Long-Acting: Insulin Glargine

Long-Acting Insulin Glargine Lantus Aventis U-100 4-5 hours Flat 22-24 1 0 mL vial, 3 mL cartridge for Opticlik... 

Long-Acting Insulin glargine solution - 1.1 5 b 24C None... 

Ultra-long-acting Insulin glargine Human, modified No peak >24... 

Insulin glargine is given SC once daily at bedtime This type of insulin is used in the treatment of adults and children with type 1 diabetes mellitus and in adults widi type 2 diabetes who need long-acting insulin for die control of hyperglycemia. 

Long-acting insulins Lantus (insulin glargine) Yes Vial, 3-mL OptiClik pen system... 

Heinemann L et al Time action profile of the long-acting insulin analog insulin glargine (HOE901) in comparison with those of NPH insulin and placebo. Diabetes Care 2000 23 644. [PMID 10834424]... 

Continuous subcutaneous insulin infusion has been compared with short-acting insulins plus glargine or isophane as long-acting insulins for 1 year in 32 patients with poor control (252). Four of them had serious attacks of hypoglycemia. There were no differences in HbAic or other metabolic parameters (including lipids). In those treated with continuous subcutaneous insulin infusion, the reduction in the amount of insulin required was larger. 

Clinical studies of new long-acting insulins, have been reviewed, mainly with reference to insulin glargine (9). The author concluded that these new analogues have efficacy and safety advantages over NPH insulin. 

Long-acting insulin analogues. The more extensive alteration of amino acids in insulin glargine changes the electric charge of the molecule. At pH 4 of the injectate, it is dissolved however, at the pH of tissue it is poorly water-soluble and precipitates. Resolubilization and diffusion into the bloodstream take about one day. 

Thisted H, Johnsen SP, Rungby J. An update on the long-acting insulin analogue glargine. Basic Clin Pharmacol Toxicol. 2006 99(1) 1-11. 

Fig. 1. Molecular structures of the long-acting insulin analogues, detemir (upper part) and glargine (lower part).

Both long-acting insulin analogues - insulin glargine and insulin detemir - have been implemented in the treat to target approach used in type 2 diabetic patients. The analogues are injectable, clear solutions, but the mechanisms by which they achieve prolonged activity differ entirely as described in detail in Chapter 8 and in [11,12]. 

Reinhart, L., and Panning, C.A. (2002) Insuhn glargine A new long-acting insulin product. American Society of Health-System Pharmacists, 59, 643-649. 

---