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Peak For Lantus

Insulin Action

Insulin Action

Insulin is a medicine that lowers blood glucose (sugar). There are several types of insulin. Each type of insulin has a certain time period in which it works. In order to understand insulin action, it is helpful to know the onset, peak and duration of the insulin you take. Onset refers to when the insulin starts to work. Peak refers to when the insulin works hardest. Duration refers to how long the insulin works. You are more likely to have a low blood glucose when your insulin is peaking, during periods of increased physical activity or if you are eating less food. If you are having problems with low blood glucose, talk to your healthcare provider about adjusting your insulin. Usual Action Times of Insulin PRODUCT WHEN TO TAKE ONSET PEAK DURATION Rapid-Acting Lispro (Humalog) Aspart (Novolog) Glulisine (Apidra) 0-15 min before meal 10-30 min 30 min - 3 hours 3-5 hours Short-Acting Regular (R) Human 30 min before meal 30-60 min 2-5 hours Up to 12 hours Intermediate-Acting NPH (N) Human Does not need to be given with meal 90 min - 4 hours 4-12 hours Up to 24 hours Long Acting Glargine (Lantus) Detemir (Levemir) Does not need to be given with meal 45 min - 4 hours Minimal Up to 24 hours Continue reading >>

Types Of Insulin

Types Of Insulin

Insulin analogs are now replacing human insulin in the US. Insulins are categorized by differences in onset, peak, duration, concentration, and route of delivery. Human Insulin and Insulin Analogs are available for insulin replacement therapy. Insulins also are classified by the timing of their action in your body – specifically, how quickly they start to act, when they have a maximal effect and how long they act.Insulin analogs have been developed because human insulins have limitations when injected under the skin. In high concentrations, such as in a vial or cartridge, human (and also animal insulin) clumps together. This clumping causes slow and unpredictable absorption from the subcutaneous tissue and a dose-dependent duration of action (i.e. the larger dose, the longer the effect or duration). In contrast, insulin analogs have a more predictable duration of action. The rapid acting insulin analogs work more quickly, and the long acting insulin analogs last longer and have a more even, “peakless” effect. Background Insulin has been available since 1925. It was initially extracted from beef and pork pancreases. In the early 1980’s, technology became available to produce human insulin synthetically. Synthetic human insulin has replaced beef and pork insulin in the US. And now, insulin analogs are replacing human insulin. Characteristics of Insulin Insulins are categorized by differences in: Onset (how quickly they act) Peak (how long it takes to achieve maximum impact) Duration (how long they last before they wear off) Concentration (Insulins sold in the U.S. have a concentration of 100 units per ml or U100. In other countries, additional concentrations are available. Note: If you purchase insulin abroad, be sure it is U100.) Route of delivery (whether they a Continue reading >>

Lantus Peak - Medhelp

Lantus Peak - Medhelp

Common Questions and Answers about Lantus peak This is a wonderful resource for Type I's...often a minority in support groups, IMHO. My first posting to the forum although I've been type I since age 7...now a healthy 45 year old (female).I am mostly happy with the current combination of Humalog Pen and Lantus. My questions are in regards to Lantus:I understand the "non-peak" aspect...but personally dropped very low in early a.m.'s (about 4-6 a.m) after injecting on a regular basis at 10 p.m. my docotor tells me lantus dose not peak like other insulins and lasts 24 hoursbut that dose not work for me as it seems to stop working sometime between 10:00 PM and 7:00 AM which is 9 hours stretch of time is there some way I can find the times that it normally peaks and the time that it normally stops working as this would be a great help in becoming more stable. And as for the sweats about a half hour after taking Lantus , there IS a slight peak action with Lantus , although this peak action for most people is several hours after taking the Lantus. In my case, I usually take my Lantus at about 6 am, and I notice a peak that causes my glucose levels to drop by about 8 am. This happens even if I have not taken any Novolog or eaten breakfast (sometimes I wait until I get to work to take Novolog and eat breakfast), so it has to be the Lantus peaking. Because excess heat can activate Lantus post injection, patients are being warned against things such as saunas and hot tubs due to the possibility of severe hypoglycemia. But I've also seen 'hot showers' included as well. I've been wondering - how hot is 'hot'? In the winter I'm always freezing, and a hot shower was great before bed. I've been hesitant to enjoy such a pleasure since starting Lantus though. Have any studies been done a 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 >>

Lantus® Can Still Be Your Choice For A Product With Demonstrated Efficacy And Safety

