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Davis Plus Nph Insulin

Special Article New Insulin Delivery Recommendations

Special Article New Insulin Delivery Recommendations

Correct technique in insulin delivery is critical for optimal control of diabetes. This article reviews the most recent studies in the field and then offers new injection and infusion recommendations for insulin users. It is meant to complement and extend the injection recommendations published in 2010.1 These latest recommendations were based on the results of the fourth Injection Technique Questionnaire (ITQ) survey (published elsewhere in this issue). From February 2014 through June 2015, 13,289 insulin-injecting patients with diabetes from 42 countries participated in the ITQ survey, one of the largest multinational studies of its kind. A smaller Infusion Technique Questionnaire survey was undertaken concurrently with the ITQ in 356 patients using continuous subcutaneous insulin infusion (CSII) in four countries and informed the drafting of the new infusion recommendations. The ITQ survey results (fo Continue reading >>

Insulin, Regular (injection, Concentrated)

Insulin, Regular (injection, Concentrated)

You have successfully created a MyAccess Profile for Insulin, Regular (Injection, Concentrated). In: Ciccone CD. Ciccone C.D. Ed. Charles D. Ciccone.eds. Davis's Drug Guide for Rehabilitation Professionals New York, NY: McGraw-Hill; . Accessed April 06, 2018. . "Insulin, Regular (Injection, Concentrated)." Davis's Drug Guide for Rehabilitation Professionals Ciccone CD. Ciccone C.D. Ed. Charles D. Ciccone. New York, NY: McGraw-Hill, , insulin, regular (injection, concentrated) (in-su-lin) Insulin-Toronto, Novolin R, Iletin II Regular, Velosulin BR, Humulin R Regular U-500 (Concentrated) Control of hyperglycemia in patients with diabetes mellitus. Concentrated regular insulin U-500: Only for use in patients with insulin requirements >200 units/day. Unlabeled Use: Treatment of hyperkalemia. Lowers blood glucose by stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production. Other actions of insulin: inhibition of lipolysis and proteolysis, enhanced protein synthesis. Therapeutic Effects: Control of hyperglycemia in diabetic patients. Local: lipodystrophy, pruritus, erythema, swelling. Misc: ALLERGIC REACTIONS, INCLUDING ANAPHYLAXIS. Monitor signs of hypoglycemia, especially during and after exercise. Common neuromuscular symptoms include anxiety; restlessness; tingling in hands, feet, lips, or tongue; chills; cold sweats; confusion; difficulty in concentration; drowsiness; excessive hunger; headache; irritability; nervousness; tremor; weakness; unsteady gait. Report persistent or repeated episodes of hypoglycemia to the physician. Monitor signs of allergic reactions and anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough, dyspnea) or skin reactions (rash, pruritus, urticaria). Notify physician imme Continue reading >>

Selecting An Insulin For Treating Diabetes Mellitus In Dogs And Cats

Selecting An Insulin For Treating Diabetes Mellitus In Dogs And Cats

Richard W. Nelson, DVM, Dipl ACVIM University of California Davis, California From: The 30th Annual Royal Canin/Ohio State University Symposium for the treatment of small animal diseases: Endocrinology, October 2006, Veterinarians often ask which insulin is the best for treating diabetes mellitus in dogs and cats. Unfortunately, this question is difficult to answer. All insulin types currently on the market have the potential to work well in some diabetic dogs and cats but not in others. Recommendations regarding the insulin of choice for treating diabetic dogs and cats are based on personal experiences and vary between clinicians. Some clinicians prefer NPH insulin while others prefer lente insulin for treating diabetic dogs. Some clinicians prefer PZI, some NPH, some lente, and some insulin glargine for treating diabetic cats. Which insulin is ultimately effective in a diabetic is unpredictable. The clinician’s role is to identify which type of insulin works best in the diabetic dog or cat currently being treated. Success with insulin therapy requires knowledge of currently available insulin preparations - their intended use, potency, trends regarding duration of effect, and potential impact of species of insulin origin on diabetic control. Overview of Insulin Types. Commercial insulin is categorized by promptness, duration, intensity of action, and origin. Short-acting prandial insulins include regular crystalline (Humulin R®, Eli Lilly, Indianapolis, IN), insulin lispro (Humulog®, Eli Lilly) and insulin aspart (Novolog®, Novo Nordisk, Princeton, NJ). Regular crystalline insulin is a recombinant human insulin while insulin lispro and insulin aspart are insulin analogs. Recombinant DNA technology has been used to alter the amino acid sequence of the insulin molec Continue reading >>

Insulin Analogs: What Are The Clinical Implications Of Structural Differences?

