From the Guidelines
Simglee insulin, a brand name for insulin glargine, is a long-acting basal insulin that should be used to manage diabetes, with a starting dose of 10 units for type 2 diabetes or 0.2-0.4 units/kg for type 1 diabetes, adjusted based on blood glucose monitoring 1. The dose should be adjusted in increments of 2-4 units every 3-7 days until target glucose levels are achieved. Simglee is injected subcutaneously in the abdomen, thigh, or upper arm, and should not be mixed with other insulins in the same syringe.
Key Considerations
- It works by providing a steady release of insulin over approximately 24 hours, helping to maintain baseline blood glucose levels.
- Common side effects include hypoglycemia, injection site reactions, and weight gain.
- Patients should monitor blood glucose regularly, recognize hypoglycemia symptoms, and always have fast-acting carbohydrates available.
- Simglee should be stored in a refrigerator before first use and can be kept at room temperature for up to 28 days after opening.
Administration and Monitoring
- The optimal time to administer prandial insulin varies, based on the pharmacokinetics of the formulation, the premeal blood glucose level, and carbohydrate consumption 1.
- Recommendations for prandial insulin dose administration should therefore be individualized.
- Education of patients on how to adjust prandial insulin to account for carbohydrate intake, premeal glucose levels, and anticipated activity can be effective and should be offered to most patients 1.
Evidence-Based Recommendations
- The use of human insulin is recommended to manage blood glucose in adults with type 1 diabetes and in adults with type 2 diabetes for whom insulin is indicated, with a strong recommendation and low-quality evidence 1.
- Consider long-acting insulin analogues to manage blood glucose in adults with type 1 or type 2 diabetes who have frequent severe hypoglycemia with human insulin, with a weak recommendation and moderate-quality evidence 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Insulin Comparison
- The studies 2, 3, 4, 5, 6 compared different types of insulin, including insulin detemir and insulin glargine, in patients with type 1 and type 2 diabetes.
- Insulin detemir and insulin glargine were found to have similar efficacy in terms of glycemic control 2, 3, 6.
- However, insulin detemir was associated with less weight gain 3 and lower within-subject variability in fasting blood sugar levels in type 1 diabetes patients 4.
- Insulin glargine was found to have a lower daily basal insulin dose and fewer injection site reactions 3.
- A biosimilar of insulin glargine, MYL1501D insulin glargine, was found to have similar efficacy and safety to reference insulin glargine 100 U/mL 5.
Glycemic Control
- The studies found that insulin detemir and insulin glargine had similar effects on glycemic control, measured by HbA1c levels 2, 3, 6.
- Insulin detemir was found to reduce glycemic variability in type 1 diabetes patients 4.
- The frequency of hypoglycemia was similar between insulin detemir and insulin glargine 2, 3, 6, although one study found that switching from insulin glargine to insulin detemir may increase the risk of hypoglycemia 6.
Patient Populations
- The studies included patients with type 1 and type 2 diabetes, as well as hospitalized patients with type 2 diabetes 6.
- The results of the studies may not be generalizable to all patient populations, and further research is needed to confirm the findings.