Lantus® Can Still Be Your Choice For A Product With Demonstrated Efficacy And Safety

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 >>

Insulin Chart

Insulin Chart

Onset of action - time period after injection that insulin will begin to work Duration of action - length of time after injection that insulin will have a measurable effect Peak effect - time after injection when insulin will have its greatest activity (effect) NOTE: Pharmacokinetic parameters are affected by age, kidney function, liver function, concomitant medications, medical conditions, and other variables. Because of this, parameters may vary widely among patients. In the U.S., most insulins cost > $150 a vial/pens with one exception; Walmart sells Novolin R, Novolin N, and Novolin 70/30 for $25 a vial * For use in HumaPen Luxura HD and HumaPen Memoir See Inhaled insulin for a complete review of Afrezza Afrezza comes in a sealed foil package with 2 blister cards inside Each blister card has 5 rows of 3 cartridges Before use, cartridge and inhaler should be at room temperature for 10 minutes Inhaler should be thrown away after 15 days Sealed foil package is good until expiration date Sealed blister cards + strips - use within 10 days SoloStar is compatible with all BD pen needles Apidra is a premeal (also called prandial) insulin Inject Apidra within 15 minutes before a meal or within 20 minutes after starting a meal Apidra is compatible with some insulin pumps UNPUNCTURED, REFRIGERATED (Vials and Pens) Inject Fiasp at the start of a meal or within 20 minutes after starting a meal KwikPen is compatible with all BD pen needles Inject Humalog within 15 minutes before a meal or immediately after a meal Humalog is compatible with some insulin pumps HumaPen Luxura HD is a reusable pen that allows dosing in 0.5 unit increments HumaPen Memoir records the time, date, and dose of the last 16 injections UNPUNCTURED, REFRIGERATED (Vials, Pens, Cartridges) UNPUNCTURED, ROOM TE Continue reading >>

Lantus

Lantus

Lantus glargine by Aventis long-acting analog U100 Special, pH 4 Line new molecular entity Also known as Glargine (generic) Similar to Levemir, PZI[1] ultralente, Ultratard (duration) Action in cats varies by animal onset variable, asymmetric peak 5-14h (4-20 h as per Nelson)[2] duration 9-24h (10-16 h as per Nelson)[3] Action in dogs onset inconsistent, peak 0.5 to 6 hours, inconsistent, duration about 13hr but inconsistent-beef/pork PZI has longer duration (10-16 h as per Nelson)[4][5][6] Use and Handling Type clear Shelf Life refrigerate, until date on package When opened 28 days at room temp, up to 6 months when stored in the refrigerator (2C to 8C)[7] In pen 28 days at room temp Notes protect from light and heat do not mix with other insulins do not dilute do not prefill syringe discard if precipitate or cloudiness discard if frozen Do not use intravenously[8] Do not use intramuscularly[9] Lantus is the brand name for insulin glargine, an insulin analog made by Aventis[10]. Lantus is a very long-acting insulin (lasting up to 24 hours in humans) that uses pH reactions to form micro-precipitates under the skin, which create a time-release action. Because of cats' faster metabolism, long-acting insulins like Lantus (and perhaps Levemir) are gaining a good reputation in veterinary research for regulating cats for a full 12 hours at a time, often better than some of their shorter-acting cousins. Proponents of Lantus in feline use point out that it lasts a full 12 hours in many cats, has a very gentle onset, a negligible peak, and (some claim) less chance of triggering hypo or rebound than faster-acting insulins. The famous Queensland University studies[11] showed that a simple protocol (in a 24-hour monitored, veterinary environment, with a Low-carb diet) could bring ma Continue reading >>

Long-acting Insulins

Long-acting Insulins

Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Drug UPDATES: TRESIBA ®- insulin degludec injection [Drug information / PDF] Click link for the latest monograph Dosing: Click (+) next to Dosage and Administration section (drug info link) Initial U.S. Approval: 2015 Mechanism of Action: The primary activity of insulin, including TRESIBA, is regulation of glucose metabolism. Insulin and its analogs lower blood glucose by stimulating peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin also inhibits lipolysis and proteolysis, and enhances protein synthesis. TRESIBA forms multi-hexamers when injected into the subcutaneous tissue resulting in a subcutaneous insulin degludec depot. The protracted time action profile of TRESIBA is predominantly due to delayed absorption of insulin degludec from the subcutaneous tissue to the systemic circulation and to a lesser extent due to binding of insulin-degludec to circulating albumin. INDICATIONS AND USAGE: TRESIBA is indicated to improve glycemic control in adults with diabetes mellitus. Limitations of Use TRESIBA is not recommended for the treatment of diabetic ketoacidosis. Dosing: Individualize dose based on type of diabetes, metabolic needs, blood glucose monitoring results and glycemic control goal. Rotate injection sites to reduce the risk of lipodystrophy. Do not dilute or mix with any other insulin or solution. Administer subcutaneously once daily at any time of day. Do NOT perform dose conversion when using the TRESIBA U-100 or U-200 FlexTouch pens. The TRESIBA U-100 and U-200 FlexTouch pens dose window shows the number of insulin units to be delivered and NO conversion is needed. HOW SUPPLIE Continue reading >>

