From the Guidelines
Basaglar (insulin glargine) can be switched to alternative long-acting insulin analogs such as Tresiba (insulin degludec) or Toujeo (a more concentrated form of insulin glargine) to potentially reduce the risk of nocturnal hypoglycemia and improve glycemic control. According to the most recent guidelines, longer-acting basal analogs like U-300 glargine or degludec may convey a lower hypoglycemia risk compared with U-100 glargine when used in combination with oral agents 1.
When considering alternatives to Basaglar, it's essential to note that other long-acting insulin analogs such as Lantus (also insulin glargine) and Levemir (insulin detemir) are available, but they may not offer the same level of hypoglycemia risk reduction as Tresiba or Toujeo. For patients seeking non-insulin alternatives, GLP-1 receptor agonists like Ozempic (semaglutide), Trulicity (dulaglutide), or Victoza (liraglutide) might be options for type 2 diabetes, though they work differently than insulin.
Some key points to consider when switching between insulin types include:
- Close monitoring is essential as potency and duration may differ slightly
- Patients should work with their healthcare provider to determine the most appropriate alternative based on their specific needs, insurance coverage, and response to treatment
- Alternatives are necessary because some patients may experience allergic reactions to specific insulin formulations, have insurance coverage limitations, or require different pharmacokinetic profiles for optimal glucose control
- Starting doses can be estimated based on body weight (0.1–0.2 units/kg/day) and the degree of hyperglycemia, with individualized titration over days to weeks as needed, as recommended by recent guidelines 1.
It's crucial to prioritize the patient's specific needs and response to treatment when selecting an alternative to Basaglar, and to be aware of the potential for overbasalization with insulin therapy, which can be evaluated by clinical signals such as basal dose greater than 0.5 units/kg or high glucose differentials 1.
From the Research
Alternative Medications to Basaglar (Insulin Glargine)
Basaglar (insulin glargine) is a long-acting basal insulin used to manage type 2 diabetes. If you're looking for alternative medications, consider the following options:
- Insulin degludec: A ultra-long-acting insulin analogue that has been shown to be effective in managing type 2 diabetes, with a lower risk of hypoglycemia compared to insulin glargine 2
- Insulin degludec/liraglutide (Xultophy): A fixed-ratio combination of an ultra-long-acting insulin analogue and a glucagon-like protein-1 (GLP-1) receptor agonist, which has been shown to be effective in managing type 2 diabetes, with significant improvements in HbA1c levels and a lower risk of hypoglycemia 3, 4, 5
- Glucagon-like peptide-1 receptor agonists (GLP-1 RAs): Such as liraglutide, exenatide, and dulaglutide, which have been shown to be effective in managing type 2 diabetes, with significant improvements in HbA1c levels and weight loss 6
- Insulin glargine U100/lixisenatide (iGlarLixi): A co-formulation of a basal insulin and a GLP-1 receptor agonist, which has been shown to be effective in managing type 2 diabetes, with significant improvements in HbA1c levels and a lower risk of hypoglycemia 4
Key Considerations
When switching from Basaglar to an alternative medication, consider the following:
- Efficacy: The alternative medication should be able to provide similar or better glycemic control compared to Basaglar
- Safety: The alternative medication should have a similar or better safety profile compared to Basaglar, with a lower risk of hypoglycemia and other adverse events
- Convenience: The alternative medication should be convenient to use, with a simple dosing regimen and minimal injections required
- Cost: The alternative medication should be affordable and covered by insurance, with minimal out-of-pocket costs