From the Guidelines
Lantus (insulin glargine) should be taken once daily, as it is designed to provide a steady, basal level of insulin for approximately 24 hours, making once-daily dosing sufficient for many people with diabetes. This recommendation is based on the most recent and highest quality study available, which suggests that once-daily dosing of Lantus is effective in maintaining consistent blood glucose control throughout the day and night 1. The injection is usually administered at the same time each day, often at bedtime, to maintain consistent blood glucose control. However, some patients, particularly those who experience blood glucose fluctuations or who require higher insulin doses, may benefit from splitting their total daily Lantus dose into two injections taken 12 hours apart.
Some key points to consider when taking Lantus include:
- The decision between once or twice daily dosing should be made in consultation with a healthcare provider based on individual blood glucose patterns, total insulin requirements, and lifestyle factors.
- Lantus should be injected subcutaneously, rotating injection sites to prevent lipohypertrophy, and should not be mixed with other insulins in the same syringe.
- Dose titration is important, and dosing adjustments may be necessary in both mealtime and basal insulins, based on blood glucose level and an understanding of the pharmacodynamic profile of each formulation (that is, pattern control) 2.
- Further options for treatment intensification include adding a single injection of rapid-acting insulin analogue before the largest meal, adding a GLP-1–receptor agonist, or stopping basal insulin and starting twice-daily premixed (or biphasic) insulin 3.
It's worth noting that the evidence from the provided studies suggests that Lantus is effective and safe when taken once daily, and that this dosing schedule is sufficient for many people with diabetes. However, individual patient needs may vary, and healthcare providers should consider factors such as blood glucose patterns, total insulin requirements, and lifestyle factors when determining the best dosing schedule for each patient.
From the Research
Administration Frequency of Lantus
- Lantus (insulin glargine) is a long-acting insulin analogue that can be administered once daily to provide basal glycaemic control in adults and children with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus 4, 5, 6, 7, 8.
- Studies have shown that once-daily administration of Lantus achieves equivalent glycaemic control to NPH insulin given once or twice daily, with a lower incidence of hypoglycaemia, especially nocturnal hypoglycaemia 4, 5, 6, 7, 8.
- The time of day at which Lantus is injected has no clinically relevant effect on glycaemic control in patients with type 1 diabetes mellitus 6.
Comparison with NPH Insulin
- Lantus has been compared to NPH insulin in several studies, with results showing that Lantus provides a more constant basal level of circulating insulin with no pronounced peak, whereas NPH insulin has a more pronounced peak 4, 5, 6, 7, 8.
- Lantus has been shown to be associated with lower fasting blood glucose levels and a reduced incidence of nocturnal hypoglycaemia compared to NPH insulin 4, 5, 6, 7, 8.