What Is Lantus Insulin Glargine?: Onset, Peak Time And Duration

What Is Lantus Insulin Glargine?: Onset, Peak Time And Duration

What is Lantus Insulin Glargine? Lantus is a long acting insulin that helps blood glucose get into the cells for energy. Lantus is the brand name of insulin glargine. Insulin glargine works by lowering high blood glucose levels in people with diabetes. It replaces the insulin we naturally make. Insulin is a natural hormone that helps our body to convert glucose into energy and store glucose in the form of glycogen for later use. People who are diabetic cannot make enough insulin or use it properly. As a result, glucose cannot be used or stored properly, which leads to a build up of glucose in the bloodstream. Injecting insulin glargine can help lower blood glucose to normal level. This medication is used to treat type 2 diabetes in adults and type 1 diabetes in adults and children who have reached the age of 6 years. Lantus onset, peak time and duration Lantus or insulin glargine refers to a man made hormone that is naturally produced in the body. This medication is used to treat both type 1 and type 2 diabetes. Lantus onset refers to how quickly insulin glargine starts to work in the body. As a long acting insulin, the medication onset is about one and a half hours and can last up to 24 hours. The drug peak refers to how long it takes before this medication achieves the maximum effects in the body. The lantus peak is 6 hours. Insulin glargine is a part of a treatment program that includes diet, exercise, weight control and testing your blood glucose. Make sure you follow the program as it is instructed by your doctor Storage Lantus should be stored in its original container and kept away from heat and light. You are not supposed to freeze this medication. In case of frozen lantus, you should throw it away. Ask your doctor how to properly dispose the medication. Do not Continue reading >>

Insulin Glargine (rdna Origin) Injection

Insulin Glargine (rdna Origin) Injection

Pharmacologic classification: pancreatic hormone Therapeutic classification: antidiabetic Pregnancy risk category C Available forms Available by prescription only Injection: 100 units/ml Indications and dosages Management of type 1 diabetes mellitus in patients who need basal (long-acting) insulin for the control of hyperglycemia. Adults and children older than age 6: Individualize dosage and administer S.C. once daily h.s. Management of type 2 diabetes mellitus in patients who need basal (long-acting) insulin for control of hyperglycemia. Adults: Individualize dosage and administer S.C. once daily h.s. Pharmacodynamics Antidiabetic action: Regulates glucose metabolism by stimulating peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production. Pharmacokinetics Absorption: After S.C. injection of insulin glargine in healthy subjects and in patients with diabetes, the insulin serum levels indicated a slower, more prolonged absorption and a relatively constant level/time profile over 24 hours with no pronounced peak compared with NPH insulin. Distribution: No information available. Metabolism: Partly metabolized to form two active metabolites with in vitro activity similar to that of insulin. Excretion: No information available. Contraindications and precautions Lantus is contraindicated in patients who are hypersensitive to insulin glargine or its excipients. Don’t use during episodes of hypoglycemia. Use cautiously in patients with renal or hepatic impairment. Interactions Drug-drug. ACE inhibitors, disopyramide, fibrates, fluoxetine, MAO inhibitors, octreotide, oral antidiabetics, propoxyphene, salicylates, somatostatin analog, sulfonamide antibiotics: May cause hypoglycemia and increased insulin effect. Monitor blood Continue reading >>

