Lantus Dosing Conversion from Levemir

Standard Conversion Approach

• The American Diabetes Association recommends converting the total daily dose of Levemir to Lantus on a 1:1 unit basis and administering once daily for most patients, with a strength of evidence based on clinical guidelines 1
• For patients at high risk of hypoglycemia, such as the elderly, those with renal impairment, or a history of severe hypoglycemia, the American Diabetes Association suggests reducing the converted dose by 10-20% 1

Key Dosing Considerations

• When converting from twice-daily Levemir to once-daily Lantus, the American Diabetes Association recommends reducing the dose by 10-20% due to the differences in dosing requirements between the two insulins 2

Practical Conversion Algorithm

• The American Diabetes Association recommends calculating the total daily Levemir dose and converting it unit-for-unit to once-daily Lantus for standard-risk patients, with titration based on fasting glucose monitoring 1
• For high-risk patients or those on twice-daily Levemir, the American Diabetes Association suggests reducing the total daily Levemir dose by 10-20% and titrating based on fasting glucose monitoring 1

Post-Conversion Monitoring

• The American Diabetes Association recommends monitoring fasting blood glucose daily during the first 1-2 weeks after conversion to assess adequacy of the new dose, with adjustments made every 3 days based on fasting glucose values 1, 3
• If hypoglycemia occurs, the American Diabetes Association suggests reducing the dose immediately by 10-20% and reassessing the conversion 1, 3