From the Guidelines
Insulin glargine typically lasts for 24 hours in the body, providing a steady, long-acting insulin effect throughout the day. This long duration of action makes it suitable for once-daily dosing, usually administered at the same time each day to maintain consistent blood glucose control. According to the study published in the American Family Physician in 2006 1, the duration of action of insulin glargine is 24 hours, with no peak action time, reducing the risk of hypoglycemia. Another study published in the same journal in 2006 1 also supports this, stating that glargine slowly releases insulin over 24 hours, causing more physiologic basal insulin levels.
Some key points to consider when using insulin glargine include:
- It works by forming microprecipitates in the subcutaneous tissue after injection, which slowly dissolve and release insulin into the bloodstream at a relatively constant rate.
- This creates a "peakless" profile, meaning there is less risk of hypoglycemia compared to intermediate-acting insulins.
- Some patients may experience slightly shorter or longer durations of effect based on individual factors such as dose, injection site, physical activity, and metabolism.
- For optimal blood glucose management, insulin glargine should be used as part of a comprehensive diabetes treatment plan that may include mealtime insulin for those with type 1 diabetes or certain cases of type 2 diabetes.
- It's essential to monitor blood glucose levels regularly when using insulin glargine to ensure appropriate coverage throughout the full 24-hour period, as supported by the study 1 that compared glargine insulin with insulin isophane suspension in patients with type 1 diabetes.
From the FDA Drug Label
The median time between subcutaneous injection and the end of pharmacological effect was 14.5 hours (range: 9. 5 to 19.3 hours) for NPH insulin, and 24 hours (range: 10. 8 to >24 hours) (24 hours was the end of the observation period) for Insulin Glargine. The duration of action after abdominal, deltoid, or thigh subcutaneous administration of Insulin Glargine was similar The time course of action of insulins, including Insulin Glargine, may vary between patients and within the same patient.
The effect of insulin glargine lasts for at least 24 hours, with a range of 10.8 to more than 24 hours. The duration of action may vary between patients and within the same patient 2.
- Key points:
- Median time to end of pharmacological effect: 24 hours
- Range of duration of action: 10.8 to more than 24 hours
- Duration of action may vary between patients and within the same patient
From the Research
Insulin Glargine Duration of Action
- The duration of action of insulin glargine is approximately 24 hours, providing a fairly constant, basal insulin supply without peaks in plasma insulin levels 3, 4, 5, 6, 7.
- Insulin glargine precipitates after subcutaneous injection, slowing absorption and resulting in a flat pharmacokinetic profile with a duration of action of at least 24 hours 4, 5.
- The activity profile of insulin glargine lacks a pronounced peak, more closely resembling that of endogenous basal insulin, and appears more likely to be associated with a reduced incidence of hypoglycemia, particularly nocturnal hypoglycemia 5, 6.
Clinical Efficacy and Tolerability
- Insulin glargine has similar tolerability and produces similar glycemic control to once- or twice-daily human NPH insulin, with a similar glucose-lowering effect on a molar basis 3, 6.
- A decreased incidence of hypoglycemia, particularly at night, has been reported with insulin glargine compared with human NPH insulin 3, 4, 5, 6, 7.
- Insulin glargine appears to be comparable to human NPH insulin in terms of toxicity, adverse effects, immunogenicity, and potential for drug interactions 6.