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Lantus Iv

1. Indications And Usage

1. Indications And Usage

Generic Name: insulin glargine Dosage Form: injection, solution Lantus is indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Limitations of Use Lantus is not recommended for the treatment of diabetic ketoacidosis. 2. DOSAGE AND ADMINISTRATION Important Administration Instructions Administer Lantus subcutaneously once daily at any time of day but at the same time every day. Prior to initiation of Lantus, train patients on proper use and injection technique. Patient should follow the Instructions for Use to correctly administer Lantus. Administer Lantus subcutaneously into the abdominal area, thigh, or deltoid, and rotate injection sites within the same region from one injection to the next to reduce the risk of lipodystrophy [see Adverse Reactions (6.1)]. Visually inspect Lantus vials and SoloStar prefilled pens for particulate matter and discoloration prior to administration. Only use if the solution is clear and colorless with no visible particles. Refrigerate unused (unopened) Lantus vials and SoloStar® prefilled pens. Do not administer intravenously or via an insulin pump. Do not dilute or mix Lantus with any other insulin or solution. General Dosing Instructions Individualize and adjust the dosage of Lantus based on the individual's metabolic needs, blood glucose monitoring results and glycemic control goal. Dosage adjustments may be needed with changes in physical activity, changes in meal patterns (i.e., macronutrient content or timing of food intake), during acute illness, or changes in renal or hepatic function. Dosage adjustments should only be made under medical supervision with appropriate glucose monitoring [see Warnings and Precautions (5.2)]. Initiation of Lantu Continue reading >>

Lantus (insulin Glargine) Dose, Indications, Adverse Effects, Interactions... From Pdr.net

Lantus (insulin Glargine) Dose, Indications, Adverse Effects, Interactions... From Pdr.net

Hormone secreted by pancreatic beta-cells of the islets of Langerhans and essential for the metabolism and homeostasis of carbohydrate, fat, and protein. Insulin glargine is a once-daily basal insulin analog without pronounced peaks. BASAGLAR, Lantus, Lantus SoloStar, Toujeo SoloStar BASAGLAR/Lantus/Lantus SoloStar/Toujeo SoloStar Subcutaneous Inj Sol: 1mL, 100U, 300U For the treatment of type 1 diabetes mellitus and type 2 diabetes mellitus. For the treatment of type 1 diabetes mellitus. Subcutaneous dosage (100 units/mL, i.e., Lantus, Basaglar) Initially, administer one-third of the total daily insulin requirements/dose subcutaneously once daily. Titrate dosage to achieve blood glucose control and A1C goals in conjunction with a short-acting insulin. Give the dose at the same time every day, at any time. Administration in the morning may avoid nocturnal hypoglycemia. When transferring from once daily NPH insulin, the dose is usually not changed. However, when transferring from twice-daily NPH insulin to insulin glargine, the total daily dose of NPH insulin (or other twice daily basal insulin) should be reduced by 20% and administered as single dose once daily. When transferring from once-daily Toujeo to once-daily Lantus or Basaglar, the recommended initial Lantus or Basaglar dose is 80% of the Toujeo dose that is being discontinued. Thereafter, the dosage of insulin glargine should be adjusted to response. Children and Adolescents 6 years and older Insulin requirements are highly variable and must be individualized based on patient-specific factors and type of insulin regimen. During partial remission phase, total combined daily insulin requirement is often less than 0.5 units/kg/day. Prepubertal children (outside the partial remission phase) usually require 0.7 to Continue reading >>

Pharmacy Consult: We Accidentally Just Gave Insulin Aspart Iv… Is That Bad?

Pharmacy Consult: We Accidentally Just Gave Insulin Aspart Iv… Is That Bad?

