From the Guidelines
Lantus (insulin glargine) does not have a distinct peak of action. Unlike regular insulin or rapid-acting insulins, Lantus is designed to provide a steady, consistent level of insulin throughout the day with minimal peaks. After injection, Lantus forms microprecipitates in the subcutaneous tissue, which slowly dissolve and release insulin into the bloodstream over approximately 24 hours, as seen in the characteristics of long-acting insulins 1. This creates a relatively flat profile of insulin activity, which is why it's classified as a long-acting basal insulin. The steady release helps maintain baseline blood glucose levels between meals and overnight without causing significant drops in blood sugar that could lead to hypoglycemia.
Some key characteristics of Lantus include:
- Onset of action: 1 hour
- No distinct peak
- Duration of action: 24 hours As noted in the study 1, the advantages of Lantus include its ability to provide a steady level of insulin activity, reducing the risk of hypoglycemia and making it suitable for once-daily dosing for most patients. This pharmacokinetic profile makes Lantus a popular choice for patients with diabetes, as it helps maintain consistent blood glucose control with minimal peaks and valleys.
In terms of dosing, Lantus is typically administered at the same time each day to maintain consistent blood glucose control. However, some patients may require twice-daily dosing to achieve optimal coverage over a full 24-hour period, particularly if they notice their glucose levels rising before their next scheduled dose. Overall, the flat profile of insulin activity provided by Lantus makes it an effective and convenient option for patients with diabetes.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Peak of Action for Lantus
- The peak of action for Lantus (insulin glargine) is characterized by its relatively constant basal level of circulating insulin with no pronounced peak 2, 3, 4, 5.
- Insulin glargine provides a fairly constant, basal insulin supply without peaks in plasma insulin levels for approximately 24 hours 3.
- The activity profile of insulin glargine lacks a pronounced peak, more closely resembling that of endogenous basal insulin than that of other intermediate- or long-acting insulins 4.
- The plasma concentration versus time profile of insulin glargine is relatively constant, with no pronounced peak over 24 hours, allowing for once-daily administration as basal therapy 5.
Comparison to Other Insulins
- Insulin glargine has a slower onset of action than NPH insulin and a longer duration of action with no peak activity 4.
- Compared to NPH insulin, insulin glargine has a lower incidence of hypoglycemia, especially nocturnal hypoglycemia 2, 3, 4, 5.
- Insulin glargine provides comparable efficacy to NPH insulin administered once or twice daily in basal-bolus regimens 4.
Clinical Implications
- The relatively constant basal level of circulating insulin with no pronounced peak makes insulin glargine a useful addition to the armamentarium of insulin therapy 2.
- Insulin glargine can be initiated aggressively to help patients reach recommended HbA(1c) targets, with a low risk of hypoglycemia and consistent improvements in HbA(1c) 6.