From the Research
The maximum recommended dose of Lantus (insulin glargine) is generally considered to be 80-100 units per day, though there is no absolute upper limit as insulin requirements vary significantly between individuals. Lantus is a long-acting basal insulin typically administered once daily, designed to provide a steady background level of insulin for 24 hours. Some patients with severe insulin resistance may require higher doses, sometimes exceeding 200 units daily, but such high doses should only be used under close medical supervision. When doses exceed 40-50 units, splitting the total into two separate injections at different sites may improve absorption and effectiveness.
Key Considerations
- Insulin requirements are highly individualized and depend on factors such as body weight, insulin sensitivity, diet, physical activity, stress levels, and concurrent illnesses.
- Dosage adjustments should always be made gradually based on blood glucose monitoring results, with increases typically limited to 2-4 units every 3-7 days to avoid hypoglycemia.
- Patients requiring unusually high insulin doses should be evaluated for underlying causes of insulin resistance, as noted in studies such as 1.
Administration Flexibility
- Once-daily glargine can be administered in a flexible morning or bedtime regimen to achieve good glycemic control without any difference in hypoglycemia, as shown in 2.
Comparison with Other Insulins
- Insulin glargine has been compared to NPH insulin in several studies, including 3 and 4, demonstrating its effectiveness in reducing hypoglycemia risk.
Important Factors
- The starting dose and the change of insulin glargine dose were significantly greater in patients achieving target HbA1c (<7%) than in those who did not, as observed in 1.
- Fasting plasma glucose (FPG) levels were significantly lower in patients achieving target HbA1c, highlighting the importance of adjusting insulin doses based on blood glucose monitoring results.