Open the Pyxis or Omnicell or fridge in your ED where insulin is stored. How many different vials are stocked? If you’re like most other EDs in the USA you’ll find a rapid acting insulin (aspart, glulisine, lispro) mainly used for hospital sliding scale regimens, insulin regular (fast acting) for IV use, an insulin mix (NPH or aspart/aspart protamine), and a long acting insulin (glargine or detemir) for maintenance. With similar sounding, appearing and often stored next to each other products, it’s not surprising that insulin is the number 1 drug related to medication errors in US hospitals. Consolidating the insulin products may be a solution, reducing the risk of grabbing the wrong vial. In pharmacy school and in residency, its rammed down your throat that your IV insulin is insulin regular. But there is no conceivable reason why rapid acting insulins (aspart, glulisine or lispro) cannot be given IV. Right in the package insert of all places, IV administration is listed as a route of administration. From an evidence-based perspective, there are two studies that compared the effects of IV aspart to IV regular and IV lispro to IV regular [1,2]. The two studies were methodologically similar. Each conducted in healthy individuals, primarily measured glycemic threshold for onset of the clinically detectable autonomic reaction to hypoglycemia induced by aspart, lispro or regular human insulin and utilized the same dosing of 2 units/kg/min. The blood glucose/time profiles were near identical between the different insulin products – practically speaking, this translates into a 1:1 dose conversion. I have not yet been able to convince anyone in the hospital pharmacy to eliminate insulin regular from the formulary. I suppose there are some valid reasons to have multiple Continue reading >>

Ask D'mine: Missing In Action

Ask D'mine: Missing In Action

Need help navigating life with diabetes? Ask D'Mine! That would be our weekly advice column, hosted by veteran type 1, diabetes author and community educator Wil Dubois. This week he's offering some wisdom on what we people with diabetes (PWD) can do if and when we miss a dose of insulin... Yes, it happens. So, read on! {Got your own questions? Email us at [email protected]} Edwin, type 2 from Maryland, writes: I have been diabetic for approximately 12 years. I take Humalog shots before meals, and one shot of 28 units of Lantus at bedtime. My question is, what do I do if I miss a bedtime Lantus shot, and I realize this the next day? This is exactly what happened this morning. The previous night, I had stayed home watching movies and I had a few vodka martinis. I got sleepy, and just went to sleep. When I woke up, I realized I forgot my shot! [email protected] D'Mine answers: Gotta watch out for those vodka martinis! But these kind of things can happen to all of us, with or without the martinis, so don't feel badly. Actually, I'm amazed you remembered in the morning. Maybe your blood sugar reminded you? ;-) As to what to do about the missed shot, this is a trickier question than you might think. I'll give you my thoughts, but this probably falls into the "ask your doctor" category, which means that I need to remind everyone that my title of Doctor WilD is a purely honorary one, granted to me by an un-accredited mail-order "university" in the northeastern part of Liechtenstein. And on top of that, my honorary doctorate isn't a medical degree, but a PhD, and it isn't even in diabetes, it's in underwater basket weaving. So, the medical disclaimer dispensed with, let us proceed... Some missed meds should be taken as soon as you realize you missed them. With others, you need to Continue reading >>

Intravenous Glargine And Regular Insulin Have Similar Effects On Endogenous Glucose Output And Peripheral Activation/deactivation Kinetic Profiles.

Intravenous Glargine And Regular Insulin Have Similar Effects On Endogenous Glucose Output And Peripheral Activation/deactivation Kinetic Profiles.

Abstract OBJECTIVE: To compare the effects of intravenously administered long-acting insulin analog glargine and regular human insulin on activation and deactivation of endogenous glucose output (EGO) and peripheral glucose uptake. RESEARCH DESIGN AND METHODS: In this single-center, randomized, double-blind, crossover euglycemic glucose clamp study, 15 healthy male volunteers (aged 27 +/- 4 years, BMI 24.2 +/- 0.7 kg/m(2) [mean +/- SE]) received a primed continuous intravenous infusion of 40 mU/m(2) of insulin glargine or regular human insulin on 2 different study days in a randomized order. Euglycemia was maintained at 90 mg/dl using a simultaneous variable intravenous infusion of 20% dextrose containing D-[3-(3)H]glucose. EGO and peripheral glucose disposal kinetics were determined during a 4-h insulin infusion activation period and a 3-h deactivation period. RESULTS: The results demonstrated no significant difference in activation or deactivation kinetics with respect to EGO and peripheral glucose disposal between insulin glargine and regular human insulin when given intravenously. The mean +/- SE time required for 50% suppression of EGO after insulin infusion was 73 +/- 23 min for regular insulin and 57 +/- 20 min for insulin glargine (NS). The mean maximum rate of glucose disposal was 10.10 +/- 0.77 and 9.90 +/- 0.85 mg. kg(-1). min(-1) for regular insulin and insulin glargine, respectively (NS). The mean time required for 50% suppression of incremental glucose disposal rate (GDR), defined as the time required for activation from the basal glucose disappearance rate (R(d)) to half-maximum insulin-stimulated R(d), was 32 +/- 5 and 42 +/- 10 min for regular insulin and insulin glargine, respectively (NS). The time required for deactivation from maximum insulin-stimul Continue reading >>