Insulin Analogs: What Are The Clinical Implications Of Structural Differences?

Insulin Analogs: What Are the Clinical Implications of Structural Differences? US Pharm. 2010;35(5)(Diabetes suppl):3-7. In healthy adults, basal insulin concentrations of 5 to 15 U/mL help to maintain fasting plasma glucose concentrations (FIGURE 1).1 Immediately following a meal, insulin concentration peaks at 60 to 80 U/mL, returning to basal levels 1 to 3 hours later. In type 2 diabetes mellitus, progressive loss of beta cells results in the disruption of endogenous insulin secretion, in turn leading to requirement for insulin therapy. Considering that the daily pattern of normal insulin secretion is complex, close replication of this pattern is needed to address both fasting and prandial glucose control. In human insulin preparations, such as regular human insulin (RHI), insulin molecules typically self-aggregate to form dimers, which in turn stabilize around zinc ions to form hexamers.2 Following injection, the subcutaneous insulin depot is diluted by the interstitial fluid, causing hexamers to break down into dimers and biologically active monomers. The dissociation of hexamers into dimers and monomers is a rate-limiting step in absorption for all insulins and contributes to the delay in the effect of RHI. Because insulin hexamers are too bulky to be transported across the vascular endothelium, there is a 30- to 60-minute lag phase between injection and onset of action, which requires careful dose administration and food consumption. In addition to slow onset, a slow clearance can result in prolonged periods of elevated insulin and delayed hypoglycemia. Exogenous basal insulin delivery has traditionally involved single or twice-daily injections of neutral protamine Hagedorn (NPH) insulin, which is a formulation of protamine insulin in a zinc suspension. Protamin Continue reading >>

Update On Insulin Therapy For Type 2 Diabetes

Update On Insulin Therapy For Type 2 Diabetes

Update on Insulin Therapy for Type 2 Diabetes Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287 Address all correspondence and requests for reprints to: Thomas Donner, M.D., Johns Hopkins University, 601 North Caroline Street, Suite 2008, Baltimore, Maryland 21287 Search for other works by this author on: Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287 Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 97, Issue 5, 1 May 2012, Pages 14051413, Thomas Donner, Miguel Muoz; Update on Insulin Therapy for Type 2 Diabetes, The Journal of Clinical Endocrinology & Metabolism, Volume 97, Issue 5, 1 May 2012, Pages 14051413, Type 2 diabetes is characterized by insulin resistance and impaired insulin secretion at diagnosis and by progressive -cell dysfunction over time. Insulin therapy is thus frequently required during the course of the disease to maintain glycemic control and prevent diabetes complications. Insulin should be initiated when alternative antihyperglycemic agents have failed or when symptomatic or marked hyperglycemia is present. Recent studies demonstrate that the addition of basal, prandial, basal/bolus, or premixed insulins to existing antihyperglycemic regimens effectively lowers glycosylated hemoglobin (HbA1c). The long-acting insulin analogs cause less nocturnal hypoglycemia than bedtime NPH, with comparable HbA1c reductions. Insulin detemir confers a weight advantage over glargine or NPH. Rapid-acting insulin analogs control postprandial hyperglycemia more effectively than regular insulin and modestly lower HbA1c. For selected patients with severe insulin resistance, U-500 is a less e Continue reading >>

Insulin Analogs: What Are The Clinical Implications Of Structural Differences?

Insulin Analogs: What Are The Clinical Implications Of Structural Differences?

