Levemir vs Lantus for Diabetes

Injectable insulin is a common treatment for all types of diabetes (type 1, type 2, and gestational diabetes). 

Levemir and Lantus are among some of the most well-known types of insulin and have been on the market since the early 2000s.

In this article, we’ll compare Levemir vs Lantus so you can decide which might be the best choice for your diabetes care plan.

What is Levemir?

Levemir is the brand name for insulin detemir, a long-acting insulin. Long-acting insulin is used to help control blood sugar levels in people with type 1, type 2, and gestational diabetes. 

Long-acting insulin is generally injected once or twice daily and is also referred to as basal insulin.

Levemir doesn’t typically last as long as Lantus in terms of duration, so it is more common for Levemir to be injected twice daily compared to Lantus, which is more often injected just once daily. 

The United States Food and Drug Administration (FDA) approved Levemir in 2005.

You can use Levemir in prefilled injector pens or vials that you draw up and inject the insulin with a syringe.

What is Lantus?

Lantus is a brand name for insulin glargine, another long-acting injectable insulin for human use. 

Lantus is typically injected once or twice daily in the morning, at bedtime, or both to help control blood sugar levels. The United States FDA approved Lantus in 2000.

Similar to Levemir, Lantus can be used in people with type 1 and type 2 diabetes, as well as gestational diabetes or women with preexisting diabetes who become pregnant.

Also, like Levemir, you can find Lantus in prefilled injectable insulin pens and vials and syringes where you draw up your dose. 

Prefilled pens are preferred by many for their ease of use, especially for older patients with limited dexterity, poor vision, etc. 

Prefilled pens can also be a better option for pediatric patients using insulin.

How do Levemir and Lantus work?

Levemir and Lantus work by providing the hormone insulin directly into your body. Insulin helps reduce blood sugar levels, which are higher than normal in people with diabetes.

Insulin deficiency is the root cause of type 1 diabetes, which means your pancreas has lost most or all of its beta-cell function (beta cells are the ones that produce insulin in your pancreas). 

If you have type 1 diabetes, you’ll need to inject several doses of both long- and short-/rapid-acting insulin since your pancreas doesn’t make its own insulin anymore.

The root cause of type 2 diabetes is insulin resistance, which is when your body doesn’t respond to insulin effectively. 

Over time, many people with insulin resistance can become more insulin deficient and require insulin. 

Requiring insulin injections with type 2 diabetes isn’t a sign of poor blood sugar management but instead reflects the gradual decline of your pancreas’ ability to make insulin.

Long-acting insulin helps mimic your body’s “basal” insulin production, which is the slow, consistent release of insulin throughout the day. 

Long-acting insulin isn’t the same as short- and rapid-acting insulin. Short-acting insulin works faster, doesn’t last as long, and is meant to help offset the rise in blood sugar levels after eating.

Are Levemir and Lantus the same?

Levemir and Lantus are both long-acting insulins, but they aren’t the same. Levemir is insulin detemir, which has an average duration of up to 24 hours and a peak time of 3-14 hours after injection. 

(Peak time is how long it takes for the medication to work the hardest to lower your blood sugar.)

Lantus is insulin glargine, has an average duration of 24 hours, and does not have a peak, which is why it is generally taken once daily compared to Levemir’s twice daily dosing. 

Lantus starts working around 3-4 hours after you inject it, which is referred to as its onset time.

Are Levemir and Lantus interchangeable?

Lantus and Levemir aren’t interchangeable, so you’ll need to work with a healthcare provider if you want to switch from one to the other. 

For example, you might need to take a higher dose or split into multiple injections if switching from one to the other.

Levemir vs Lantus effectiveness

Both Levemir and Lantus can be very effective at controlling blood sugar levels, especially when combined with other medications (as needed), lifestyle modifications, and consistently monitoring blood sugar levels both at home and with regular hemoglobin A1c checks.

Levemir

According to a study, Levemir was found to be “at least as effective” as NPH insulin (intermediate-acting insulin) and Lantus. 

In addition, Levemir resulted in less weight gain compared to the use of NPH insulin. 

Levemir was also less likely to cause nocturnal hypoglycemia (low blood sugar in the middle of the night/while sleeping) compared to NPH insulin, according to that same study.

Lantus

A pooled analysis of almost 3,000 patients ranging in age from 18-80 was done in 2013. Lantus was superior to other treatments in lowering blood sugar levels in both young and older patients with type 2 diabetes.