Subcutaneous Administration Of Glargine To Diabetic Patients Receiving Insulin Infusion Prevents Rebound Hyperglycemia

Subcutaneous Administration Of Glargine To Diabetic Patients Receiving Insulin Infusion Prevents Rebound Hyperglycemia

The Journal of Clinical Endocrinology & Metabolism Subcutaneous Administration of Glargine to Diabetic Patients Receiving Insulin Infusion Prevents Rebound Hyperglycemia Division of Endocrinology (E.H., S.S., J.G., R.M.H., E.C., N.R., C.W., B.D.), Denver, Colorado 80045 Search for other works by this author on: Division of Endocrinology (E.H., S.S., J.G., R.M.H., E.C., N.R., C.W., B.D.), Denver, Colorado 80045 Search for other works by this author on: Division of Endocrinology (E.H., S.S., J.G., R.M.H., E.C., N.R., C.W., B.D.), Denver, Colorado 80045 Search for other works by this author on: Division of Endocrinology (E.H., S.S., J.G., R.M.H., E.C., N.R., C.W., B.D.), Denver, Colorado 80045 Search for other works by this author on: Division of Endocrinology (E.H., S.S., J.G., R.M.H., E.C., N.R., C.W., B.D.), Denver, Colorado 80045 Search for other works by this author on: University of Colorado School of Medicine, and Denver Veterans Affairs Medical Center (N.R., C.W.), Denver, Colorado 80045 Search for other works by this author on: University of Colorado School of Medicine, and Denver Veterans Affairs Medical Center (N.R., C.W.), Denver, Colorado 80045 Search for other works by this author on: Department of Medicine, Division of Transplant Surgery, and Department of Surgery (I.K.), Denver, Colorado 80045 Search for other works by this author on: Division of Endocrinology (E.H., S.S., J.G., R.M.H., E.C., N.R., C.W., B.D.), Denver, Colorado 80045 Address all correspondence and requests for reprints to: Boris Draznin, M.D., Ph.D, University of Colorado, Denver, School of Medicine, Division of Endocrinology, Metabolism, and Diabetes, MS 8106, 12801 East 17th Avenue, RC1 South RM 7103, Aurora, Colorado 80045. Search for other works by this author on: The Journal of Clinic Continue reading >>

Lantus® Can Still Be Your Choice For A Once-daily Injection

Lantus® Can Still Be Your Choice For A Once-daily Injection

Lantus® is a long-acting insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Lantus® should be administered once a day at the same time every day. Limitations of Use: Lantus® is not recommended for the treatment of diabetic ketoacidosis. Contraindications Lantus® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or one of its excipients. Warnings and Precautions Insulin pens, needles, or syringes must never be shared between patients. Do NOT reuse needles. Monitor blood glucose in all patients treated with insulin. Modify insulin regimen cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. Do not dilute or mix Lantus® with any other insulin or solution. If mixed or diluted, the solution may become cloudy, and the onset of action/time to peak effect may be altered in an unpredictable manner. Do not administer Lantus® via an insulin pump or intravenously because severe hypoglycemia can occur. Hypoglycemia is the most common adverse reaction of insulin therapy, including Lantus®, and may be life-threatening. Medication errors, such as accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. Patients should be instructed to always verify the insulin label before each injection. Severe life-threatening, generalized allergy, including anaphylaxis, can occur. Discontinue Lantus®, treat and monitor until symptoms resolve. A reduction in the Lantus® dose may be re Continue reading >>

