Lantus (insulin Glargine) Not Only For Bedtime?
Physicians are pursuing several different possibilities of dosing that deviate from the FDA-approved instructions for Lantus dosing. Lantus is approved only for bedtime dosing. That’s because the pre-approval studies were conducted only using bedtime dosing, therefore the FDA approved the drug that way. But from experience, patients can also use Lantus in the morning. Lantus is a “peakless” insulin…giving steady concentrations throughout the day. But for some patients, it doesn’t last the full 24 hours. Morning dosing might be preferred for these patients. That way, Lantus wears off at night when insulin requirements are lower. Some patients use BID dosing if Lantus doesn’t last all day. Explain that the big advantage to Lantus is once daily dosing. Lantus (insulin glargine) is a recombinant human insulin analog with a duration of action up to 24 hours.1 The microprecipitates that are formed in the subcutaneous tissue after injection slow the absorption of Lantus and provide a relatively constant level of insulin over 24 hours without a pronounced peak.1 This prolonged effect over 24 hours enables it to be administered once daily. Lantus is FDA approved for once-daily subcutaneous administration at bedtime for adults and children six years of age and older with type 1 diabetes mellitus or adults with type 2 diabetes mellitus who require basal (long-acting) insulin for the control of hyperglycemia.1 When changing a patient (child >6 years or adult) from intermediate- or long-acting insulin to Lantus, the amount of short-acting insulin or oral antidiabetic agent may need to be adjusted. In premarketing studies, for patients using once-daily NPH or Ultralente insulin, the initial dose of Lantus was not changed. For patients using twice-daily NPH insulin, the in Continue reading >>
- The Unexpected Link Between Bedtime, Diabetes, and Depression
- Newly Discovered Link Between Sleep and Diabetes Warrants Early Bedtime for Children
- Type 2 diabetes breakthrough: Scientists create first pill that not only STOPS the condition in its tracks but also helps patients lose weight - and it could be available on the NHS within 3 years
Lantus In The Morning Instead Of Evening
I recently read on here somewhere that Lantus is usually given at bedtime because it lasts 18-24 hours and that by the time it is dwindling the dinner injection is given kind of as the bridge between the first Lantus injection and the next one the following evening. Thus making a steady regimen. However I quite frequently fail to give myself injections at dinner. I am just careless sometimes. But my Lantus peaks around 3 or 4 every morning, and depending on the night before I may experience a mild/mildly severe low. Has it ever been suggested to take Lantus in the AM? My thought is this: If I took Lantus in the A.M. (Aprox 6:30 or so) my peak would be about 5 or 6 hours later. This would be my lunch time. I could use a sliding scale determined at lunch. If I forgot the dinner shot, the Lantus would still be working. And I could still test at bedtime and bolus if needed. I see it this way because at least then I would have some insulin in my system at dinner, rather than the tiny amount of Lantus left, there would be a bit more (since I would be taking it about 8 & 1/2 hours later). Anyone have any suggestions or comments tomy thoughts? Continue reading >>
Insulin Glargine (rx)
Dosage Forms & Strengths injectable solution 100 units/mL (Lantus; 10mL vial) 100 units/mL (Lantus SoloSTAR; Basaglar KwikPen; 3 mL disposable prefilled pens) 300 units/mL (Toujeo; 1.5 mL SolosStar disposable prefilled pen) Note: Recent studies have suggested that glargine-300 extends blood glucose control well beyond 24 hr Type 1 or 2 Diabetes Mellitus Lantus and Toujeo are recombinant human insulin analogs indicated to improve glycemic control in adults with type 1 or 2 diabetes mellitus Dosing Considerations Indicated for once-daily SC administration; exhibits relatively constant glucose-lowering profile over 24 hr May be administered at any time during the day; should be administered SC once daily at the same time every day 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 In patients with type 1 diabetes, insulin glargine must be used in regimens with short-acting insulin Should not be administered IV or via an insulin pump; IV administration of the usual SC dose could result in severe hypoglycemia As with all insulins, injection sites should be rotated within the same region (abdomen, thigh, or deltoid) from one injection to the next to reduce the risk of lipodystrophy; no clinically relevant difference in insulin glargine absorption after abdominal, deltoid, or thigh SC administration As with all insulins, the rate of absorption and, consequently, the onset and duration of action may be affected by exercise and other variables (eg, stress, intercurrent illness, changes in coadministered drugs, meal patterns) Type 1 diabetes mellitus: Starting dose sho Continue reading >>
