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Levemir vs Tresiba
Introduction
For individuals with diabetes, specific medications that can regulate blood glucose levels are vital in managing symptoms and preventing complications. Levemir and Tresiba are two such long-acting insulins prescribed for patients with both type 1 and type 2 diabetes. They each perform the same function of lowering high blood sugar levels but have different durations of action. Levemir is a long-acting insulin analog that starts to work several hours after injection and generally lasts for up to 24 hours or more. On the other hand, Tresiba classified as an ultra-long-acting basal insulin analog has an extended duration of action lasting beyond 42 hours which allows flexibility in dosing time for some patients.
Levemir vs Tresiba Side By Side
| Attribute | Levemir | Tresiba |
|---|---|---|
| Brand Name | Levemir | Tresiba |
| Contraindications | Should not be taken if there is a risk of adverse interaction with other medications. Requires consultation if there are kidney or liver diseases. | Should not be taken if there is a risk of adverse interaction with other medications. Requires consultation if there are kidney or liver diseases. |
| Cost | Around $500 for 5 pens (3 mL each) | Approximately $600 for 5 pens (3 mL each) |
| Generic Name | Insulin detemir | Insulin degludec |
| Most Serious Side Effect | Severe hypoglycemia leading to seizures or loss of consciousness | Severe hypoglycemia, allergic reactions, hypokalemia, or hyperglycemia |
| Severe Drug Interactions | May need dose adjustments if used alongside beta-blockers due to effects on blood sugar level responses. | May need dose adjustments if used alongside beta-blockers due to effects on blood sugar level responses. |
| Typical Dose | 0.1 to 0.2 units/kg/day, possibly divided into two doses | Starts with one-third to one-half of the total daily insulin requirements, adjusted based on monitoring |
What is Levemir?
Insulin detemir (the generic name for Levemir) and insulin degludec (the generic name for Tresiba) are both long-acting insulins used in the management of type 1 and type 2 diabetes. Insulin detemir was first approved by the FDA in 2005. It works by mimicking the function of naturally occurring insulin, which is to allow cells in the body to absorb sugar from your bloodstream, thus preventing high blood sugar levels after meals. Levemir has a consistent, peakless action profile with a duration of up to 24 hours.
In comparison, insulin degludec was first approved by the FDA much later, in 2016. Like Levemir it helps control blood sugar levels but tends to be more flexible and longer acting with a duration exceeding 42 hours if needed. This ultra-long action allows patients more flexibility around dosing times which can help improve adherence to treatment schedules.
Both medications have potential side effects including hypoglycaemia or low blood sugar; however research suggests that there's less risk of nocturnal hypoglycaemia with Tresiba than there is with Levemir due its extended duration of activity.
What conditions is Levemir approved to treat?
Levemir and Tresiba are both approved for the treatment of diabetes, but they have different applications:
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Levemir is used in the management of type 1 and type 2 diabetes for adults as well as children who are at least two years old. It provides a steady supply of insulin to control blood sugar levels throughout the day.
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Tresiba is also used in managing type 1 and type 2 diabetes. However, it's suitable for adults and pediatric patients who are at least one year old. Compared to Levemir, Tresiba has an even longer duration of action which can last up to 42 hours, providing a more flexible dosing schedule for patients.
How does Levemir help with these illnesses?
Levemir and Tresiba are both long-acting insulins that help manage blood sugar levels in individuals with diabetes. They work by mimicking the function of naturally occurring insulin, a hormone produced by the pancreas which regulates glucose uptake into cells from the bloodstream for energy production.
Levemir functions by binding to insulin receptors on cell surfaces, thereby facilitating glucose absorption and reducing high blood sugar levels. Its consistent release profile allows it to maintain its effects over a period of up to 24 hours, providing comprehensive coverage throughout the day.
On the other hand, Tresiba possesses an even longer duration of action than Levemir - up to 42 hours. It achieves this through multi-hexamer formation once injected subcutaneously; these hexamers gradually dissociate over time for slow, steady insulin release. This extended action can be particularly beneficial for patients requiring more flexible dosing schedules or those who experience significant fluctuations in their daily blood glucose readings. By maintaining consistently stable circulation of insulin within the body just like natural basal/bolus secretion pattern, both Levemir and Tresiba contribute towards better regulation of blood sugar levels and aid in effective management of diabetes.
