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Insulin Glargine Production

Long-acting Insulin Analogs In Type 1 Diabetes : Effects On Metabolic Control, Endogenous Insulin Production And The Gh-igf-axis

Long-acting Insulin Analogs In Type 1 Diabetes : Effects On Metabolic Control, Endogenous Insulin Production And The Gh-igf-axis

JavaScript is disabled for your browser. Some features of this site may not work without it. Long-acting insulin analogs in type 1 diabetes : effects on metabolic control, endogenous insulin production and the GH-IGF-axis Location: Skandiasalen, Q3:01, Astrid Lindgrens barnsjukhus, Solna Department: Inst fr kvinnors och barns hlsa / Dept of Women's and Children's Health Open: Thesis_Jenny_Salemyr.pdf (1.188Mb) The treatment goal in type 1 diabetes is to achieve near-normal glycemia. Despite of the advancements of subcutaneous insulin therapy and glucose monitoring, metabolic control is not fully normalized and secondary endocrine disturbances in the growth-hormone (GH) - Insulin-like Growth Factor (IGF)-axis are important for the deterioration of metabolic control, particularly in children at puberty. The long-acting insulin analogs, glargine and detemir, have prolonged effect duration compared to intermediate-acting NPH insulin. Sustained nightly insulin actions could be particularly important in pubertal children with type 1 diabetes by opposing the low IGF-I production and increase feedback inhibition of elevated GH. Even the successive decline in endogenous insulin production could be affected. The purpose of this thesis was to evaluate if glargine or detemir, compared to NPH, could improve metabolic control, prolong endogenous insulin production and reverse the abnormalities in the GH-IGF-axis in children and adolescents with type 1 diabetes. In Paper I we studied the effects of changing insulin therapy from NPH to glargine for up to 12 weeks on the GH-IGF-axis and metabolic control in 12 pubertal subjects with type 1 diabetes. A fifty percent increase in IGF-I levels, decreased overnight IGFBP-1 secretion and unchanged overnight GH secretion were associated with Continue reading >>

Analogue Insulin

Analogue Insulin

Tweet Analogue insulin is a sub-group of human insulin. Analogue insulin is laboratory grown but genetically altered to create either a more rapid acting or more uniformly acting form of the insulin. This can have advantages for blood sugar management. Analogue insulins have been available since just before the start of the new millennium. How is human analogue insulin produced? Similar to human insulin, analogue insulin is laboratory created by growing insulin proteins within E-coli bacteria (Escherichia coli). The process goes further through changing the order of amino acids to allow the insulin to be used by the body either more rapidly or more uniformly by the body than with regular human insulin. This type of process is known as undergoing ‘recombinant DNA’ technology. What types of analogue insulin are available? Analogue insulin is available in two main forms, rapid acting and long acting, as well as premixed combinations. Examples of analogue insulin: Rapid acting: Humalog, NovoRapid Long acting: Lantus, Levemir, Tresiba Premixed analogue insulins: Humalog Mix 25, Humalog Mix 50, NovoMix 30 Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why people with diabetes are advised to avoid sources of dietary suga Continue reading >>

Insulin Glargine: A New Basal Insulin Analogue

Insulin Glargine: A New Basal Insulin Analogue

Insulin glargine: a new basal insulin analogue From the Department of Endocrinology, Arrowe Park Hospital, Wirral, UK Search for other works by this author on: From the Department of Endocrinology, Arrowe Park Hospital, Wirral, UK Search for other works by this author on: From the Department of Endocrinology, Arrowe Park Hospital, Wirral, UK Search for other works by this author on: QJM: An International Journal of Medicine, Volume 95, Issue 11, 1 November 2002, Pages 757761, N. Younis, H. Soran, D. BowenJones; Insulin glargine: a new basal insulin analogue, QJM: An International Journal of Medicine, Volume 95, Issue 11, 1 November 2002, Pages 757761, Currently, the therapeutic challenges in the treatment of both type 1 and 2 diabetes mellitus (DM) are the maintenance of nearnormal glycaemia, to prevent longterm complications, 1, 2 and the avoidance of episodes of hypoglycaemia. For many people with DM, intensive insulin therapy means multiple insulin injections and frequent blood sampling, at the expense of an increased risk of hypoglycaemia. This article will discuss the potential use of a new longacting insulin analogue, insulin glargine, already prescribed in the US but expected to be available in the UK later this year. Normal insulin secretion consists of discrete components: low basal levels secreted between meals, through the night and during fasting; and very high levels secreted postprandially (Figure 1 ). Basalbolus insulin regimens attempt to reproduce this insulin secretion profile, which consists of one or two injections per day of intermediate or longacting insulins (basal) and multiple mealtime (bolus) injections of rapidacting or regular insulins. The disadvantages of conventional insulin preparations include variable absorption with considerable intra Continue reading >>