Lantus (insulin Glargine)
What is it used for? How does it work? Lantus vials, Lantus SoloStar pre-filled pens and Lantus penfill cartridges (for use with ClikSTAR or Autopen 24 pens) contain the active ingredient insulin glargine. They are used to treat diabetes. People with diabetes have a deficiency or absence of a hormone manufactured by the pancreas called insulin. Insulin is the main hormone responsible for the control of sugar (glucose) in the blood. People with type one diabetes need to have injections of insulin to control the amount of glucose in their bloodstream. Insulin injections act as a replacement for natural insulin and allow people with diabetes to achieve normal blood glucose levels. Insulin injections work in the same way as natural insulin, by binding to insulin receptors on cells in the body. Insulin causes cells in the liver, muscle and fat tissue to increase their uptake of glucose from the bloodstream. It also decreases the production of glucose by the liver, and has various other effects that lower the amount of glucose in the blood. Lantus contains a type of insulin called insulin glargine. This is known as a long-acting insulin. When injected under the skin it starts working within two to three hours and produces a steady effect for 25 hours. It is used to help provide background control of blood glucose throughout the day. Insulin glargine is normally used in combination with a short-acting insulin, which is given before meals to control the increasing blood glucose levels after eating. It is important to monitor your blood glucose regularly and adjust your insulin dose as required. Your doctor or diabetic team will explain how to do this. Keeping your blood glucose level as close to normal as possible, and not too high or too low, significantly reduces the risk of Continue reading >>
Well, I never thought I’d say this, but it’s a great week to be a person with Type 1 diabetes. With all of the bad news surrounding the Type 2 drug Avandia (rosiglitazone), it’s a relief to know I don’t have to worry about it. I recommended you read my colleague Tara’s blog entry (“Type 2 Drug Avandia Linked to Increased Risk of Heart Attacks”) for the full story. That’s one of the first times in my life I’ve referred to someone as a colleague. What can I say? It’s just not a word in my describe-a-friend/coworker vocabulary. While all of the controversy surrounds Avandia, I’m way over in Type 1 land contemplating whether or not to lower my daily dose of Lantus (insulin glargine). I’ve just started a brand new bottle of Lantus and I’ve been taking my normal 15 units in the morning and then eating a rather normal breakfast and lunch, but I’m still going low in the midmorning and early afternoon. This happened Monday after eating Brussels sprouts and whole-wheat pasta for lunch and only taking one unit of rapid-acting NovoLog (insulin aspart) to help out the Lantus. I’ve known for a while that my body is sensitive to insulin, but lately it’s been a little more sensitive than usual. I took 13 units of Lantus yesterday and my blood glucose was 86 mg/dl before lunch. I often wonder how much of an adjustment two units of Lantus is. While I’m very much locked in on an insulin-to-carbohydrate ratio with my NovoLog, it’s a bit tricky to judge how much the longer-lasting insulins affect your blood glucose. Is there a chart for your Lantus dose? I seem to remember something from when I was diagnosed. I wonder what Google will tell me to do. I realize that Lantus doesn’t have a true peak the way some of the other insulins do, but sometimes it su Continue reading >>
Do I Take Insulin Before Or After A Meal?
Question Originally asked by Community Member elainenakamura Do I Take Insulin Before Or After A Meal? How soon after a meal should I take insulin? I don’t know whether I should take it before or after, actually. Can anyone help? Answer Elaine- Hello! What kind of insulin are you taking? You should find out from your physician when the best time for you to take your insulin would be. When I was taking shots (insulin) I would give myself a shot before breakfast, before lunch, before dinner and I would give myself lantus before bed. We all have different requirements. Your physician would be able to answer this questions a lot better than I could. You can read more about how insulin works, and other useful information at this link. Cherise Community Moderator You should know Answers to your question are meant to provide general health information but should not replace medical advice you receive from a doctor. No answers should be viewed as a diagnosis or recommended treatment for a condition. Answered By: Cherise Nicole Continue reading >>
Lantus Vs. Levemir