What is Tresiba?
Tresiba, a brand name for insulin degludec, is a long-acting basal insulin analog that steadily releases insulin over 24 hours to control blood sugar levels in individuals with diabetes. Approved by the FDA in 2015, Tresiba functions by mimicking the action of natural insulin, thus aiding glucose absorption from the bloodstream and into cells. As it's not an intermediate-acting insulin like Levemir (insulin detemir), it does not peak then taper off but maintains constant levels thereby offering more predictable blood sugar control. Its unique mechanism allows for flexible dosing times if necessary without sacrificing glycemic control or increasing hypoglycemia risk - common issues with other insulins such as Levemir. The more stable coverage that Tresiba provides can be particularly beneficial for patients who struggle with maintaining consistent injection routines or those who have shown less optimal response to other basal insulins like Levemir.
What conditions is Tresiba approved to treat?
Tresiba, a long-acting insulin, is approved for the treatment of both type 1 and type 2 diabetes in adults. It offers flexible dosing times and has been proven to manage blood sugar levels effectively. The conditions it aids include:
- Type 1 Diabetes Mellitus
- Type 2 Diabetes Mellitus
How does Tresiba help with these illnesses?
Insulin degludec, the active ingredient in Tresiba, is a long-acting insulin analog that helps control glucose levels in the body. It works by mimicking your body's natural insulin response, albeit with a longer duration of action compared to other insulins such as Levemir (insulin detemir). The extended action of Tresiba means it has a more steady effect on blood sugar levels across 24 hours and beyond. This can be beneficial for patients who need consistent glucose control and prefer less frequent injections. Similar to how Wellbutrin increases norepinephrine availability for better management of depression symptoms, Tresiba provides lasting insulin activity for optimized diabetes management. Unlike some SSRI antidepressants like Prozac that mainly impact serotonin levels, both Levemir and Tresiba work on regulating blood sugar - but it's often the prolonged effect of Tresiba that might make it a preferred choice over Levemir for certain individuals.
How effective are both Levemir and Tresiba?
Both insulin detemir (Levemir) and insulin degludec (Tresiba) are long-acting basal insulins used in the management of both type 1 and type 2 diabetes, with similar safety profiles. They were approved by the FDA a few years apart, Levemir in 2005 and Tresiba in 2015.
A head-to-head comparison study conducted between these two insulins demonstrated that both drugs had comparable glucose-lowering effects. However, there was a slight difference when it comes to duration of action: Tresiba has an ultra-long duration of over 42 hours compared to Levemir's up to 24-hour duration. This longer action provides more flexibility regarding injection timing for patients using Tresiba.
A systematic review published in Diabetes Research and Clinical Practice suggested that both Levemir and Tresiba effectively control blood sugar levels without causing hypoglycemia or weight gain. Furthermore, many patients prefer them due to their straightforward dosage regimen - once-daily dosing is usually sufficient for most individuals.
Although more research is needed, some studies suggest that people taking Tresiba may have fewer episodes of low blood sugar at night than those taking Levemir. Despite this potential advantage for certain patient populations who struggle with nocturnal hypoglycemia, choice between the two medications will largely depend on individual health needs as well as insurance coverage options.
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At what dose is Levemir typically prescribed?
Injectable dosages of Levemir, a long-acting insulin, vary based on the individual's needs but typically range between 0.1 to 0.2 units/kg/day. The dose may be divided and given twice daily if needed for adequate glucose control. On the other hand, Tresiba, another long-acting insulin, is usually started at a dosage of approximately 10 units per day in adults or adolescents depending on their weight and overall health status; however this can be adjusted up or down as necessary over time. Children might start with a lower dose according to their body size and need. With both Levemir and Tresiba, it’s crucial that one never exceeds the prescribed dosage without consulting with healthcare providers due to potentially serious hypoglycemic effects.
At what dose is Tresiba typically prescribed?
Tresiba treatment, also known as insulin degludec, usually starts with a dosage tailored to the individual's needs. It is advised to begin Tresiba at one-third to one-half of the total daily insulin requirements. The dose can then be adjusted based on blood glucose monitoring results and clinical judgement. Tresiba provides up to 42 hours of action offering flexibility in day-to-day dosing time when needed. Importantly, it should not be administered more frequently than once every 24 hours. If there is no response after several weeks or your blood sugar levels are consistently above target range even with daily administration, consult your health care provider for possible adjustments.