US Pharm. 2010;35(5)(Diabetes suppl):3-7. In healthy adults, basal insulin concentrations of 5 to 15 µU/mL help to maintain fasting plasma glucose concentrations (FIGURE 1).1 Immediately following a meal, insulin concentration peaks at 60 to 80 µU/mL, returning to basal levels 1 to 3 hours later. In type 2 diabetes mellitus, progressive loss of beta cells results in the disruption of endogenous insulin secretion, in turn leading to requirement for insulin therapy. Considering that the daily pattern of normal insulin secretion is complex, close replication of this pattern is needed to address both fasting and prandial glucose control. In human insulin preparations, such as regular human insulin (RHI), insulin molecules typically self-aggregate to form dimers, which in turn stabilize around zinc ions to form hexamers.2 Following injection, the subcutaneous insulin depot is diluted by the interstitial fluid, causing hexamers to break down into dimers and biologically active monomers. The dissociation of hexamers into dimers and monomers is a rate-limiting step in absorption for all insulins and contributes to the delay in the effect of RHI. Because insulin hexamers are too bulky to be transported across the vascular endothelium, there is a 30- to 60-minute lag phase between injection and onset of action, which requires careful dose administration and food consumption. In addition to slow onset, a slow clearance can result in prolonged periods of elevated insulin and “delayed” hypoglycemia. Exogenous basal insulin delivery has traditionally involved single or twice-daily injections of neutral protamine Hagedorn (NPH) insulin, which is a formulation of protamine insulin in a zinc suspension. Protamine prolongs the absorption of NPH insulin, causing an intermediate dura Continue reading >>

Nclex Style Practice Questions - Medsurg Diabetes

Nclex Style Practice Questions - Medsurg Diabetes

The guidelines for Carbohydrate Counting as medical nutrition therapy for diabetes mellitus includes all of the following EXCEPT: a. Flexibility in types and amounts of foods consumed b. Unlimited intake of total fat, saturated fat and cholesterol c. Including adequate servings of fruits, vegetables and the dairy group d. Applicable to with either Type 1 or Type 2 diabetes mellitus b. Unlimited intake of total fat, saturated fat and cholesterol The nurse working in the physician's office is reviewing lab results on the clients seen that day. One of the clients who has classic diabetic symptoms had an eight-hour fasting plasma glucose test done. The nurse realizes that diagnostic criteria developed by the American Diabetes Association for diabetes include classic diabetic symptoms plus which of the following fasting plasma glucose levels? When taking a health history, the nurse screens for manifestations suggestive of diabetes type I. Which of the following manifestations are considered the primary manifestations of diabetes type I and would be most suggestive of diabetes type I and require follow-up investigation? a. Excessive intake of calories, rapid weight gain, and difficulty losing weight b. Poor circulation, wound healing, and leg ulcers, c. Lack of energy, weight gain, and depression d. An increase in three areas: thirst, intake of fluids, and hunger D. An increase in three areas: thirst, intake of fluids, and hunger The primary manifestations of diabetes type I are polyuria (increased urine output), polydipsia (increased thirst), polyphagia (increased hunger). The nurse is working with an overweight client who has a high-stress job and smokes. This client has just received a diagnosis of Type II Diabetes and has just been started on an oral hypoglycemic agent. Continue reading >>

Similar Risk Of Malignancy With Insulin Glargine And Neutral Protamine Hagedorn (nph) Insulin In Patients With Type 2 Diabetes: Findings From A 5year Randomised, Open-label Study

Similar Risk Of Malignancy With Insulin Glargine And Neutral Protamine Hagedorn (nph) Insulin In Patients With Type 2 Diabetes: Findings From A 5year Randomised, Open-label Study

Similar risk of malignancy with insulin glargine and neutral protamine Hagedorn (NPH) insulin in patients with type 2 diabetes: findings from a 5year randomised, open-label study 1University of Texas Southwestern Medical School, Dallas, TX USA 2Dallas Diabetes and Endocrine Center at Medical City, 7777 Forest Lane C-685, Dallas, TX 75230 USA 1University of Texas Southwestern Medical School, Dallas, TX USA 2Dallas Diabetes and Endocrine Center at Medical City, 7777 Forest Lane C-685, Dallas, TX 75230 USA 3Tulane University Medical Center, New Orleans, LA USA 4Washington University School of Medicine, St Louis, MO USA 5Oregon Health and Science University, Portland, OR USA 6Universit de Montral, Montral, QC Canada 7University of Western Ontario, London, ON Canada 9University of Wisconsin School of Medicine and Public Health, Madison, WI USA J. Rosenstock, Email: [email protected] . Received 2009 Jun 26; Accepted 2009 Jun 29. Keywords: Cancer, Insulin analogues, Insulin glargine, Insulin therapy, Malignancy, NPH insulin, Type 2 diabetes This article has been cited by other articles in PMC. To the Editor: We have reported a randomised, long-term safety study comparing the effects of using the insulin analogue glargine (A21Gly,B31Arg,B32Arg human insulin) versus human neutral protamine Hagedorn (NPH) insulin for 5years in the management of type 2 diabetes [ 1 ]. The study, in which 1017 patients were randomised and treated, was designed to assess ocular complications of diabetes: there was no excess of such effects with insulin glargine compared with NPH insulin treatment and there was a similar slow progression of diabetic retinopathy with both types of insulin. Because of recent concerns about postulated neoplastic effects of insulins [ 2 5 ], we report h Continue reading >>

