What is an example of long-acting insulin?

From the Guidelines

Long-acting insulins, such as insulin glargine or insulin detemir, are the preferred choice for basal insulin therapy due to their ability to provide a steady, basal level of insulin throughout the day with modestly less overnight hypoglycemia compared to intermediate-acting insulins 1.

Key Characteristics of Long-Acting Insulins

• Provide relatively uniform insulin coverage throughout the day and night
• Mainly control blood glucose by suppressing hepatic glucose production in between meals and during sleep
• Associated with modestly less overnight hypoglycemia and possibly slightly less weight gain compared to intermediate-acting insulins

Examples of Long-Acting Insulins

• Insulin glargine [A21Gly,B31Arg,B32Arg human insulin]
• Insulin detemir [B29Lys (´-tetradecanoyl),desB30 human insulin]

Clinical Considerations

• The dosing of these basal insulin analogs may differ, with most comparative trials showing a higher average unit requirement with insulin detemir 1
• An insulin treatment program should be designed specifically for an individual patient, to match the supply of insulin to his or her dietary/exercise habits and prevailing glucose trends, as revealed through self-monitoring 1

From the FDA Drug Label

Insulin degludec is a long-acting basal human insulin analog for subcutaneous injection Insulin glargine is a long-acting human insulin analog

• Examples of long-acting insulin include:
  • Insulin degludec
  • Insulin glargine These are both long-acting basal insulin analogs used for subcutaneous injection 2, 2, 3

From the Research

Examples of Long-Acting Insulin

• Insulin glargine (Lantus) is a long-acting, human insulin analogue that has been specifically designed to overcome the deficiencies of traditionally available 'intermediate-acting' insulins 4, 5, 6.
• Insulin degludec (Tresiba, Novo Nordisk) is another long-acting human insulin analogue, also approved in the EU for patients with type 1 and type 2 diabetes 7.
• Insulin detemir is a long-acting insulin analogue that seems beneficial for type 2 diabetes patients 8.

Characteristics of Long-Acting Insulin

• Insulin glargine provides a relatively constant basal level of circulating insulin with no pronounced peak 4, 5, 6.
• Insulin degludec has a slower onset of action and a longer duration of action with no peak activity 7.
• Insulin detemir is associated with less weight gain and can be injected once-daily or twice-daily 8.

Comparison of Long-Acting Insulin

• Insulin glargine and insulin detemir have similar efficacy and safety profiles, but insulin detemir is often injected twice-daily in a higher dose with less weight gain 8.
• Insulin glargine and insulin degludec have similar efficacy in terms of HbA1c control, but insulin degludec has a higher concentration of 200 units per ml, which creates a risk of confusion and overdose 7.