What are the most common side effects for Levemir?
Potential side effects of Levemir and Tresiba, both long-acting insulin medications, may include:
- Hypoglycemia (low blood sugar)
- Reactions at the injection site such as pain or rash
- Weight gain
- Swelling in your hands and feet
- Itching, localized allergic reactions
- Lipodystrophy (changes in skin thickness around the injection site)
- Dry mouth or throat
Remember that not everyone experiences all these side effects. However, if you do experience any unusual symptoms while taking either of these medications, it is important to consult with your healthcare provider promptly.
Are there any potential serious side effects for Levemir?
In rare instances, both Levemir and Tresiba can lead to serious side effects. These may include:
- Signs of an allergic reaction: hives, difficulty breathing, swelling of your face or throat
- Low potassium levels in the body - symptoms may include leg cramps, constipation, irregular heartbeats or fluttering in your chest
- Hypoglycemia (low blood sugar) - signs include headache, hunger, sweating, irritability,dizziness,fast heart rate,and feeling anxious or shaky
- Lipodystrophy (changes in skin at the injection site)
- Rapid weight gain with no clear reason
- Swelling in your hands and feet
In extremely rare cases severe hypoglycemia can cause seizures and loss consciousness. If you experience any of these severe symptoms while using either Levemir or Tresiba seek medical help immediately.
What are the most common side effects for Tresiba?
Tresiba, as an insulin drug, might bring about side effects such as:
- Injection site reactions (pain, redness, or irritation)
- Weight gain
- Headache
- Tiredness
- Rash or itching at the injection site
- Back pain
- Cold symptoms like stuffy nose, sneezing, and sore throat.
Most notably though is the risk of low blood sugar (hypoglycemia), which may cause symptoms such as sweating, tremors, fast heartbeat and confusion. It's crucial to monitor your blood glucose levels regularly when on Tresiba to prevent this.
Are there any potential serious side effects for Tresiba?
While Tresiba is generally well tolerated, there are certain serious side effects that you should be aware of:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Low potassium level (hypokalemia): leg cramps, constipation, irregular heartbeats, fluttering in your chest and increased thirst or urination
- Hypoglycemia (low blood sugar): headache, hunger weakness confusion irritability dizziness fast heartbeat sweating shaking faintness or having a seizure
- Hyperglycemia (high blood sugar): frequent urination dry mouth increased thirst fruity breath odor unexplained weight loss nausea vomiting stomach pain tiredness trouble focusing vision changes shortness of breath rapid shallow breathing
- Kidney problems: little to no urinating painful difficult urination swelling in your feet or ankles feeling tired shortness of breath
If you experience any such symptoms after starting Tresiba therapy it's crucial to contact your healthcare provider immediately.
Contraindications for Levemir and Tresiba?
Levemir and Tresiba, similar to most other insulin medications, may cause hypoglycemia (low blood sugar) in some people. If you notice symptoms of low blood sugar such as sudden sweating, shaking, fast heartbeat, hunger, blurred vision or dizziness please seek immediate medical attention.
You should not take Levemir or Tresiba if you are already taking any medication that could interact with them adversely. Tell your doctor about all the medications you are currently using including over-the-counter drugs and herbal supplements; this will help prevent dangerous interactions.
Furthermore, both Levemir and Tresiba might need dose adjustments if used alongside certain medications like beta-blockers which can affect how your body responds to symptoms of low blood sugar levels. Always consult a healthcare provider before starting on these insulins especially if you have kidney or liver disease because these conditions can change how long the drug stays effective in your system.
How much do Levemir and Tresiba cost?
For the brand name versions of Levemir and Tresiba:
- The price for 5 pens (3 mL each) of Levemir averages around $500, which works out to about $10 per day if you use a dose of 0.6 units/kg/day.
- The price for 5 pens (3 mL each) of Tresiba is approximately $600, which comes out to roughly $12 per day at a dosage rate of 0.4–0.8 units/kg/day.
Therefore, if you are using higher dosages (i.e., closer or equal to the maximum recommended), then brand-name Levemir tends to be less expensive on a daily basis than Tresiba. However, cost should not be your primary consideration when deciding between these two options.
