2015-07-15

Day 2 Levemir Update

I promise I won't make this a daily or even a monthly feature, but in the interest of good record keeping, and for my own personal future reference, I thought I would type up a few first impressions about my first twenty-four hours on Levemir instead of Lantus.

First, the numbers: My blood glucose appears to be in better control. I know you can't say much after a single day of therapy, but the few firsthand accounts I had read on various diabetes forums lead me to believe that my blood sugar would be higher in general. I say this because many people report that they need a higher dose of Levemir than they needed for Lantus, and that a dose of Levemir lasts a shorter period of time. If I remember correctly, even Dr. Bernstein says as much about Levemir; but, of course, every body is different. I had a hefty day of exercise yesterday, however, and today is my day off from the gym, so I expect that if my blood sugar starts to rise, I'll see it at my before-dinner blood glucose reading in a couple of hours.

Second, I am not a huge fan of the "FlexTouch" injector. I have experience with the old Huma-Pen, the Humalog KwikPen, and the Lantus SoloStar. All three of these are slightly different, but so far, my favorites of the above have been the Huma-Pen and the SoloStar, because when you push the button to inject the insulin, you can feel the injector's plunger move. The KwikPen, the worst of the bunch, doesn't even click. It has a squishy feeling as you push the injection button and it isn't at all obvious whether the plunger has stopped moving. It's hard to know whether you've received the full dose.

Well, the FlexTouch injector is an improvement over the KwikPen. The FlexTouch clicks as the plunger moves forward for each unit of insulin you've dialed-in - that's good. The problem is that you push the button in and hold it... and wait... and wait... as the injector slowly clicks through each unit of insulin one-by-one (rather than all-at-once with the SoloStar and the Huma-Pen). As a result, I feel like I'm putting a lot of trust in a plastic auto-injector unnecessarily. A simpler mechanism would make me feel a lot better about whether I'm getting my full dose. But, for all I know, the FlexTouch may have mechanical advantages of which I am unaware.

Third, I am experiencing no adverse reactions so far. I am clearly not allergic to Levemir, and I'm suffering from none of the side effects listed in the documentation or elsewhere. So, thankfully, I have avoided the statistically anomalystic "worst-case scenario."

Fourth, there is no burning sensation during the injection. As previously reported, part of the reason Lantus burns when injected is because it's acidic; the neutralization of that acid is what forms the crystals that delay insulin uptake. Since Levemir utilizes a different mechanism of delay, there is no burning sensation related to acid neutralization. So that's a good, albeit minor, plus-point for Levemir.

Now the real test is to see how things develop over a longer period of time - weeks and months. Only then will I know whether Levemir is an improvement over Lantus for me, personally.