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Help patients get started on Levemir® for 24/7 glucose control

Levemir® allows you and your patients to titrate toward goal with a dosing algorithm1,2

The TITRATE® trial2 tested the Levemir® 3–0–3 dosing algorithm in patients with type 2 diabetes with baseline A1C levels as high as 9%.

  • When initiating Levemir®, start insulin-naïve patients with type 2 diabetes on 10 units or 0.1 to 0.2 units/kg with the evening meal or at bedtime3
  • Patients can self-titrate at home based on three-day average fasting plasma glucose (FPG) values

Additional information

Pablo Mora, MD, discusses a long-acting basal insulin analog that may help with day-to-day challenges of managing type 2 diabetes.

Watch the eDetail Download the audio program

Starting patients on Levemir®

Self-titration with the Levemir 3–0–3 dosing model

Dose adjustments: can be made every third day based on average of 3 consecutive FPG values.

Results from a 20-week, randomized, controlled, multicenter, open-label, parallel-group, treat-to-target trial using the PREDICTIVE® 303 self-titration algorithm in insulin-naïve patients with type 2 diabetes, A1C ≥7% and ≤9% on OAD therapy randomized to Levemir® and OAD (1:1) to 2 different FPG titration targets (70-90 mg/dL [n=121] or 80-110 mg/dL [n=122]).2

This study was exclusively once-daily treatment with Levemir® in patients with type 2 diabetes

  • Majority of patients achieved the ADA –recommended target of A1C <7%2,4
  • Average insulin doses: 0.57 units/kg (70-90 mg/dL group) and 0.51 units/kg (80-110 mg/dL group)2
  • Low rates of hypoglycemia2
    • Nearly all hypoglycemic events were minor or symptoms only †
    • Minor hypoglycemia rates were 5.09 (70–90 mg/dL) and 3.16 (80–110 mg/dL) per patient-year
    • A single major hypoglycemic event was reported in the 70 to 90 mg/dL group; no major hypoglycemic events were reported in the 80 to 110 mg/dL group

†Minor = SMPG <56 mg/dL and not requiring third-party assistance; symptoms only = SMPG ≥56 mg/dL or no measurement.

Levemir® FlexPen® is available for the same copay as vial/syringe on most managed care plans†

  • One prescription for FlexPen® (1 box of 5 pens) = 1500 units
  • One prescription for vial = 1000 units
Levemir vial and FlexPen

Needles are sold separately and may require a prescription in some states.

Insulin delivery with Levemir® FlexPen®

  • Pre-filled, ready to use in just a few steps
  • Discreet—fits neatly in your patient’s purse or pocket
  • Covered on more than 90% of managed care plans5††

†† Intended as a guide. Lower acquisition costs alone do not necessarily reflect a cost advantage in the outcome of the condition treated because there are other variables that affect relative costs. Formulary status is subject to change.

Related Support

Access the Patient Assistance Program The Novo Nordisk Patient Assistance Program (PAP) can help your patients who have difficulty affording their medications.

Watch the Levemir® FlexPen® demo See how Levemir® FlexPen® is ready to use in just a few steps.

Up Next

Learn about the benefits of Levemir® FlexPen®

References:

  1. Meneghini L, Koenen C, Weng W, Selam J-L. The usage of a simplified self-titration dosing guideline (303 Algorithm) for insulin detemir in patients with type 2 diabetes—results of the randomized, controlled PREDICTIVE™ 303 study. Diabetes Obes Metab. 2007;9(6):902-913.
  2. Blonde L, Merilainen M, Karwe V, Raskin P; TITRATE Study Group. Patient-directed titration for achieving glycaemic goals using a once-daily basal insulin analogue: an assessment of two different fasting plasma glucose targets—the TITRATE study. Diabetes Obes Metab. 2009;116:623-631.
  3. Philis-Tsimikas A, Charpentier G, Clauson P, Ravn GM, Roberts VL, Thorsteinsson B. Comparison of once-daily insulin detemir with NPH insulin added to a regimen of oral antidiabetic drugs in poorly controlled type 2 diabetes. Clin Ther. 2006;28(10):1569-1581.
  4. American Diabetes Association. Standards of medical care in diabetes–2011. Diabetes Care. 2011;34(suppl 1):S11-S61.
  5. Data on file, Novo Nordisk, Inc., Princeton, NJ.

  1. Levemir® (insulin detemir [rDNA origin] injection) Indications and Usage

    Levemir® is indicated for once- or twice-daily subcutaneous administration for the treatment of adult and pediatric patients with type 1 diabetes mellitus or adult patients with type 2 diabetes mellitus who require basal (long-acting) insulin for the control of hyperglycemia.

    Levemir® Important Safety Information

    Levemir® is contraindicated in patients hypersensitive to insulin detemir or one of its excipients.

    Levemir® should not be diluted or mixed with any other insulin preparations.

    Hypoglycemia is the most common adverse effect of all insulin therapies, including Levemir®. As with other insulins, the timing of hypoglycemic events may differ among various insulin preparations. Glucose monitoring is recommended for all patients with diabetes. Levemir® is not to be used in insulin infusion pumps. Any change of insulin dose should be made cautiously and only under medical supervision. Concomitant oral antidiabetes treatment may require adjustment.

    Needles and Levemir® FlexPen® must not be shared.

    Inadequate dosing or discontinuation of treatment may lead to hyperglycemia and, in patients with type 1 diabetes, diabetic ketoacidosis. Insulin may cause sodium retention and edema, particularly if previously poor metabolic control is improved by intensified insulin therapy. Dose and timing of administration may need to be adjusted to reduce the risk of hypoglycemia in patients being switched to Levemir® from other intermediate or long-acting insulin preparations. The dose of Levemir® may need to be adjusted in patients with renal or hepatic impairment.

    Other adverse events commonly associated with insulin therapy may include injection site reactions (on average, 3% to 4% of patients in clinical trials) such as lipodystrophy, redness, pain, itching, hives, swelling, and inflammation. Less common but more serious are severe cases of generalized allergy, including anaphylactic reaction, which may be life threatening.

    *Whether these observed differences represent true differences in the effects of Levemir®, NPH insulin, and insulin glargine is not known since these trials were not blinded and the protocols (e.g., diet and exercise instructions and monitoring) were not specifically directed at exploring hypotheses related to weight effects of the treatments compared. The clinical significance of the observed differences in weight has not been established.

    Please click hereclick here for Prescribing Information.

FlexPen® and Levemir® are registered trademarks of Novo Nordisk.
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