font size A A A 1 2 Next Are Lantus and Levemir the Same Thing? Lantus (insulin glargine [rdna origin]) and Levemir (insulin detemir [rDNA origin] injection) are man-made forms of a hormone produced in the body used to treat type 1 (insulin-dependent) or on some rare occasions, type 2 (non insulin-dependent) diabetes. What Are Possible Side Effects of Lantus? Side effects of Lantus include: headache, hunger, weakness, sweating, tremors, irritability, trouble concentrating, rapid breathing, fast heartbeat, fainting, or seizure (severe hypoglycemia can be fatal). What Are Possible Side Effects of Levemir? Common side effects of Levemir include: injection site reactions (e.g., pain, redness, irritation), swelling of the hands/feet, thickening of the skin where you inject Levemir, weight gain, headache, back pain, stomach pain, flu symptoms, or cold symptoms such as stuffy nose, sneezing, sore throat. Tell your doctor if you experience serious side effects of Levemir including: signs of low potassium level in the blood (such as muscle cramps, weakness, or irregular heartbeat). What is Lantus? Lantus is a long-acting man-made insulin used to control high blood sugar in adults with diabetes mellitus. Lantus is not for use to treat diabetic ketoacidosis. It is not known if Lantus is safe and effective in children less than 6 years of age with type 1 diabetes. It is not known if Lantus is safe and effective in children with type 2 diabetes. What is Levemir? Levemir is a man-made insulin that is used to control high blood sugar in adults and children with diabetes mellitus. Levemir is not meant for use to treat diabetic ketoacidosis. font size A A A Previous 1 2 Lantus vs. Levemir (cont.) Read the detailed Instructions for Use that come with your Lantus SoloStar disposable prefi Continue reading >>
Insulin Glargine (rdna Origin) Injection
Insulin glargine is used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood). It is also used to treat people with type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood) who need insulin to control their diabetes. In people with type 1 diabetes, insulin glargine must be used with another type of insulin (a short-acting insulin). In people with type 2 diabetes, insulin glargine also may be used with another type of insulin or with oral medication(s) for diabetes. Insulin glargine is a long-acting, manmade version of human insulin. Insulin glargine works by replacing the insulin that is normally produced by the body and by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes. Insulin glargine comes as a solution (liquid) to inject subcutaneously (under the Continue reading >>
(insulin Glargine Injection) 300 Units/ml
Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®. Do NOT reuse needles or share insulin pens even if the needle has been changed. Before starting Toujeo®, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed. Continue reading >>
Basal Insulins | Diabetesnet.com
Lantus and Levemir are long-acting insulins that supply the background insulin needed to supply cells with glucose around the clock while preventing release of excess glucose from the liver and excess fat from fat cells. The waking glucose level best measures the activity of these insulins. All Type 1s and many Type 2s also require a faster insulin (Humalog, Novolog, or Apidra) to cover meals and lower any high glucose. Some Type 2s who have adequate insulin production do well with one of these long-acting insulins, plus oral medications or a daily or weekly injection of a GLP-1 agonist. Lantus insulin (glargine) made by Sanofi-Aventis is promoted as a once a day background insulin. However, many users find that it does not last a full 24 hours for them and these users often notice a peak in activity about 6-8 hours after the injection. If once a day injection is giving you good control, there is no need to change and a bedtime injection is typically best. For others, splitting the dose and injecting twice a day (usually at breakfast and bedtime) often works better, lessens peaks and gaps in activity, and helps those who cannot inject Lantus within one hour of the same time each day. Lantus is slightly acidic and some may notice slight discomfort at the injection site. Levemir insulin (detemir) made by Novo Nordisk works for about 18 hours and may have a peak in activity 4-6 hours after the injection. It is taken twice a day. Different people react to each insulin differently. The best advice is trying the other insulin if one does not seem to be working well for you. Both insulins generally work quite well, but neither can be mixed in a syringe with fast-acting insulin, and neither should ever be used in an insulin pump. Keep in mind that an older insulin called NPH c Continue reading >>
What Is The Most Important Information I Should Know About Insulin Glargine (lantus, Lantus Opticlik Cartridge, Lantus Solostar Pen)?