The Care Of Pregestational And Gestational Diabetes And Drug Metabolism Considerations

The Care Of Pregestational And Gestational Diabetes And Drug Metabolism Considerations

The care of pregestational and gestational diabetes and drug metabolism considerations Accepted author version posted online: 29 Aug 2017 Get access /doi/full/10.1080/17425255.2017.1372423?needAccess=true Introduction: Normal pregnancy development involves gradual decline in insulin sensitivity, which sometimes requires pharmacotherapy. Insulin is the drug of choice for gestational and pregestational diabetes. Metabolism of traditional insulins results in inadequate onset and duration of action and marked peak activity. These properties increase risk of excessive glucose excursions, which are especially undesirable during pregnancy. Insulin analogs have been emerging as a safer and more effective treatment of diabetes during pregnancy. Areas covered: This manuscript reviews currently used antihyperglycemic agents: fast and long-acting insulins, metformin and glyburide. Trials demonstrating their efficacy and safety during pregnancy are described. Certain drug metabolism considerations (e.g. affinity to IGF-1) are emphasized. Expert opinion: The theories that insulin analogs bind to immunoglobulin and cross placenta have been disproved. Lispro, aspart, glargine and detemir do not transfer across the placenta and do not result in adverse maternal and neonatal outcomes. In addition, favorable pharmacokinetic profiles (rapid onset and 24-hour near peakless activity) substantially reduce blood glucose variability including hypoglycemia. We believe that insulin analogs should be given strong consideration for the treatment of diabetes during pregnancy. Metformin has also proven to be safe and may be considered as an initial single agent for milder gestational diabetes. Continue reading >>

Similar Progression Of Diabetic Retinopathy With Insulin Glargine And Neutral Protamine Hagedorn (nph) Insulin In Patients With Type 2 Diabetes: A Long-term, Randomised, Open-label Study.

Similar Progression Of Diabetic Retinopathy With Insulin Glargine And Neutral Protamine Hagedorn (nph) Insulin In Patients With Type 2 Diabetes: A Long-term, Randomised, Open-label Study.

A comment on this article appears in " The longest ever randomised controlled trial of insulin glargine: study design and HbA(1c) findings. " Diabetologia. 2009 Oct;52(10):2234-5; author reply 2236-9. A comment on this article appears in " Diabetic retinopathy and insulin glargine. " Diabetologia. 2009 Oct;52(10):2233; author reply 2236-9. This long-term study was designed to further characterise the retinal safety profile of insulin glargine and human neutral protamine Hagedorn (NPH) insulin in patients with type 2 diabetes mellitus.An open-label, 5 year, randomised (1:1), multicentre, stratified, parallel-group study conducted in the USA and Canada enrolled individuals with type 2 diabetes and either no or non-proliferative retinopathy (less than severe; Early Treatment Diabetic Retinopathy Study [ETDRS] level less than 53 in both eyes) who were treated with oral hypoglycaemic agents (OHAs) alone, insulin alone or OHAs with insulin for >/=3 months prior to study entry and a baseline HbA(1c) level of 6.0-12.0%. Patients were randomised by the investigator according to the centralised interactive voice response system to receive twice-daily NPH insulin (n = 509) or once-daily basal insulin glargine (n = 515). The investigator was not blinded to the treatment group to which each participant had been assigned. The main objective of this study was to compare the progression of diabetic retinopathy between treatment groups by analysing the percentage of patients with three or more step progression in the ETDRS retinopathy patient-level severity scale after treatment with either basal insulin. Masked, centralised grading of seven-field stereoscopic fundus photographs was used.Similarly sustained glycaemic control was observed in both the insulin glargine and NPH insulin tre Continue reading >>

Comparison Of Insulin Glargine And Nph Insulin In The Treatment Of Type 2 Diabetes: A Review Of Clinical Studies

Comparison Of Insulin Glargine And Nph Insulin In The Treatment Of Type 2 Diabetes: A Review Of Clinical Studies