Types Of Insulin For Diabetes Treatment

Types Of Insulin For Diabetes Treatment

Many forms of insulin treat diabetes. They're grouped by how fast they start to work and how long their effects last. The types of insulin include: Rapid-acting Short-acting Intermediate-acting Long-acting Pre-mixed What Type of Insulin Is Best for My Diabetes? Your doctor will work with you to prescribe the type of insulin that's best for you and your diabetes. Making that choice will depend on many things, including: How you respond to insulin. (How long it takes the body to absorb it and how long it remains active varies from person to person.) Lifestyle choices. The type of food you eat, how much alcohol you drink, or how much exercise you get will all affect how your body uses insulin. Your willingness to give yourself multiple injections per day Your age Your goals for managing your blood sugar Afrezza, a rapid-acting inhaled insulin, is FDA-approved for use before meals for both type 1 and type 2 diabetes. The drug peaks in your blood in about 15-20 minutes and it clears your body in 2-3 hours. It must be used along with long-acting insulin in people with type 1 diabetes. The chart below lists the types of injectable insulin with details about onset (the length of time before insulin reaches the bloodstream and begins to lower blood sugar), peak (the time period when it best lowers blood sugar) and duration (how long insulin continues to work). These three things may vary. The final column offers some insight into the "coverage" provided by the different insulin types in relation to mealtime. Type of Insulin & Brand Names Onset Peak Duration Role in Blood Sugar Management Rapid-Acting Lispro (Humalog) 15-30 min. 30-90 min 3-5 hours Rapid-acting insulin covers insulin needs for meals eaten at the same time as the injection. This type of insulin is often used with Continue reading >>

Avoiding Accidental Iv With Lantus

Avoiding Accidental Iv With Lantus

Diabetes Forum The Global Diabetes Community This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies. Learn More. Get the Diabetes Forum App for your phone - available on iOS and Android . Find support, ask questions and share your experiences. Join the community Hello, I am new to this forum. I have been suffering from diabetes Type II for about eight years. I have gone through the usual progression from diet control through to insulin. About four years ago when I was still living in Australia my Dr commenced me on Lantus. I have responded really well to this taking 36 units daily. In the last 18 months or so I have experienced two incidents of accidental IV. Whilst rare it is not uncommon. The last one was about two months ago. It resulted in severe hypo about 30 minutes after the injection falling rapidly to 2.4 mmol. I managed this myself taking glucose and anything else I could get my hands on that was sweet. This causes very rapid swings taken my BSL up to 9 mmol then falling within a minute or so to about 3 mmol. If I remember right it took me about two hours or more to stabilise myself to the satisfaction that I could go to bed. As this was the second incident and I will be honest it is a bit scary I split the Lantus to to injections twice a day of 18 units each. Using the rationale that 18 units IV is easier to manage than 36 units. I was speaking to my diabetic nurse today and she suggested using a much shorter needle. Currently I am using Novofine 28G X 12 mm. She suggested using 6 mm. I see on this site you can even get 4 mm. My question is what is forum members views on using ultra short needles I guess that it would certainly miss any blood vessels that are obviously deeper down. I don't mind buying the needles if NH Continue reading >>

Lantus

Lantus

Lantus is a prescription medication used to treat type 1 and type 2 diabetes. Lantus is a long-acting form of insulin and works by replacing the insulin that is normally produced by the body and by helping the body to use sugar for energy. It also stops the liver from producing more sugar. This medication comes in an injectable form and is usually used once daily. Common side effects include low blood sugar, redness and skin thickening at the injection site, and weight gain. Lantus is a prescription medication used to treat people with type 1 and type 2 diabetes for the control of high blood sugar. Lantus may be used along with fast-acting insulin or oral medications to control blood sugar. This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. Lantus can cause hypoglycemia (low blood sugar), hyperglycemia (high blood sugar), allergy, and skin reactions. Hypoglycemia (low blood sugar): Early warning signs of hypoglycemia may be different, less noticeable or not noticeable at all in some people. That is why it is important to check your blood sugar as you have been advised by your doctor. Symptoms of hypoglycemia may include: anxiety, irritability, restlessness, trouble concentrating, personality changes, mood changes, or other abnormal behavior tingling in your hands, feet, lips, or tongue dizziness, light-headedness, or drowsiness nightmares or trouble sleeping headache blurred vision slurred speech palpitations (fast heart beat) sweating tremor (shaking) unsteady gait (walking). If you have hypoglycemia often or it is hard for you to know if you have the symptoms of hypoglycemia, talk to your doctor. Mild to moderate hypoglycemia is treated by eating or drinking carbohydrates, such as fruit juice, raisins, sugar candies, Continue reading >>