A A A Medications and Drugs Brand Names: Lantus, Lantus OptiClik Cartridge, Lantus Solostar Pen Generic Name: insulin glargine (Pronunciation: IN su lin AS part, IN su lin AS part PRO ta meen) What is the most important information I should know about insulin glargine (Lantus, Lantus OptiClik Cartridge, Lantus Solostar Pen)? What should I discuss with my healthcare provider before using insulin glargine (Lantus, Lantus OptiClik Cartridge, Lantus Solostar Pen)? What is insulin glargine (Lantus, Lantus OptiClik Cartridge, Lantus Solostar Pen)? Insulin glargine is a man-made form of a hormone that is produced in the body. It works by lowering levels of glucose (sugar) in the blood. Insulin glargine is a long-acting form of insulin that is slightly different from other forms of insulin that are not man-made. Insulin glargine is used to treat type 1 or type 2 diabetes. Insulin glargine may also be used for purposes not listed in this medication guide. What are the possible side effects of insulin glargine (Lantus, Lantus OptiClik Cartridge, Lantus Solostar Pen)? Get emergency medical help if you have any of these signs of insulin allergy: itching skin rash over the entire body, wheezing, trouble breathing, fast heart rate, sweating, or feeling like you might pass out. Hypoglycemia, or low blood sugar, is the most common side effect of insulin glargine. Symptoms include headache, hunger, weakness, sweating, tremors, irritability, trouble concentrating, rapid breathing, fast heartbeat, fainting, or seizure (severe hypoglycemia can be fatal). Carry hard candy or glucose tablets with you in case you have low blood sugar. Tell your doctor if you have itching, swelling, redness, or thickening of the skin where you inject insulin glargine. This is not a complete list of side effect Continue reading >>
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 >>
Getting The Right Dosage
Even for those on Lantus® for a while, it may take a little time to get to the right dose of insulin. Your doctor may change your Lantus® dose several times in the first few weeks. This is to be expected. For best results, keep taking your Lantus® as prescribed, and keep talking to your doctor. What if You Miss a Dose? Your doctor will guide you on when to take Lantus®. Ask him or her what to do if you forget to take your insulin, so you can be prepared in advance in case it ever happens. Here are a few ways to remember to take your Lantus® once-a-day: 3 Helpful Tips Make yourself a reminder If you take your Lantus® at night, it might also be a good idea to leave yourself a note on your nightstand as a way to remember. If you take it in the morning, put your supplies where you can't miss them—next to your toothbrush, for example. Keep out of reach of children. Add it to your other daily "to dos" Many people take Lantus® right after brushing their teeth in the evening or while making breakfast in the morning. Set an Alarm Some people set alarms on their wristwatches or mobile devices to remind them when to take their Lantus®. “We changed doses a couple of times when I started on Lantus®, until we found the right amount for me.” Continue reading >>
Is There A Maximum Insulin Glargine (lantus) Dose?
Is there a maximum insulin glargine (Lantus) single-injection dose? Anecdotally, I have heard that patients receiving more than 50 units should split the dose from daily dosing to twice-daily. What’s the evidence? The question of a maximum insulin glargine dose is not straightforward because it encompasses several issues: How long does insulin glargine last? Does it ever need to be given twice-daily? Is there a difference in efficacy between daily and twice-daily insulin glargine dosing? Can you administer more than 50 units of insulin glargine as one single injection? Pharmacodynamics and Duration of Insulin Glargine In theory, insulin glargine should last a full 24 hours without a significant peak effect. Glargine forms a depot effect because it is only soluble at an acidic pH.1 In the vial (pH 4), the drug is completely soluble. Once injected, the solution is neutralized to biologic pH (7.4), which causes the insulin molecules to precipitate. These microprecipitates slowly dissolve over a 24-hour period. This slow dissolution results in a slower onset and a lack of a peak effect compared to other insulins, as shown below: Efficacy of Daily versus Twice-Daily Lantus Administration Although insulin glargine should last a full 24 hours, there is some evidence that its duration of action may be reduced to 20-23 hours, particularly following injection due to its delayed onset of activity of about 3-5 hours.2 Currently, the best estimate is that 15-30% of type-I diabetics will have pre-injection hyperglycemia and may benefit from twice-daily dosing. The idea of twice-daily dosing was explored in an 8-week, open-label crossover trial of 20 patients with type-I diabetes.2 Patients received either 100% of a pre-determined dose daily (dinner) or 50% twice-daily (breakfast an Continue reading >>
Lantus (insulin Glargine) Side Effects
What Is Lantus (Insulin Glargine)? Lantus is the brand name of insulin glargine, a long-acting insulin used to treat adults and children with type 1 diabetes mellitus and adults with type 2 diabetes mellitus to control high blood sugar. Lantus replaces the insulin that your body no longer produces. Insulin is a natural substance that allows your body to convert dietary sugar into energy and helps store energy for later use. In type 2 diabetes mellitus, your body does not produce enough insulin, or the insulin produced is not used properly, causing a rise in blood sugar. Like other types of insulin, Lantus is used to normalize blood sugar levels. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual dysfunction. Proper control of diabetes has also been shown to reduce your risk of a heart attack or stroke. Lantus is meant to be used alongside a proper diet and exercise program recommended by your doctor. Lantus is manufactured by Sanofi-Aventis. It was approved for use by the Food and Drug Administration (FDA) in 2000 as the first long-acting human insulin administered once a day with a 24-hour sugar-lowering effect. Lantus Warnings You will be taught how to properly inject this medication since that is the only way to use it. Do not inject cold insulin because this can be painful. Always wash your hands before measuring and injecting insulin. Lantus is always clear and colorless; look for cloudy solution or clumps in the container before injecting it. Do not use Lantus to treat diabetic ketoacidosis. A short-acting insulin is used to treat this condition. It is recommended that you take a diabetes education program to learn more about diabetes and how to manage it. Other medical problems may affect the use of this Continue reading >>