BackgroundThe aim of this study was to evaluate the safety and effectiveness of insulin glargine in a large population from a variety of clinical care in Iranian people with type 2 diabetes mellitus (T2DM) and to measure the percentage of patients achieving glycosylated hemoglobin (HbA1c) <7% by the end of 24 weeks of treatment in routine clinical practice.MethodsThis study was a 24 week, observational study of patients with T2DM, for whom the physician had decided to initiate or to switch to insulin glargine. The safety and efficacy of glargine were assessed at baseline and at week 24.ResultsSeven hundred and twenty-five people with T2DM (63% female) including both insulin nave and prior insulin users were recruited in this study. The mean age of the participants was 54.211.2 years, and the mean HbA1c level was 8.88%0.93% at baseline. By the end of the study, 27% of the entire participants reached to HbA1c target of less than 7% and 52% had HbA1c 7.5%. No serious adverse event was reported in this study. Furthermore, overall hypoglycemia did not increase in prior insulin users and the entire cohort. In addition, body weight did not change in participants while lipid profile improved significantly.ConclusionTreatment with insulin glargine could improve glycemic control without increasing the risk of hypoglycemic events in people with T2DM. In addition, a significant clinical improvement was observed in lipid profile. Pharmacological and clinical differences between insulin glargine and NPH insulin may translate into differences in patient reported outcomes, but existing data are equivocal.In this 48-week, open-label, randomized, multi-center, crossover phase IV trial, insulin nave type 2 diabetes patients with blood glucose not at target on oral hypoglycemic agents had Continue reading >>

A Review Of Insulin For The Treatment Of Diabetes Mellitus

A Review Of Insulin For The Treatment Of Diabetes Mellitus

A Review of Insulin for the Treatment of Diabetes Mellitus September 2016, Volume 34 Number 8 , p 416 - 423 This article has an associated Continuing Education component. Expires September 30, 2018. Go to CE Details Insulin is commonly used in the treatment of diabetes in the home care setting. Understanding the wide variety of insulin preparations available will assist the clinician in guiding people with diabetes and their caregivers through the complexities of self-care and promote safe and optimal glucose control. The purpose of this article is to review the various available insulin preparations and discuss their use in the treatment of diabetes mellitus. Insulin is the most effective means of lowering blood glucose, allowing the body to maintain glucose within a normal range. In people with diabetes, there is either a complete absence of this naturally occurring hormone (type 1 diabetes) or there is an issue with diminished insulin secretion and/or insulin resistance (type 2 diabetes). The treatment of gestational diabetes may also include insulin therapy as oral agents are generally not approved for use in pregnancy. Exogenous insulin improves the body's ability to metabolize carbohydrate, store glucose in the liver, and convert glycogen to fat storage ( Lilley et al., 2014 ). This article will review the various available insulin products and their use in the treatment of diabetes mellitus. Commercially produced insulin was not available in the United States until 1923 when short-acting regular insulin required multiple injections a day ( White, 2014 ). Prior to that time, people with type 1 diabetes died without insulin and those with type 2 slowly succumbed to multiple complications. Longer-acting insulin preparations were developed over the subsequent years Continue reading >>

A Retrospective Study Comparing Neutral Protamine Hagedorn Insulin With Glargine As Basal Therapy In Prednisone-associated Diabetes Mellitus In Hospitalized Patients

A Retrospective Study Comparing Neutral Protamine Hagedorn Insulin With Glargine As Basal Therapy In Prednisone-associated Diabetes Mellitus In Hospitalized Patients

A RETROSPECTIVE STUDY COMPARING NEUTRAL PROTAMINE HAGEDORN INSULIN WITH GLARGINE AS BASAL THERAPY IN PREDNISONE-ASSOCIATED DIABETES MELLITUS IN HOSPITALIZED PATIENTS Subarna M. Dhital , MBBS,1 Yoram Shenker , MD,1 Melissa Meredith , MD,1 and Dawn Belt Davis , MD, PhD1,2 1University of Wisconsin School of Medicine and Public Health, Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Madison, Wisconsin 1University of Wisconsin School of Medicine and Public Health, Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Madison, Wisconsin 1University of Wisconsin School of Medicine and Public Health, Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Madison, Wisconsin 1University of Wisconsin School of Medicine and Public Health, Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Madison, Wisconsin 2William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 1University of Wisconsin School of Medicine and Public Health, Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Madison, Wisconsin 2William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin Address correspondence to Dr. Dawn Belt Davis, 1685 Highland Ave, MC 5148, Madison, WI 53705. [email protected] The publisher's final edited version of this article is available at Endocr Pract See other articles in PMC that cite the published article. To compare glycemic outcomes in hospitalized patients with or without type 2 diabetes mellitus receiving neutral protamine Hagedorn insulin (NPH) vs glargine as basal insulin for management of glucocorticoid-associated hyperglycemia. We conducted a retrospective review of electronic medical records in prednisone-treated adult patients w Continue reading >>

