, coming out to approximately $14–$35/day when using an equivalent dosage.
This implies that if you are in the higher dosage range for Levemir (i.e., over 30 units per day), then brand-name Humalog could potentially be less expensive on a per-day treatment basis. Remember that cost should not be your primary consideration in deciding which medication is best suited for your needs.
Currently there are no generic versions available for either Levemir or Humalog. However, there are lower-cost biosimilar alternatives like Basaglar and Admelog respectively:
- A single pack containing five KwikPens each with three milliliters of Basaglar (equivalent to ~1500 units total) costs between $260 and $315 depending on where you buy it. That equates to roughly between $5.20 and $6.30 per day at typical dosages ranging from 15 up to 50+ units.
- Similarly priced is Admelog, also comes as a pen-injector set - five pens each loaded with three milliliters form one package costing anywhere between about $280 and up towards almost twice that amount ($530). As such the daily cost can vary greatly; starting from just under six dollars ($5.60) upwards past twenty bucks within standard usage ranges (~15 – circa fifty-plus [50+] IU).
Popularity of Levemir and Humalog
Insulin detemir, known by the brand name Levemir, was prescribed to approximately 1.4 million individuals in the United States in 2020. As a long-acting insulin, it is often used as a basal (background) insulin to control blood sugar levels throughout the day and night. It accounts for about 15% of all long-acting insulin prescriptions.
Insulin lispro, available under brands like Humalog, was prescribed to around 2.7 million people in the USA during the same period. This fast-acting insulin is typically administered at meal times and accounts for roughly 29% of rapid-acting insulin prescriptions in America.
The usage prevalence ratio between these two insulins has remained relatively constant over recent years; however, there's an overall increase observed due to rising rates of diabetes management.
Conclusion
Both Levemir (insulin detemir) and Humalog (insulin lispro) are vital in the management of diabetes, with a proven track record backed by numerous clinical studies showing that they effectively lower blood sugar levels. Sometimes, these insulins may be used together as part of an individual's overall insulin therapy plan, but this is always subject to careful consideration by a healthcare professional due to their different timings and durations of action.
Levemir is a long-acting insulin typically administered once or twice daily to provide basal glucose control, while Humalog is a rapid-acting insulin taken right before or after meals to manage post-meal spikes in blood sugar. Thus, they are prescribed under different circumstances based on patients' needs for basal or prandial coverage.
As prescription medications available only in branded form currently, both Levemir and Humalog can be quite expensive especially for those paying out-of-pocket. It might take some time for individuals starting these therapies to notice an improvement in their glycemic control as dose adjustments may be needed according to blood glucose monitoring results.
The side effect profile between the two insulins is similar: hypoglycemia being the most common one but with Levemir slightly less likely than Humalog to cause severe low blood sugars. Patients should watch closely for symptoms of hypoglycemia such as shakiness, sweating or confusion when using either drug and seek medical help immediately if experiencing serious hypo events.
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Refrences
- De Leeuw, I., Vague, P., Selam, J. ‐L ., Skeie, S., Lang, H., Draeger, E., & Elte, J. W. F. (2004, November 10). Insulin detemir used in basal‐bolus therapy in people with type 1 diabetes is associated with a lower risk of nocturnal hypoglycaemia and less weight gain over 12 months in comparison to NPH insulin. Diabetes, Obesity and Metabolism. Wiley.http://doi.org/10.1111/j.1463-1326.2004.00363.x
- Jovanovic, L., Giammattei, J., Acquistapace, M., Bornstein, K., Sommermann, E., & Pettitt, D. J. (2004, September). Efficacy Comparison between preprandial and postprandial insulin aspart administration with dose adjustment for unpredictable meal size. Clinical Therapeutics. Elsevier BV.http://doi.org/10.1016/j.clinthera.2004.09.001
- Young, J. R., & Mcadam-Marx, C. (2010, January). Treatment of Type 1 and Type 2 Diabetes Mellitus with Insulin Detemir, a Long-Acting Insulin Analog. Clinical Medicine Insights: Endocrinology and Diabetes. SAGE Publications.http://doi.org/10.4137/cmed.s5330
- Keating, G. M. (2012, December). Insulin Detemir. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11470200-000000000-00000
- Gale, E. A. (1997, September). Insulin lispro:a new quick-acting insulin analogue. Expert Opinion on Investigational Drugs. Informa Healthcare.http://doi.org/10.1517/13543784.6.9.1247
- Mayerson, A. B. (2007, August). Levemir® Early Clinical Experience Case Series. Endocrinology and Metabolism Clinics of North America. Elsevier BV.http://doi.org/10.1016/s0889-8529(07)80007-7
- Funnell, M. M. (2007, September 25). Insulin detemir: A new option for the treatment of diabetes. Journal of the American Academy of Nurse Practitioners. Wiley.http://doi.org/10.1111/j.1745-7599.2007.00258.x