Levemir vs. Apidra for Diabetes Type 2 and Diabetes Type 1: Important Differences and Potential Risks.

Key takeaways

Levemir (insulin detemir) and Apidra (insulin glulisine) are both insulins used to manage diabetes, but they have different purposes and characteristics. Levemir is a long-acting insulin that helps control blood sugar levels for up to 24 hours and is typically injected once or twice daily. In contrast, Apidra is a rapid-acting insulin that starts working within 15 minutes and is used to control blood sugar spikes around meal times. You usually inject Apidra within 15 minutes before or 20 minutes after eating. Levemir is available in vials and FlexPens, while Apidra comes in vials, pre-filled pens, and can also be used in insulin pumps. Levemir Flexpens has been discontinued as of April 2024 and vials will be discontinued by December 2024, whereas Apidra comes in brand only. Both insulins can cause low blood sugar, but Apidra has a higher risk due to its rapid action. Additionally, Apidra can be mixed with NPH insulin, while Levemir should not be mixed with other insulins within the same syringes.

Levemir

(insulin detemir)

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Apidra

(insulin glulisine)

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Summary for Levemir

Prescription only

Levemir (insulin detemir) is a long-acting insulin that helps control high blood sugar levels in children and adults. It's injected under the skin, typically once or twice daily. Like all insulins, Levemir (insulin detemir) can raise your risk for low blood sugar, so make sure to keep fast-acting sugars with you in case your blood sugar level drops too low. This medication comes in vials. But it's also available as a Flexpen for people who have trouble drawing up insulin from the vial.

Indications for Levemir

Pros and Cons for Levemir

Pros

Lower risk of weight gain compared to some other types of insulin
Doses can be adjusted to meet your body's needs
Insulin pens available for people who've trouble using insulin vials
Provides blood sugar control for up to 24 hours

Cons

Must be injected
Might need to inject it twice daily
Can cause low blood sugar
No generic option available

Common Side Effects for Levemir

Shakiness, hunger, and other symptoms of low blood sugar (up to 93%, depending on what other blood sugar medications you're taking)
Common cold involving the nose, throat, and lungs (up to 27%)
Headache (up to 23%)
Pain or irritation of the throat (10%)
Back pain (8%)
Fever, chills, and other flu-like symptoms (up to 8%)
Stomach pain (6%)

Please note: These side effects were reported by people who took Levemir (insulin detemir) for type 1 diabetes. Your risk for side effects might be different if you have type 2 diabetes.

Warnings for Levemir

Infections
Low blood sugar
Severe allergic reactions
Low blood potassium levels
Swelling from fluids and risk of heart failure

Summary for Apidra

Prescription only

Insulin glulisine is a rapid-acting insulin that's available as a vial (Apidra) and a pre-filled pen (Apidra Solostar). It's used to control blood sugar from meals for people with either Type 1 diabetes (T1D) or Type 2 diabetes (T2D). Apidra (insulin glulisine) is given under the skin as either a quick injection or continuously through an insulin pump. It can also be given as an injection through the veins (IV) for people in the hospital. Side effects include low blood sugar (hypoglycemia) and common cold symptoms.

Indications for Apidra

Type 1 diabetes (T1D) in people ages 4 years and older
Type 2 diabetes (T2D) in people ages 18 years and older

Pros and Cons for Apidra

Pros

Works within 15 minutes to lower blood sugar
Available as a prefilled pen, which might be easier to use than the vial
Can be used with some insulin pumps
Can be mixed with NPH insulin (e.g., Novolin N), if instructed by your care team

Cons

Raises risk of dangerously low blood sugar levels
Given as an injection
Might need to inject multiple times a day
Might cause weight gain

Common Side Effects for Apidra

Type 1 diabetes

Common cold (11%)
Low blood sugar (up to 7%)
Upper respiratory tract infection (7%)
Headache (7%) - children only
Seizure from low blood sugar (6%) - children only
Flu (4%)

Type 2 diabetes

Upper respiratory tract infection (up to 11%)
Common cold (8%)
Swelling in the hands, ankles, or legs (8%)
Flu (6%)
Joint pain (6%)

Warnings for Apidra

Spread of infections from sharing injection supplies
Risk of high and low blood sugar levels
Dangerously low blood sugar levels (hypoglycemia)
Allergic reaction
Low blood potassium levels
Swelling from fluid buildup and risk of heart failure
Dangerously high blood sugar levels or buildup of ketones (for people who use insulin pump)