Diabetes Management

Levemir, a Lengthy-Performing Insulin, Will Be Discontinued – Diabetes Every day

Final week, Novo Nordisk introduced that it plans to discontinue gross sales of Levemir in america. Folks with diabetes who use Levemir ought to plan now on transitioning to an alternate.

Levemir is available in two kinds, a vial and a “FlexPen.” FlexPen customers must change first: the producer states that provide disruptions will start in mid-January 2024 and that the treatment can be discontinued completely by April 1, 2024. Those that use Levemir in a vial have an extended time to transition: vials could also be accessible till the tip of 2024.

Why is Levemir going away? In a assertionthe producer defined that Levemir can be discontinued “due to global manufacturing constraints, formulary losses impacting patient access, and the availability of alternative options.”

It’s doable that Levemir gross sales have flagged after the introduction of quite a lot of lower-cost variations of a rival basal insulin, insulin glargine. Levemir prescriptions have dropped 23 p.c within the final 12 months, in keeping with SingleCarea web-based prescription financial savings service.

It’s also doable that Novo Nordisk needs to reinforce gross sales of its different (costlier) long-acting insulin, Tresiba. Or maybe the pharmaceutical big desires to commit extra of its manufacturing capability to the blockbusters Ozempic and Wegovy, which are available an identical injector pen machine.

On social media, some members of the diabetes group responded with skepticism. The non-profit T1International referred to as the transfer “indefensible.” Others commented that Levemir was the one basal insulin on their insurance coverage formulary, and feared that the change would imply a large number of crimson tape and better prices.

Regardless of the causes, this text will attempt to assist make sense of the transition that Levemir customers could must make.

Various Choices for Sort 1 Diabetes

For folks with sort 1 diabetes, who’ve an absolute want of insulin, Levemir customers will undoubtedly have to modify to a different long-acting insulin. Listed below are the choices:

  • Lantus (insulin glargine) — The nation’s best-selling long-acting insulin
  • Basalgar (insulin glargine) — An alternate that’s basically similar to Lantus
  • Rezvoglar (insulin glargine) — A “biosimilar” that’s basically similar to Lantus
  • Semglee (insulin glargine) — A “biosimilar” that’s basically similar to Lantus
  • Toujeo (insulin glargine) — a super-concentrated type of insulin glargine, that lively ingredient in Lantus, primarily used for sufferers that require bigger doses
  • Tresiba (insulin degludec) — Novo Nordisk’s different long-acting insulin, Tresiba lasts even longer than Levemir, which can improve dose timing flexibility
  • NPH (isophane insulin) — an intermediate-acting insulin. NPH is cheap however more difficult to make use of than Tresiba and will include a better danger of hypoglycemia.

It’s necessary to talk to your physician (and work together with your insurer) to study which insulins can be reasonably priced and work greatest for you. Inexpensive unbranded options might also be accessible.

Levemir’s discontinuation might also be an opportune time to debate an insulin pump, which makes use of solely speedy insulin.

Switching Insulins

Most sufferers switching from Levemir (insulin detemir) will start utilizing insulin glargine (Lantus and its many equivalents) or insulin degludec (Tresiba).

The Annals of Drugs has revealed a sensible steerage for healthcare practitioners on the right way to change basal insulins safely. In lots of instances, basal insulin dosages seem like completely interchangeable between formulations, which means that you simply received’t want to vary the quantity of insulin you are taking when switching. However the steerage states that “dose adjustment may be needed if switching from detemir to glargine,” which can be related to the big variety of folks switching from Levemir to any insulin within the Lantus household. Consultants advocate performing further blood glucose monitoring throughout the first weeks of transition.

Particular warning is required when switching from Levemir to NPH, which has a really totally different motion curve.

Any change of insulins ought to be achieved solely beneath the steerage of your medical workforce. The Diabetes Every day discussion board can be full of fine recommendation from people who have switched insulin formulations previously.

Various Choices for Sort 2 Diabetes

Folks with sort 2 diabetes who require a basal insulin could also be suggested to modify to an alternate insulin listed within the earlier part.

Clinicians could wish to take into account non-insulin options, too. In recent times, sort 2 diabetes authorities have systematically de-emphasized the usage of insulin in favor of each GLP-1 receptor agonists and SGLT2 inhibitors, newer medicines which might help enhance excessive blood sugars however add extra advantages that insulin can not: weight reduction, coronary heart and kidney safety, and a diminished danger of hypoglycemia.

Novo Nordisk’s personal GLP-1, semaglutide (Ozempic), has rapidly grow to be the world’s greatest diabetes and weight reduction blockbuster, and lots of clinicians are transitioning their sufferers away from insulin and onto Ozempic or comparable medication equivalent to dulaglutide (Trulicity) or tirzepatide (Mounjaro). Insulin has more and more been seen as a final resort for folks with sort 2 diabetes — it could be a superb time to debate non-insulin options together with your medical supplier.

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Learn extra about GLP-1, insulin, insulin pumps, Intensive administration, Lantus, Levemir, low blood sugar (hypoglycemia), Novo Nordisk, SGLT-2, toujeo, Tresiba insulin.

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