The treatments Lantus was compared against included rapid-acting insulin, premixed insulins, NPH insulin, and some oral medications for type 2 diabetes called thiazolidinediones (TZDs).

A 2018 study compared Lantus vs Levemir directly, with a conclusion that there aren’t clear differences in the safety and effectiveness between the two.

How effective Lantus or Levemir are will depend on many other factors, including your dose, any other medications you might be taking, how long you’ve had diabetes (and the type), and your lifestyle habits.

In general, injectable insulin is the most effective at lowering blood sugar compared to other types of diabetes medications because it directly addresses the issue of insulin deficiency or insulin resistance by providing insulin directly to your body. 

Other medications might help stimulate your pancreas to make more insulin or help your liver produce less sugar, but they don’t work in the same way as injectable insulin.

Similarities and differences

Similarities

• Both Levemir and Lantus are long-acting injectable insulins available in both a vial and syringe of prefilled injector pens.
• Levemir and Lantus have long duration times of around 24 hours, though Levemir tends to “wear off” sooner due to it having a peak time.
• Both types of insulin are approved to treat type 1, type 2, and gestational diabetes.
  

Differences

• Lantus is most often a once-daily dose, whereas Levemir tends to be divided into two doses spread 12 hours apart.
• If you have health insurance or prescription drug coverage, one drug might be preferred over the other, meaning the cost will likely be lower for the preferred drug.
• Price differences – Levemir and Lantus don’t have generic alternatives, but insulin glargine can be purchased without the brand name of Lantus, making it less expensive.

Levemir vs Lantus side effects

The potential side effects of Levemir and Lantus are similar and include:

• low blood sugar (hypoglycemia), which is when your blood sugar is less than 70 mg/dL
• allergic reactions
• injection site reactions
• changes in body fat distribution (lipodystrophy), one of the more common complications of injecting insulin
• itching
• rash
• fluid retention (edema)
• weight gain

Which medication is cheaper?

According to GoodRx, at the time this article was written, here are the average costs for Levemir and Lantus out-of-pocket (meaning no insurance benefits are applied).

Levemir: one carton of (5) 3-milliliter prefilled pens containing 300 units each (a total of 1500 units): around $460-$480

Lantus: one carton of (5) 3-milliliter prefilled pens containing 300 units each (a total of 1500 units): $130-$150 for insulin glargine (the active ingredient for Lantus)

Neither Levemir nor Lantus have generic alternatives. However, you can buy insulin glargine, which is the same as Lantus but without the brand name, making it less expensive than Levemir. 

Alternatives to Levemir and Lantus

Semglee vs Lantus and Levemir

Semglee is a brand name for insulin glargine-yfgn, a type of long-acting insulin, and the FDA approved it in 2020.

Glargine-yfgn is considered biosimilar to insulin glargine, so Semglee and Lantus are considered interchangeable. 

The comparison for Levemir vs Semglee is similar to that of Levemir vs Lantus since Lantus and Semglee are considered interchangeable.

Toujeo (insulin glargine) vs Lantus and Levemir

Toujeo is a concentrated form of long-acting insulin with the same active ingredient as Lantus that has been approved since 2015. 

However, instead of the normal 100 units per milliliter concentration, Toujeo is 300 units per milliliter, making it more concentrated compared to Lantus.

Toujeo also has a longer shelf life compared to Lantus (up to 8 weeks for Toujeo compared to 28 days for Lantus), so it can be more cost-effective by not having to throw away expired insulin. 

Basaglar (insulin glargine) vs Lantus and Levemir

Basaglar’s active ingredient has a similar chemical structure as Lantus, but it isn’t considered interchangeable because it is made differently than Lantus. 

You can expect similar results when using Basaglar vs Lantus, but you might not be able to seamlessly switch from one type to the other since they aren’t considered interchangeable. The FDA approved Basaglar in 2015.

Tresiba (insulin degludec) vs Lantus and Levemir

Tresiba is a newer long-acting insulin (approved in 2015). It should last even longer than Lantus and Levemir (at least 42 hours per the manufacturer). 

Tresiba is available in 100 units/mL and 200 units/mL concentrations, whereas Lantus and Levemir are only available in 100 units/mL concentrations.

Conclusion

Levemir and Lantus are both types of long-acting insulins with long durations (up to 24 hours).

The main differences between Levemir vs Lantus are their durations (Levemir doesn’t usually last as long as Lantus) and their cost.

Both Levemir and Lantus can be very helpful in managing blood sugar levels in people with diabetes and have similar effectiveness.

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