Early Administration Of Long-acting Insulin Treatment Of Diabetic Ketoacidosis In Pediatric Type 1 Diabetes

Early Administration Of Long-acting Insulin Treatment Of Diabetic Ketoacidosis In Pediatric Type 1 Diabetes

The management goals of diabetic ketoacidosis (DKA) in the pediatric type 1 diabetes (T1DM) population are fluid and electrolyte repletion, insulin administration, and correction of acidosis in order to stabilize the patient. Traditionally, a rapid-acting insulin IV infusion is begun immediately and continued until the acidosis is corrected and hyperglycemia normalized. Once the acidosis is corrected, patients are able to be transitioned to a subcutaneous insulin regimen. The role that a subcutaneous long-acting insulin such as glargine has in the acute treatment of DKA has not been extensively studied. While giving glargine during the treatment of DKA is becoming more common place, few studies have examined the potential risks and benefits of its use. This study will investigate the effects of early administration of glargine during DKA in patients with newly diagnosed TIDM. The design of this study is a prospective, double-blind study of children ages 2-21 who are admitted to the hospital in DKA with a diagnosis of T1DM. The control group will receive all traditional methods of treatment for DKA, including a placebo subcutaneous injection. The study group will receive the same treatment, but will be supplemented with a subcutaneous glargine injection. Study Type : Interventional (Clinical Trial) Estimated Enrollment : 90 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Triple (Participant, Care Provider, Investigator) Primary Purpose: Treatment Official Title: Early Administration of Long-acting Insulin Glargine for the Treatment of Diabetic Ketoacidosis in Pediatric Type 1 Diabetes: A Randomized Double Blind Trial Study Start Date : November 2015 Estimated Primary Completion Date : December 2018 Estimated Study Completion Date : De Continue reading >>

Insulin Glargine

Insulin Glargine

Insulin glargine, marketed under the names Lantus, among others, is a long-acting basal insulin analogue, given once daily to help control the blood sugar level of those with diabetes. It consists of microcrystals that slowly release insulin, giving a long duration of action of 18 to 26 hours, with a "peakless" profile (according to the insulin glargine package insert). Pharmacokinetically, it resembles basal insulin secretion of non-diabetic pancreatic beta cells. Sometimes, in type 2 diabetes and in combination with a short acting sulfonylurea (drugs which stimulate the pancreas to make more insulin), it can offer moderate control of serum glucose levels. In the absence of endogenous insulin—type 1 diabetes, depleted type 2 (in some cases) or latent autoimmune diabetes of adults in late stage—insulin glargine needs the support of fast acting insulin taken with food to reduce the effect of prandially derived glucose. Medical uses[edit] The long-acting insulin class, which includes insulin glargine, do not appear much better than neutral protamine Hagedorn (NPH) insulin but have a significantly greater cost making them, as of 2010, not cost effective.[1] It is unclear if there is a difference in hypoglycemia and not enough data to determine any differences with respect to long term outcomes.[2] Mixing with other insulins[edit] Unlike some other longer-acting insulins, glargine must not be diluted or mixed with other insulin or solution in the same syringe.[3] However, this restriction has been questioned.[4] Adverse effects[edit] Cancer[edit] As of 2012 tentative evidence shows no association between insulin glargine and cancer.[5] Previous studies had raised concerns.[6] Pharmacology[edit] Mechanism of action[edit] Insulin glargine has a substitution of glycine for Continue reading >>