Cell Factories For Insulin Production

Cell Factories For Insulin Production

Go to: Introduction The pioneering work of Stanley Cohen and Herbert Boyer, who invented the technique of DNA cloning, signaled the birth of genetic engineering, which allowed genes to transfer among different biological species with ease [1]. Their discovery led to the development of several recombinant proteins with therapeutic applications such as insulin and growth hormone. Genes encoding human insulin and growth hormone were cloned and expressed in E. coli in 1978 and 1979 respectively. The first licensed drug produced using recombinant DNA technology was human insulin, which was developed by Genentech and licensed as well as marketed by Eli Lilly in 1982. There are more than 300 biopharmaceutical products including therapeutic proteins and antibodies in the market with sales exceeding USD100 billion [2,3]. Therapeutic monoclonal antibodies have captured the major market share (>USD18 billion) followed by the hormones (>USD11 billion) and growth factors (>USD10 billion) [4]. Biopharmaceuticals approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) from 2004 to 2013 are largely derived from mammalian cell (56%); E. Coli (24%); S. Cerevisiae (13%); Transgenic animals & plants (3%) and insect cells (4%) as shown in Figure 1 [5-13]. At present, insulin is being produced predominantly in E. coli and Saccharomyces cerevisiae for treatment of diabetic patients. Since the early 1920s, diabetic patients were treated with insulin, which was purified from bovine or porcine pancreas. The development in the field of genetic engineering allowed the production of insulin in E. coli and yeast, which have been approved for therapeutic applications in human by FDA [14,15]. Nowadays, recombinant human insulin is mainly produced either in E. coli or Continue reading >>

Enhancement In Production Of Recombinant Two-chain Insulin Glargine By Over-expression Of Kex2 Protease In Pichia Pastoris.

Enhancement In Production Of Recombinant Two-chain Insulin Glargine By Over-expression Of Kex2 Protease In Pichia Pastoris.

Enhancement in production of recombinant two-chain Insulin Glargine by over-expression of Kex2 protease in Pichia pastoris. Sreenivas S, et al. Appl Microbiol Biotechnol. 2015. Biocon Research Limited, Plot No.2&3, Phase IV, Bommasandra-Jigani Link Road, Bangalore, 560099, Karnataka, India, [email protected] Appl Microbiol Biotechnol. 2015 Jan;99(1):327-36. doi: 10.1007/s00253-014-6052-5. Epub 2014 Sep 20. Glargine is an analog of Insulin currently being produced by recombinant DNA technology using two different hosts namely Escherichia coli and Pichia pastoris. Production from E. coli involves the steps of extraction of inclusion bodies by cell lysis, refolding, proteolytic cleavage and purification. In P. pastoris, a single-chain precursor with appropriate disulfide bonding is secreted to the medium. Downstream processing currently involves use of trypsin which converts the precursor into two-chain final product. The use of trypsin in the process generates additional impurities due to presence of Lys and Arg residues in the Glargine molecule. In this study, we describe an alternate approach involving over-expression of endogenous Kex2 proprotein convertase, taking advantage of dibasic amino acid sequence (Arg-Arg) at the end of B-chain of Glargine. KEX2 gene over-expression in Pichia was accomplished by using promoters of varying strengths to ensure production of greater levels of fully functional two-chain Glargine product, confirmed by HPLC and mass analysis. In conclusion, this new production process involving Kex2 protease over-expression improves the downstream process efficiency, reduces the levels of impurities generated and decreases the use of raw materials. Continue reading >>

How Insulin Is Made - Material, Manufacture, History, Used, Parts, Components, Structure, Steps, Product

How Insulin Is Made - Material, Manufacture, History, Used, Parts, Components, Structure, Steps, Product

