What to Do If Your Insulin Is Being Discontinued

Fact checked by Nick Blackmer

Key Takeaways

• Novo Nordisk is discontinuing one of its discounted insulin brands, Levemir, because of manufacturing issues, decreasing patient coverage, and the availability of alternative treatments.

• Levemir is a long-acting insulin that’s used to control high blood sugar levels in adults and children with type 1 and type 2 diabetes.

• There are alternative insulins that could replace Levemir; however, endocrinologists and doctors advise patients to check in with their healthcare provider before making a switch.
  

Pharmaceutical company Novo Nordisk has announced it will be discontinuing one of its discounted insulin brands: Levemir (insulin detemir), a long-acting insulin taken to control high blood sugar. This news comes months after Eli Lilly, Sanofi, and Novo Nordisk announced insulin list price cuts of up to 70%.

As a result of manufacturing issues, decreasing patient coverage, and alternative treatments, the insulin maker plans to discontinue U.S. sales of the FlexPen version of Levemir in April 2024 and Levemir vials by the end of December.

While other insulins are available, you’re not going to want to make the switch overnight. Here’s what you can do to prepare if you take Levemir, according to experts.

Your Provider Should Be Well-Versed in Alternative Insulin Brands

Insulin discontinuation isn’t uncommon, Mihail Zilbermint, MD, MBA, director of endocrine hospitalists at Johns Hopkins Community Physicians, told Verywell. As of 2019, 62 insulin products had been removed from the market.

Luckily, there are many alternative insulins, both rapid-acting and long-acting. Zilbermint highlights Lantus (insulin glargine) as a good option. Although Levermir and Lantus have different chemical structures, both are typically used to help control blood sugar levels overnight.

If your insulin is being discontinued, Zilbermint recommends consulting with your primary care provider and endocrinologist first before switching insulins or stockpiling Levemir. Endocrinologists can discuss both insulin alternatives and dosages, as well as help you develop a plan to keep your blood sugar in check.

Insulin options and dosing will vary from person to person. However, Zilbermint said endocrinologists typically transition doses one to one. For example, someone who’s taking 20 units of Levemir at night will likely be transitioned to 20 units of Lantus.

“They’re similar and work in approximately 24 hours,” he said.

After switching insulins, Zilbermint recommends that patients monitor their blood sugar a little more closely.

“We want to make sure that the new insulin regimen is going to control a patient’s blood sugar levels and allow for necessary adjustments to be made, if needed,” he said.

Switching Insulin Brands May Mean Fewer Injections

One potential positive of switching insulins is that people who’ve been prescribed two daily doses of Levemir may be able to drop down to one dose of another brand.

“Levemir has more often been used as a twice-daily insulin injection, as opposed to some of the [other] longer-acting insulins used once daily,” Freeby said. “By switching people from Levemir to even longer-acting insulins, we may be able to reduce the number of injections.”

Pregnant People May Be Impacted the Most

Levemir’s discontinuation disproportionately affects vulnerable groups, such as pregnant people with diabetes, Matthew J. Freeby, MD, director of the Gonda Diabetes Center and associate director of diabetes clinical programs at the David Geffen UCLA School of Medicine, told Verywell.

"Levemir has become one of the main insulins that we use in pregnancy and diabetes,” Freeby said. Now, providers will have to determine which other insulin brand is preferred during pregnancy.

Tresiba (insulin degludec), a longer-acting insulin, has been shown to be safe and effective in pregnancy, but “there are some concerns in terms of its length of action and its ability to make changes in real time,” Freeby said, citing a risk of hypoglycemia if blood sugar levels aren’t stabilized quickly enough.

What This Means For You

If you take Levemir and will be impacted by its discontinuation, know that other, similar insulin options are available to you. Your endocrinologist can help you make the transition.

Read the original article on Verywell Health.