Transitioning Safely From Intravenous To Subcutaneous Insulin

Transitioning Safely From Intravenous To Subcutaneous Insulin

Current Diabetes Reports Authors Kathryn Evans Kreider, Lillian F. Lien Abstract The transition from intravenous (IV) to subcutaneous (SQ) insulin in the hospitalized patient with diabetes or hyperglycemia is a key step in patient care. This review article suggests a stepwise approach to the transition in order to promote safety and euglycemia. Important components of the transition include evaluating the patient and clinical situation for appropriateness, recognizing factors that influence a safe transition, calculation of proper SQ insulin doses, and deciding the appropriate type of SQ insulin. This article addresses other clinical situations including the management of patients previously on insulin pumps and recommendations for patients requiring glucocorticoids and enteral tube feedings. The use of institutional and computerized protocols is discussed. Further research is needed regarding the transition management of subgroups of patients such as those with type 1 diabetes and end-stage renal disease. Introduction Intravenous (IV) insulin is used in the hospitalized patient to control blood sugars for patients with and without diabetes who may exhibit uncontrolled hyperglycemia or for those who need close glycemic attention. Common hospital uses for IV insulin include the perioperative setting, during the use of high-risk medications (such as corticosteroids), or during crises such as diabetic ketoacidosis (DKA) [1,2]. Other conditions such as hyperglycemic hyperosmolar state (HHS) and trauma frequently require IV insulin, as well as specific hospital units such as the cardiothoracic intensive care unit [3,4]. The correlation between hyperglycemia and poor inpatient outcomes has been well described in the literature [5,6]. The treatment of hyperglycemia using an IV Continue reading >>

Insulin Glargine In Dka

Insulin Glargine In Dka

No difference in primary outcome (time to AG closure 10.2 hours in experimental group vs 11.6 hours in control group) No difference in secondary outcomes (hospital LOS, ICU LOS, ICU admission rate, hypoglycemic episodes) Study design (prospective, randomized trial) It is unclear if the primary and secondary endpoints are clinically relevant; ie. even if the difference between time to closure of AG and/or LOS for the groups was statistically significant, how would that translate into a clinically significant endpoint? Coadministration of glargine in combination with an insulin infusion in the acute management of DKA is feasible. Further study is needed to determine the true efficacy in terms of TCAG and hospital LOS. Based on the findings of this one small study, it does not appear beneficial to co-administer insulin glargine with IV insulin in the acute management of DKA. While the pharmacokinetics and pharmacodynamics of administering insulin glargine in DKA make intuitive sense, large studies are needed to determine if this is the case. Additionally, the primary outcome (time to closure of AG) chosen by the authors is difficult to interpret for clinical impact, even if the findings were statistically significant. While the idea of co administering insulin glargine in acute DKA makes sense, larger studies with more clinically relevant endpoints are needed to determine if doing so would be advantageous . Continue reading >>

Lantus, Toujeo (insulin Glargine) Dosing, Indications, Interactions, Adverse Effects, And More

Lantus, Toujeo (insulin Glargine) Dosing, Indications, Interactions, Adverse Effects, And More

100 units/mL (Lantus SoloSTAR; Basaglar KwikPen; 3 mL disposable prefilled pens) 300 units/mL (Toujeo; 1.5 mL SoloStar disposable prefilled pen) 300 units/mL (Toujeo Max; 3 mL SoloStar disposable prefilled pen) Note: Recent studies have suggested that glargine-300 extends blood glucose control well beyond 24 hr Long-acting basal insulin indicated to improve glycemic control in adults with type 1 diabetes mellitus Start ~1/3 of total daily insulin dose; use remaining 2/3 of daily insulin dose on short-acting, premeal insulin Usual initial dose range: 0.2-0.4 units/kg; optimal glucose lowering effect may take 5 days to fully manifest and the first insulin glargine dose may be insufficient to cover metabolic needs in the first 24 hr of use Titrate insulin glargine per instructions, and adjust coadministered glucose-lowering therapies per standard of care See Dosing Considerations and Administration Long-acting basal insulin indicated to improve glycemic control in adults with type 2 diabetes mellitus Start 0.2 units/kg qDay; if necessary, adjust dosage of other antidiabetic drugs when starting insulin glargine to minimize the risk of hypoglycemia See Dosing Considerations and Administration Dose must be individualized based on clinical response; blood glucose monitoring is essential in all patients receiving insulin therapy Patients adjusting the amount or timing of dosage should do so only under medical supervision with appropriate glucose monitoring Titrate Toujeo dose no more frequently than every 3-4 days Use with caution in patients with visual impairment who may rely on audible clicks to dial their dose If changing from a treatment regimen with an intermediate- or long-acting insulin to a regimen with insulin glargine, the amount and timing of shorter-acting insulin Continue reading >>

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