Background Insulin is a hormone that regulates the amount of glucose (sugar) in the blood and is required for the body to function normally. Insulin is produced by cells in the pancreas, called the islets of Langerhans. These cells continuously release a small amount of insulin into the body, but they release surges of the hormone in response to a rise in the blood glucose level. Certain cells in the body change the food ingested into energy, or blood glucose, that cells can use. Every time a person eats, the blood glucose rises. Raised blood glucose triggers the cells in the islets of Langerhans to release the necessary amount of insulin. Insulin allows the blood glucose to be transported from the blood into the cells. Cells have an outer wall, called a membrane, that controls what enters and exits the cell. Researchers do not yet know exactly how insulin works, but they do know insulin binds to receptors on the cell's membrane. This activates a set of transport molecules so that glucose and proteins can enter the cell. The cells can then use the glucose as energy to carry out its functions. Once transported into the cell, the blood glucose level is returned to normal within hours. Without insulin, the blood glucose builds up in the blood and the cells are starved of their energy source. Some of the symptoms that may occur include fatigue, constant infections, blurred eye sight, numbness, tingling in the hands or legs, increased thirst, and slowed healing of bruises or cuts. The cells will begin to use fat, the energy source stored for emergencies. When this happens for too long a time the body produces ketones, chemicals produced by the liver. Ketones can poison and kill cells if they build up in the body over an extended period of time. This can lead to serious illne Continue reading >>

Lillymedical Authentication

Lillymedical Authentication

Independent Research Clinical Trial Investigational Drugs You are now leaving the LillyMedical.com Web site The link you clicked on will take you to a site maintained by a third party, which is solely responsible for its content. Lilly USA, LLC does not control, influence, or endorse this site, and the opinions, claims, or comments expressed on this site should not be attributed to Lilly USA, LLC. Lilly USA, LLC is not responsible for the privacy policy of any third-party Web sites. We encourage you to read the privacy policy of every Web site you visit. Click "Continue" to proceed or "Return" to return to LillyMedical.com. You are now leaving the LillyMedical.com Web site The link you clicked on will take you to a site maintained by a third party, which is solely responsible for its content. Lilly USA, LLC does not control, influence, or endorse this site, and the opinions, claims, or comments expressed on this site should not be attributed to Lilly USA, LLC. Lilly USA, LLC is not responsible for the privacy policy of any third-party Web sites. We encourage you to read the privacy policy of every Web site you visit. Click "Agree" to proceed or "Cancel" to return to LillyMedical.com. Continue reading >>

Lantus (insulin Glargine [rdna Origin] Injection)

Lantus (insulin Glargine [rdna Origin] Injection)

The following drug information is obtained from various newswires, published medical journal articles, and medical conference presentations. Lantus is a sterile solution of insulin glargine for use as an injection. The primary activity of insulin is regulation of glucose metabolism. Insulin and its analogs lower blood glucose levels by stimulating peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin inhibits lipolysis in the adipocyte, inhibits proteolysis, and enhances protein synthesis. Lantus is specifically indicated for once-daily subcutaneous administration for the treatment of adult and pediatric patients with type 1 diabetes mellitus or adult patients with type 2 diabetes mellitus who require basal (long-acting) insulin for the control of hyperglycemia. Lantus is supplied as 10 mL vials, 3 mL cartridges or as a 3 mL SoloStar disposable insulin device, all designed for subcutaneous administration. Lantus should be administered subcutaneously once a day at the same time every day. The desired blood glucose levels as well as the doses and timing of antidiabetes medications must be determined individually. FDA Approval The FDA approval of Lantus was based on the following trials: Type 1 Diabetes-Adults Study A This randomized, controlled study enrolled 585 subjects who were randomized to basal-bolus treatment with Lantus (once daily at bedtime) or to NPH human insulin (once daily in the morning or at bedtime or twice daily at bedtime) and treated for 28 weeks. Regular human insulin was administered before each meal. The results were as follows: HbA1c adjusted mean change from baseline: Lantus +0.21 and NPH +0.10. the basal insulin dose mean change from baseline: Lantus -1.7 and NPH -0.3 the total ins Continue reading >>

Toujeo (insulin Glargine) Dosing, Side Effects, Cost, And Prescribing Information For Diabetes Treatment

Toujeo (insulin Glargine) Dosing, Side Effects, Cost, And Prescribing Information For Diabetes Treatment

