From the Guidelines
Lantus Solostar (insulin glargine) is typically dosed once daily at the same time each day, with an initial recommended dose of 0.2-0.4 units/kg of body weight for insulin-naïve patients with type 2 diabetes, as recommended by the most recent guidelines 1. The dosing of Lantus Solostar should be individualized based on the patient's specific needs and glucose control goals.
- For patients with type 1 diabetes, the starting dose is usually about one-third to one-half of the total daily insulin requirement as basal insulin, with the remainder provided as mealtime insulin.
- Dosage adjustments should be made gradually, typically 2-4 units at a time based on fasting blood glucose levels, with a target range of 80-130 mg/dL.
- Lantus should be injected subcutaneously into the abdomen, thigh, or upper arm, rotating injection sites to prevent lipodystrophy.
- The pen should be primed with 2 units before each injection to ensure proper flow.
- Patients should be aware that Lantus is a clear solution that should not be mixed with other insulins, and the pen should be stored in the refrigerator before first use and can be kept at room temperature (below 86°F) for up to 28 days after opening.
- Dose adjustments may be needed during illness, stress, or changes in diet or physical activity, and regular blood glucose monitoring is essential for proper management. It's also important to consider the patient's overall health status, medical history, and other medications they are taking when determining the optimal dosing regimen for Lantus Solostar, as recommended by previous guidelines 1. However, the most recent guideline 1 takes precedence in determining the recommended dosing regimen.
From the Research
Dosing Recommendations for Lantus Solostar (Insulin Glargine)
The recommended dosing for Lantus Solostar (insulin glargine) is typically as a single daily dose, which can be administered at any time of day, although it is often given at nighttime 2.
- In type 2 diabetes patients, it is often the first insulin introduced as a single daily dose 2.
- The dose can be adjusted based on the patient's needs, and it may be necessary to supplement with short-acting insulin at mealtimes to control glucose surges after meals 2.
- In some cases, such as in labile type 1 diabetes or obese, insulin-resistant patients, it may be necessary to administer insulin glargine in two separate doses 2.
- A study comparing morning and bedtime administration of insulin glargine found that both regimens were effective in achieving good glycemic control without any difference in hypoglycemia 3.
Administration and Device
Lantus Solostar is administered using a disposable insulin pen, such as the SoloStar pen, which has been shown to have good dose accuracy and injection force dynamics 4.
- The SoloStar pen is a state-of-the-art device that is suitable for most patients with diabetes 4.
- The use of insulin glargine with a disposable pen can make administration more convenient and easier to manage.
Benefits and Risks
Insulin glargine has been shown to have several benefits, including a lower risk of hypoglycemia compared to NPH insulin 5, 6.
- A meta-analysis found that insulin glargine reduced the risk of overall symptomatic and nocturnal hypoglycemia by 11% and 26%, respectively, compared to NPH insulin 6.
- Insulin glargine has also been shown to reduce the risk of severe hypoglycemia and severe nocturnal hypoglycemia by 46% and 59%, respectively, compared to NPH insulin 6.