Max B Every Morning

Max B Every Morning

36,069 views. Heart Rate 101 Got questions about heart rate? You can sleep with your heart rate monitor on and in the morning read it first thing. VigilanteApr 30, 2014 Stream Dj Get It Rite & Dj Stylez - French Montana & Max B - Cokewave Files Mixtape by COKEWAVE FILES-05-Every Morning download; 6. 3. Here are just 10 Benefits to Drinking Warm Lemon Water Every Morning. Every Monday morning, artnet News Get a weekly local sports round-up from www. Listen LIVE to ESPN Radio on your iPhone or Android with the ESPN app. His father was Sir Oswald Mosley, while his mother was Lady Diana Mosley, one of the Mitford sisters. If youre considering buying a C-Max, you might be concerned about the cost of replacing the lithium ion battery when it fails. MAX Workout Club membership and just 30 minutes a day are all you need to build a lean, well defined body. Legislature Home; House of Representatives; Senate; Find Your District Find Your District; Laws & Agency Rules; Bill Information; Agendas, Schedules, and Calendars; Legislative Committees We woke up every morning and we came in and we played hockey and tried to do the best that we can thats all we thought of. MOBILE. Just ask the over 300,000 members who have already tried it!Your station will play momentarily. Family and early life. 1 mg/24 hr patch or changing to a larger system Miranda owns the B&B with her husband Max, and their dog Tessy. - When I Wake Up. The procedure for checking on games for the finals series (semis - prelim - grand final) is as follows:- Click on fixtures - click on your grade - fixtures - finals matches. Welcome and entertain them all! Even if they're a crowd of sorrows, who violently sweep your house empty of its furniture, still treat each guest honorably. Technical SupportTHE FIRST SHOW BACK: "S Continue reading >>

What Are The Possible Side Effects Of Insulin Glargine (lantus, Lantus Opticlik Cartridge, Lantus Solostar Pen)?

What Are The Possible Side Effects Of Insulin Glargine (lantus, Lantus Opticlik Cartridge, Lantus Solostar Pen)?

LANTUS® (insulin glargine) Injection DESCRIPTION LANTUS (insulin glargine injection) is a sterile solution of insulin glargine for subcutaneous use. Insulin glargine is a recombinant human insulin analog that is a long-acting, parenteral blood-glucose-lowering agent [see CLINICAL PHARMACOLOGY]. Insulin glargine has low aqueous solubility at neutral pH. At pH 4 insulin glargine is completely soluble. After injection into the subcutaneous tissue, the acidic solution is neutralized, leading to formation of microprecipitates from which small amounts of insulin glargine are slowly released, resulting in a relatively constant concentration/time profile over 24 hours with no pronounced peak. This profile allows oncedaily dosing as a basal insulin. LANTUS is produced by recombinant DNA technology utilizing a non-pathogenic laboratory strain of Escherichia coli (K12) as the production organism. Insulin glargine differs from human insulin in that the amino acid asparagine at position A21 is replaced by glycine and two arginines are added to the C-terminus of the B-chain. Chemically, insulin glargine is 21A-Gly-30Ba-L-Arg-3030b-L-Arg-human insulin and has the empirical formula C267H404N72O78S6 and a molecular weight of 6063. Insulin glargine has the following structural formula: LANTUS consists of insulin glargine dissolved in a clear aqueous fluid. Each milliliter of LANTUS (insulin glargine injection) contains 100 Units (3.6378 mg) insulin glargine. The 10 mL vial presentation contains the following inactive ingredients per mL: 30 mcg zinc, 2.7 mg m-cresol, 20 mg glycerol 85%, 20 mcg polysorbate 20, and water for injection. The 3 mL prefilled pen presentation contains the following inactive ingredients per mL: 30 mcg zinc, 2.7 mg m-cresol, 20 mg glycerol 85%, and water for inje Continue reading >>

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