Brand Name: Toujeo Generic Name: insulin glargine injection, U-300 Medication Class: Long-acting insulin Similar Drugs: insulin glargine (Lantus), insulin detemir (Levemir) Manufacturer: Sanofi-Aventis US FDA Approval date: February 2015 What is Toujeo and its mechanism of action? Toujeo (insulin glargine) is an ultra long-acting type of insulin used for treating diabetes. It is a more concentrated version of Lantus and it releases insulin more gradually than Lantus. Insulin is a hormone produced and released by beta cells in the pancreas to help the body regulate blood glucose. Insulin release is triggered by an increase in blood glucose from food consumption. Toujeo is a basal insulin analog produced by recombinant DNA technology. Compared to human insulin, it has a slower onset, no pronounced peak, and longer duration of action. Like other types of insulin, Toujeo regulates the use of glucose by the body. It lowers blood glucose by stimulating glucose uptake by skeletal muscle and adipose (fat) tissue, and also reduces glucose production in the liver. Insulin enhances protein production and reduces the breakdown of protein into smaller protein molecules (polypeptides) and breakdown of fats to release fatty acids. What is Toujeo used for treating? Toujeo is used to lower blood glucose and improve diabetes control in adults with type 1 or 2 diabetes mellitus. How effective is Toujeo? The safety and efficacy of Toujeo, given once daily, have been compared to Lantus given once daily in patients with type 1 or 2 diabetes mellitus. The baseline average glycated hemoglobin (HbA1c) was 8.13. Toujeo or Lantus was given either every morning or every evening for 26 weeks. All subjects received mealtime insulin along with their basal insulin. At the end of the trial, the reducti Continue reading >>

Enhancement In Production Of Recombinant Two-chain Insulin Glargine By Over-expression Of Kex2 Protease In Pichia Pastoris

Enhancement In Production Of Recombinant Two-chain Insulin Glargine By Over-expression Of Kex2 Protease In Pichia Pastoris

, Volume 99, Issue1 , pp 327336 | Cite as Enhancement in production of recombinant two-chain Insulin Glargine by over-expression of Kex2 protease in Pichia pastoris Applied genetics and molecular biotechnology Glargine is an analog of Insulin currently being produced by recombinant DNA technology using two different hosts namely Escherichia coli and Pichia pastoris. Production from E. coli involves the steps of extraction of inclusion bodies by cell lysis, refolding, proteolytic cleavage and purification. In P. pastoris, a single-chain precursor with appropriate disulfide bonding is secreted to the medium. Downstream processing currently involves use of trypsin which converts the precursor into two-chain final product. The use of trypsin in the process generates additional impurities due to presence of Lys and Arg residues in the Glargine molecule. In this study, we describe an alternate approach involving over-expression of endogenous Kex2 proprotein convertase, taking advantage of dibasic amino acid sequence (Arg-Arg) at the end of B-chain of Glargine. KEX2 gene over-expression in Pichia was accomplished by using promoters of varying strengths to ensure production of greater levels of fully functional two-chain Glargine product, confirmed by HPLC and mass analysis. In conclusion, this new production process involving Kex2 protease over-expression improves the downstream process efficiency, reduces the levels of impurities generated and decreases the use of raw materials. Two-chain GlargineKex2 proteaseOver-expressionPichia pastoris This is a preview of subscription content, log in to check access We thank Molecular Biology group of R&D for their support and suggestions. We thank Biocon Research Limited for supporting this work. Abad S, Kitz K, Hormann A, Schreiner U, Continue reading >>

Recombinant Glargine Insulin Production Process Using Escherichia Coli.

Recombinant Glargine Insulin Production Process Using Escherichia Coli.