Insulin Actions Times And Peak Times

Insulin Actions Times And Peak Times

A good way to improve your glucose levels is to track the peaks and drops in your glucose , so you can figure out why they happened and how to correct them. Once you identify glucose patterns (they ARE there!), you also want to understand when each of your insulins is active and when they typically stop lowering your glucose. This helps you adjust your doses or food intake to stop unwanted ups and downs in your readings. The table below shows the start, peak, and end times for various insulins with some explanations and typical uses for each. When Does My Insulin Peak and How Long Does It Last? designed to peak, covers meals and lowers high BGs Humalog , Novolog and Apidra insulins currently give the best coverage for meals and help keep the glucose lower afterward. Their glucose lowering activity starts to work about 20 minutes after they are taken, with a gradual rise in activity over the next 1.75 to 2.25 hours. Their activity gradually falls over the next 3 hours with about 5 to 6 hours of activity being common with these insulins.Although insulin action times are often quoted as 3-5 hours, the actual duration of insulin action is typically 5 hours or more. See our article Duration of Insulin Action for more information on this important topic. In general, "rapid" insulins are still too slow for many common meals where the glucose peaks within an hour and digestion is complete within 2-3 hours. The best kept secret on stopping post meal spiking is to eake the injection or bolus earlier before the meal and to eat slower low glycemic carbs. Regular insulin still carries its original name of "fast insulin" but its slower action often works better for people who take Symlin or for those who have gastroparesis (delayed digestion). It is also a great choice for those who Continue reading >>

A1c Reduction

A1c Reduction

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 >>

Insulin Chart

Insulin Chart

List of insulin types available in the U.S. and how they work. By the dLife Editors Each type of insulin has its own unique behavior. One difference among types of insulin is how long they take to start working at lowering blood-glucose levels. The “insulin peak” is the point at which the dose is working at its maximum, and the “duration” is how long the blood-glucose-lowering effect of the injection will last. The following is a list of insulin types available in the United States, along with how soon they start working, their peak, and how long they last. Talk to your healthcare provider about your insulin regimen. Insulin Type Onset of Action Peak Duration of Action Lispro U-100 (Humalog) Approximately 15 minutes 1-2 hours 3-6 hours Lispro U-200 (Humalog 200) Approximately 15 minutes 1-2 hours 3-6 hours Aspart (Novolog) Approximately 15 minutes 1-2 hours 3-6 hours Glulisine (Apidra) Approximately 20 minutes 1-2 hours 3-6 hours Regular U-100 (Novolin R, Humulin R) 30-60 minutes 2-4 hours 6-10 hours Humulin R Regular U-500 30-60 minutes 2-4 hours Up to 24 hours NPH (Novolin N, Humulin N, ReliOn) 2-4 hours 4-8 hours 10-18 hours Glargine U-100 (Lantus) 1-2 hours Minimal Up to 24 hours Glargine U-100 (Basaglar) 1-2 hours Minimal Up to 24 hours Glargine U-300 (Toujeo) 6 hours No significant peak 24-36 hours Detemir (Levemir) 1-2 hours Minimal** Up to 24 hours** Degludec U-100 & U-200 (Tresiba) 1-4 hours No significant peak About 42 hours Afrezza < 15 minutes Approx. 50 minutes 2-3 hours *Information derived from a combination of manufacturer’s prescribing information, online professional literature sources and clinical studies. Individual response to insulin preparations may vary. **Peak and length of action may depend on size of dose and length of time since ini 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 >>

Long-acting Insulin: How It Works

Long-acting Insulin: How It Works

When you eat, your pancreas releases a hormone called insulin. Insulin moves sugar (glucose) from your blood to your cells for energy or storage. If you take insulin, you may need some at mealtime to help lower your blood sugar after you eat. But even between meals, you need insulin in small amounts to help keep blood sugar stable. This is where long-acting insulin comes in. If you have diabetes, either your pancreas can’t produce enough (or any) insulin, or your cells can’t use it efficiently. To control your blood sugar, you need to replace or supplement the normal function of your pancreas with regular insulin injections. Insulin comes in many types. Each type differs in three ways: onset: how quickly it starts working to lower your blood sugar peak: when its effects on your blood sugar are strongest duration: how long it lowers your blood sugar According to the U.S. Food and Drug Administration (FDA), the five types of insulin are: Rapid-acting insulin: This type starts to work just 15 minutes after you take it. It peaks within 30 to 90 minutes, and its effects last for three to five hours. Short-acting insulin: This type takes about 30 to 60 minutes to become active in your bloodstream. It peaks in two to four hours, and its effects can last for five to eight hours. It is sometimes called regular-acting insulin. Intermediate-acting insulin: The intermediate type takes one to three hours to start working. It peaks in eight hours and works for 12 to 16 hours. Long-acting insulin: This type takes the longest amount of time to start working. The insulin can take up to 4 hours to get into your bloodstream. Pre-mixed: This is a combination of two different types of insulin: one that controls blood sugar at meals and another that controls blood sugar between meals. Lo Continue reading >>

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