As insulin products, neither Levemir nor Tresiba currently has generic equivalents available in the market due to their biological nature and complex manufacturing processes:
- Insulin detemir (Levemir) and insulin degludec (Tresiba) are both long-acting insulins used in managing diabetes mellitus type I or II.
Please note that prices can vary significantly depending on individual insurance coverage and pharmacy rates so it's always advisable to check with your healthcare provider or pharmacist for more accurate pricing information based on your specific circumstances.
Popularity of Levemir and Tresiba
Insulin detemir, also known by the brand name Levemir, was estimated to be prescribed to about 2.9 million people in the US in 2020. It accounted for just under 16% of basal insulin prescriptions in the US. This long-acting insulin provides a steady level of insulin over a long period and has been steadily popular since its introduction.
Insulin degludec, or Tresiba as it is more commonly known, was prescribed to roughly 1.8 million individuals in the USA during 2020. In terms of basal insulin prescriptions within the country, Tresiba accounts for nearly 10%. Despite being newer to the market compared with other insulins like Levemir, use of Tresiba has shown an increasing trend over recent years due to its ultra-long duration of action up to 42 hours which allows more flexibility around dosing time compared with other long acting insulins.
Conclusion
Both Levemir (insulin detemir) and Tresiba (insulin degludec) are long-acting insulin used in the management of both type 1 and type 2 diabetes. They have been proven efficient through numerous clinical trials, showing that they can effectively maintain blood glucose levels within a normal range for extended periods. Due to their different durations of action, with Levemir being effective for up to 24 hours and Tresiba lasting even longer - up to 42 hours, they may be prescribed under different circumstances.
Levemir is often given once or twice daily depending on the patient's needs while Tresiba has more flexibility due to its longer duration, allowing it to be taken at any time of day.
Both medications are available in generic form which provides considerable cost savings especially for patients paying out-of-pocket. Both Levemir and Tresiba require an initial period where dosage adjustments might be needed before optimal blood sugar control is achieved.
The side effect profile is somewhat similar between the two insulins; common side effects include hypoglycemia (low blood sugar), weight gain, allergic reactions and injection site reactions. However, because each person responds differently to medication based on various factors like other medical conditions or concomitant drugs use , it's essential that individuals closely monitor their blood glucose levels when starting treatment or adjusting doses.
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Refrences
- Dżygało, K., Golicki, D., Kowalska, A., & Szypowska, A. (2014, November 28). The beneficial effect of insulin degludec on nocturnal hypoglycaemia and insulin dose in type 1 diabetic patients: a systematic review and meta-analysis of randomised trials. Acta Diabetologica. Springer Science and Business Media LLC.http://doi.org/10.1007/s00592-014-0604-0
- Home, P., Bartley, P., Russell-Jones, D., Hanaire-Broutin, H., Heeg, J.-E., Abrams, P., … on behalf of the Study to Evaluate the Administration of Detemir Insulin Efficacy, Safety and Suitability (Steadiness) Study Group. (2004, May 1). Insulin Detemir Offers Improved Glycemic Control Compared With NPH Insulin in People With Type 1 Diabetes. Diabetes Care. American Diabetes Association.http://doi.org/10.2337/diacare.27.5.1081
- Keating, G. M. (2013, April 26). Insulin Degludec and Insulin Degludec/Insulin Aspart: A Review of Their Use in the Management of Diabetes Mellitus. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-013-0051-1
- Keating, G. M. (2012, December). Insulin Detemir. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11470200-000000000-00000
- Stokes, V., & Gough, S. C. (2014, May 9). Recent advances with insulin degludec for the treatment of Type 2 diabetes. Expert Review of Endocrinology & Metabolism. Informa UK Limited.http://doi.org/10.1586/17446651.2014.917045
- Wysham, C., Bhargava, A., Chaykin, L., de la Rosa, R., Handelsman, Y., Troelsen, L. N., … Norwood, P. (2017, July 4). Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 2 Diabetes. Jama. American Medical Association (AMA).http://doi.org/10.1001/jama.2017.7117
- Fadini, G. P., Feher, M., Hansen, T. K., de Valk, H. W., Koefoed, M. M., Wolden, M., … Jendle, J. (2019, August 9). Switching to Degludec From Other Basal Insulins Is Associated With Reduced Hypoglycemia Rates: A Prospective Study. The Journal of Clinical Endocrinology & Metabolism. The Endocrine Society.http://doi.org/10.1210/jc.2019-01021