Half-Life of Lantus (Insulin Glargine)
Insulin glargine (Lantus) does not have a traditional "half-life" in the pharmacokinetic sense because it functions as a depot formulation that provides relatively constant insulin levels over approximately 24 hours without a pronounced peak. 1, 2
Pharmacokinetic Profile
Insulin glargine has an onset of action of approximately 1 hour after subcutaneous injection, with a duration of action of approximately 24 hours, allowing for once-daily dosing. 2
The unique pharmacokinetic characteristics of insulin glargine distinguish it from conventional insulins:
Insulin glargine provides a peakless profile with relatively constant concentration over 24 hours, which is fundamentally different from intermediate-acting insulins like NPH that have distinct peaks 2, 3
The medication slowly releases insulin over 24 hours, causing more physiologic basal insulin levels rather than following traditional absorption-distribution-elimination kinetics 2
Subcutaneous insulin glargine forms microprecipitates at neutral tissue pH from which small amounts are gradually released, creating sustained action rather than a bolus effect 4, 5
Clinical Implications for Your Patient
For a patient with type 2 diabetes, coronary artery disease, and hypertension:
The 24-hour duration of action allows once-daily administration at any consistent time of day 2, 6
The absence of peak action time reduces hypoglycemia risk compared to NPH insulin, which is particularly important given the cardiovascular disease 2, 7
The peakless profile provides more stable blood glucose control between meals and overnight, minimizing glycemic variability that could impact cardiovascular risk 2, 3
Important Clinical Considerations
Starting doses can be estimated at 0.1-0.2 units/kg/day based on body weight and degree of hyperglycemia, with individualized titration over days to weeks. 2
Insulin glargine primarily restrains hepatic glucose production and limits hyperglycemia overnight and between meals 2
The medication demonstrates significantly lower rates of nocturnal hypoglycemia compared to NPH insulin while achieving equivalent glycemic control 7, 4
No dose adjustment is required across all stages of chronic kidney disease, which may be relevant given the cardiovascular comorbidities 1