Can type 2 diabetes be treated with insulin glargine (Lantus) and semaglutide (Ozempic) together?

From the Guidelines

Yes, people with type 2 diabetes can use insulin lantus (insulin glargine) and Ozempic (semaglutide) together, as this combination therapy has been shown to have potent glucose-lowering actions with less weight gain and hypoglycemia compared to intensified insulin regimens 1.

Key Points to Consider

• The combination of basal insulin and GLP-1 RA, such as insulin glargine and semaglutide, can be an effective approach for managing blood glucose levels in individuals with type 2 diabetes who require additional therapy beyond basal insulin alone.
• This combination works well because the medications act through different mechanisms - Lantus directly supplies insulin that the body needs, while Ozempic helps the body produce more of its own insulin when needed, reduces glucose production by the liver, and slows food absorption.
• The DUAL VIII randomized controlled trial demonstrated greater durability of glycemic treatment effect with the combination GLP-1 RA–insulin therapy compared to addition of basal insulin alone 1.
• When initiating combination injectable therapy, metformin therapy should be maintained, while sulfonylureas and DPP-4 inhibitors are typically weaned or discontinued.
• Side effects to watch for include hypoglycemia (low blood sugar), nausea, and gastrointestinal issues.

Dosage and Administration

• Lantus is typically injected once daily at the same time each day, with dosing individualized based on blood glucose readings.
• Ozempic is injected subcutaneously once weekly regardless of meals, with a starting dose of 0.25 mg for the first 4 weeks, then increased to 0.5 mg, with possible further increases to 1 mg or 2 mg if needed.
• It is essential to monitor blood glucose levels and adjust the doses of Lantus and Ozempic as needed to achieve optimal glycemic control while minimizing the risk of hypoglycemia and other side effects.

From the FDA Drug Label

OZEMPIC has been studied as monotherapy and in combination with metformin, metformin and sulfonylureas, metformin and/or thiazolidinedione, and basal insulin in patients with type 2 diabetes mellitus.

The use of Ozempic with basal insulin (such as Lantus) is mentioned in the drug label as a studied combination in patients with type 2 diabetes mellitus. Therefore, yes, diabetes type 2 can have insulin Lantus and Ozempic together 2.

From the Research

Combination Therapy for Type 2 Diabetes

• The use of insulin and GLP-1 receptor agonists, such as semaglutide (Ozempic), together in the treatment of type 2 diabetes has been explored in various studies 3, 4, 5, 6.
• Insulin glargine (Lantus) is a long-acting insulin that can be used in combination with oral antidiabetic agents (OADs) to improve glycemic control in patients with type 2 diabetes 7.
• GLP-1 receptor agonists, including semaglutide, have been shown to be effective in reducing HbA1c levels and body weight, with a low risk of hypoglycemia, and can be used as an adjunct to insulin therapy 3, 4, 5, 6.

Efficacy and Safety of Combination Therapy

• Studies have demonstrated that the combination of insulin and GLP-1 receptor agonists can provide improved glycemic control and weight loss, with a reduced risk of hypoglycemia compared to insulin therapy alone 3, 4, 5.
• Semaglutide, in particular, has been shown to be effective in reducing HbA1c levels and body weight, with a low risk of hypoglycemia, and can be used in combination with insulin therapy 4, 6.
• The safety and efficacy of combination therapy with insulin and GLP-1 receptor agonists, including semaglutide, have been established in several clinical trials 3, 4, 5, 6.

Clinical Use of Combination Therapy

• The use of combination therapy with insulin and GLP-1 receptor agonists, including semaglutide, should be individualized based on patient needs and medical history 3, 4, 5, 6.
• Patients with type 2 diabetes who are not achieving adequate glycemic control with insulin therapy alone may benefit from the addition of a GLP-1 receptor agonist, such as semaglutide 3, 4, 5, 6.
• The combination of insulin and GLP-1 receptor agonists, including semaglutide, can provide a useful treatment option for patients with type 2 diabetes who require improved glycemic control and weight loss 3, 4, 5, 6.