What is Insulin Glargine (Lantus, insulin glargine)?

From the Guidelines

Insulin Glargine Overview

Insulin Glargine, also known by its brand name Lantus, is a long-acting insulin analog that is typically administered subcutaneously once daily 1.

• It is designed to provide a basal insulin effect, helping to control blood glucose levels between meals and during sleep.
• The recommended starting dose can vary, but for patients with type 1 diabetes, it is often considered in the range of 16 to 24 units once daily 1.
• Insulin Glargine has a 24-hour duration of action, with no pronounced peak, which reduces the risk of hypoglycemia compared to intermediate-acting insulins 1.
• Key benefits of Insulin Glargine include its ability to provide more physiologic basal insulin levels, reducing the risk of hypoglycemia, especially when compared to insulin isophane suspension (neutral protamine Hagedorn) in patients with type 1 diabetes 1.
• Examples of Insulin Glargine products include Lantus, which is commonly used for the management of type 1 and type 2 diabetes.
• Patients using Insulin Glargine should monitor their blood glucose levels regularly and work closely with their healthcare provider to adjust the dose based on individual needs, aiming to achieve stable blood glucose control without excessive hypoglycemia 1.

From the FDA Drug Label

Insulin glargine

Insulin Glargine (Lantus, insulin glargine) is a type of long-acting insulin.

• It is used to help control blood sugar levels in people with diabetes.
• The provided drug label does not offer a detailed description of Insulin Glargine, but it is compared to other insulins, such as NPH human insulin, in terms of efficacy and safety 2.

From the Research

Definition and Characteristics of Insulin Glargine

• Insulin Glargine, also known as Lantus, is a long-acting insulin analog produced by recombinant DNA technology 3.
• It has a modified structure that allows it to dissolve in an acidic solution but precipitate in the physiological subcutaneous tissue, forming a depot effect 4, 5.
• This property enables Insulin Glargine to provide a fairly constant, basal insulin supply without peaks in plasma insulin levels for approximately 24 hours 4.

Clinical Use and Efficacy

• Insulin Glargine is indicated for the management of type 1 and type 2 diabetes mellitus, typically administered as a single daily dose 3, 5.
• It has been shown to have comparable efficacy to Neutral Protamine Hagedorn (NPH) insulin in controlling glycemic levels, with a lower frequency of hypoglycemic reactions 3, 6, 7.
• Clinical trials have demonstrated that Insulin Glargine can improve fasting plasma glucose and fasting blood glucose levels, as well as reduce the incidence of nocturnal hypoglycemia 6, 7, 4.

Administration and Safety

• Insulin Glargine can be administered at any time of day, but it is typically given at bedtime 3.
• It is not recommended to mix Insulin Glargine with other insulins in the same syringe, as it may coprecipitate and affect its action 3.
• The most common adverse event associated with Insulin Glargine is injection site pain, which is usually mild and does not require treatment discontinuation 4.