2015-07-14

Levemir

I suppose this blog post will function mainly as a note to my future self.

Today, I changed from Lantus (long-acting insulin) to Levemir (long-acting insulin). As per Levemir's documentation and the recommendation of my endocrinologist, I did an exact, one-to-one switch. That is, I replaced my twelve-unit injection of Lantus with a twelve-unit injection of Levemir. I'm anxious to see what happens next.

Why the switch? 

First of all, there is a weak correlation between Lantus and cancer, which you can read about here. That's not enough for me to go running away from Lantus. In fact, I imagine the risk is no greater than the risk of any number of every-day carcinogens we happen to encounter over the course of our lives. On the other hand, if a viable replacement exists, for which there is no known cancer correlation, why not use it?

Second, my hA1c levels have not been as low as I want them to be, and truth be told, I'm struggling to get them down any further than they are now. After having taken Lantus for a good five years now, I thought it might be time to try something new and see if it helps or hinders. I have no reason to expect wildly different results with Levemir compared to Lantus, but it certainly can't hurt to try.

Third, I've heard nothing but good things about Levemir. A close friend of mine uses it, and when I asked him how it was, he said (and I quote), "It's fantastic." That's a ringing endorsement from someone I trust, so the "word on the street" for Levemir is mostly favorable.

Finally, the mechanism of action made a lot of sense to me. Lantus delays action because it is acidic; upon injection, it neutralizes in the body, forming crystals; these crystals then slowly dissolve over the course of a 12-20 hour period, delivering a basal supply of insulin throughout.

Levemir, by contrast, binds to serum albumin, which slows insulin uptake. Albumin is a protein in the bloodstream to which many important chemicals - including hormones - bind in order to be delivered later. In other words, Levemir utilizes a normal biochemical process to deliver synthetic insulin to the body. This more natural process subjectively "seems" better to me, compared to having crystallized insulin floating around and dissolving in my bloodstream. There is no scientific basis to this feeling I have, just an underlying sense that, if I can deliver insulin to my body through a more "natural" process, then that might be "better" somehow.

I'm open to being wrong about that. At least I'm being honest.

Anyway, time will tell how the switch ends up working for me. For now, I am about four hours into the switch and things are going quite normally. I think that means that, at the very least, I am not severely allergic to insulin detemir. First hurdle cleared.