J Microbiol Biotechnol. 2016 Oct 28;26(10):1781-1789. doi: 10.4014/jmb.1602.02053. Recombinant Glargine Insulin Production Process Using Escherichia coli. Department of Pharmacy, Sunchon National University, Suncheon 57922, Republic of Korea. Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon 57922, Republic of Korea. Division of Animal Resources and Life Science, Sangji University, Wonju 26339, Republic of Korea. Department of Integrated Biotechnology, Sogang University, Seoul 04107, Republic of Korea. Department of Food and Nutrition, Chonnam National University, Gwangju 61186, Republic of Korea. Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 56212, Republic of Korea. Suncheon Research Center for Natural Medicines, Suncheon 57922, Republic of Korea. Glargine insulin is a long-acting insulin analog that helps blood glucose maintenance in patients with diabetes. We constructed the pPT-GI vector to express prepeptide glargine insulin when transformed into Escherichia coli JM109. The transformed E. coli cells were cultured by fed-batch fermentation. The final dry cell mass was 18 g/l. The prepeptide glargine insulin was 38.52% of the total protein. It was expressed as an inclusion body and then refolded to recover the biological activity. To convert the prepeptide into glargine insulin, citraconylation and trypsin cleavage were performed. Using citraconylation, the yield of enzymatic conversion for glargine insulin increased by 3.2-fold compared with that without citraconylation. After the enzyme reaction, active glargine insulin was purified by two types of chromatography (ion-exchange chromatography and reverse-phase chromatography). We obtained recombinant human glargine i Continue reading >>

Production And Manufacturing Of Biosimilar Insulins: Implications For Patients, Physicians, And Health Care Systems

Production And Manufacturing Of Biosimilar Insulins: Implications For Patients, Physicians, And Health Care Systems

1Department of Internal Medicine–Nephrology, Klinikum im Friedrichshain, Berlin, Germany; 2Sanofi, Frankfurt, Germany Abstract: More than 380 million people worldwide have diabetes, a disease that accounts for almost US$550 billion in global health care spending. The majority of patients with diabetes will require insulin replacement as part of their therapeutic regimen. In some countries, the approaching patent expiry dates for the long-acting insulin analog insulin glargine mean there is increasing interest in the potential of biosimilar insulins. However, the production and manufacturing of biosimilar insulins is a proprietary, complex, multistep process in which each stage can potentially introduce variability, possibly leading to adverse clinical and safety outcomes. Thus, marketing authorization in countries in which stringent regulatory requirements are in place requires manufacturers to demonstrate similarity in pharmacokinetic/pharmacodynamic properties, clinical efficacy, and adverse event and immunogenicity profiles, as well as provide proof of the quality of the production process between the biosimilar and the reference insulin product. A risk management plan and pharmacovigilance program may also be needed for the approval process. Regulatory guidelines for the introduction of biosimilar insulins differ between countries but are most developed for the European Union. As of the date of submission of this manuscript (April 30, 2014), no insulin or insulin analogs have received marketing authorization based on the European Union standards established for biosimilars; however, European Medicines Agency approval of a biosimilar glargine insulin is awaited for the end of 2014. In recent years several copies of the long-acting insulin glargine have been brought Continue reading >>

Biocon Plant Set For Eu Supply Of Lantus Biosimilar Under Review

Biocon Plant Set For Eu Supply Of Lantus Biosimilar Under Review

Related tags: Insulin glargine , European union Biocon says it is well-positioned to up production of its Lantus biosimilar after the insulin glargine co-developed with Mylan was accepted for review in the EU. The regulatory filing - containing data showing the long-acting insulin analogs is bioequivalent to Sanofis Lantus - was accepted by the European Medicines Agency (EMA), Biocon announced yesterday. The product filed in EU has been co-developed by Biocon and Mylan for developed markets, a Biocon spokesperson told this publication. This filing of Insulin Glargine in EU is the first filing in a developed market that incorporates product validated at our new state-of-the-art integrated Insulins Manufacturing facility in Malaysia. The facility in Malaysia was commissioned in 2015 , and is now qualified for commercial sales of rh-insulin in the local Malaysian market. Regulatory filings for a couple of emerging markets are underway to enable commercial sales from the Malaysian facility, we were told, and from a capacity perspective, we are well-placed to cater to our mid-term demand in both emerging and developed markets. If accepted, the product will be marketed in the EU by Mylan, under terms of a co-development partnership which also incorporates six biosimilar mAbs and recombinant proteins - trastuzumab, adalimumab, bevacizumab, pegfilgrastim, etanercept and filgrastim. The firms are also co-developing three insulin analogs - glargine, lispro and aspart. If approved, the product would become the second Lantus biosimilar in Europe following Eli Lilly and Boehringer-Ingelheims Abasaglarwhich was given the thumbs up in 2014 (at the time under the name Abasria). Eli Lilly/B-Is product is also approved in the US under the brand name Basaglar, though as a new chemical en 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 >>

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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