What are some names for basal insulin?

Names of Basal Insulin

Basal insulin options include NPH, glargine, detemir, and degludec, which are designed to provide a relatively constant level of insulin to control blood glucose between meals and overnight. 1

Types of Basal Insulin

Human Basal Insulin

• NPH (Neutral Protamine Hagedorn) - an intermediate-acting human insulin that may be administered once or twice daily 1

Long-Acting Insulin Analogs

• Insulin glargine (U-100 and U-300 formulations)

  • Brand names: Lantus (U-100), Toujeo (U-300) 1, 2
  • Once-daily administration 1

• Insulin detemir

  • Brand name: Levemir 1, 3
  • May require once or twice-daily administration 1, 4

• Insulin degludec

  • Brand names: Tresiba (available as U-100 and U-200 formulations) 1, 5
  • Ultra-long-acting with duration >42 hours 6
  • Once-daily administration 1

Characteristics of Basal Insulins

Mechanism of Action

• Basal insulins are designed to cover the body's basal metabolic insulin requirement by primarily regulating hepatic glucose production 1
• They provide relatively constant insulin levels without pronounced peaks, unlike prandial (mealtime) insulins 2

Pharmacodynamic Differences

• NPH insulin has a more pronounced peak and shorter duration compared to long-acting analogs 1
• Long-acting analogs (glargine, detemir, degludec) have flatter profiles with less within-patient variability 6, 7
• Insulin degludec forms multi-hexamers when injected subcutaneously, resulting in an ultra-long duration of action 5

Clinical Considerations

• Long-acting insulin analogs generally have a lower risk of nocturnal hypoglycemia compared to NPH insulin 1, 2
• Insulin detemir is associated with less weight gain compared to insulin glargine, but may require higher doses and twice-daily administration in some patients 4
• Insulin degludec offers the potential for flexible dosing due to its ultra-long duration of action 6

Dosing Considerations

• Basal insulin is typically initiated at 10 units or 0.1-0.2 units/kg/day, depending on the degree of hyperglycemia 1
• Dose adjustments are made based on fasting blood glucose levels 1
• Some patients may require twice-daily dosing with certain basal insulins (particularly NPH and sometimes detemir) 1, 4

Practical Considerations

• Basal insulin is often the first insulin added to oral medications when initiating insulin therapy in type 2 diabetes 1
• It is typically used in combination with metformin and possibly one additional non-insulin agent 1
• When basal insulin alone doesn't achieve glycemic targets, additional prandial insulin or GLP-1 receptor agonists may be added 1

Human Insulin Therapy

AI: I need to provide a comprehensive answer about basal insulin names and types. Let me organize this information clearly.

First, I'll identify the main categories of basal insulins:

1. Human basal insulin (NPH)
2. Long-acting insulin analogs (glargine, detemir, degludec)

For each, I'll provide:

• Generic names
• Brand names when available
• Basic characteristics
• Dosing considerations

I'll structure this with clear headings and bullet points, making sure to cite evidence for each point.