Lantus |
Insulin glargine, sold under the name Lantus, is a long-acting basal insulin analogue,
usually given once or twice daily to help control the blood sugar level of
those with diabetes. Its theoretical advantage is that it has a 24 hour duration
of action, with a "peakless" profile. Thus, it more closely resembles the basal
insulin secretion of the normal pancreatic beta cells. 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 or depleted type
2), Lantus needs the support of a fast acting insulin taken with food to reduce
the effect of prandially derived glucose. It is post-prandial glucose elevation
which more significantly affects HbA1c and thus determines the progression of
the long-term complications of diabetes mellitus. glargine vs. NPH insulinThe peakless profile of Lantus also enables the dose to be relatively higher than standard NPH insulin. Because standard NPH is normally administered at night, its peak of action tends to coincide with the lower serum glucose levels associated with nocturnal metabolism. This can induce nocturnal hypoglycaemia. Lantus offers the benefit of a more consistent pharmacological dynamic without nocturnal hypoglycaemia. The result of this is a patient who feels more confident and more comfortable with a lower pre-bed and pre-breakfast capillary glucose level. Lantus is formulated at pH 4, where it is completely water soluble. After subcutaneous injection, the body, at pH 7, slowly neutralizes the solution, causing insulin microcrystals to gradually precipitate from the insulin glargine solution, which then release insulin in bioloigically active form. This gradual process ensures that small amounts of Lantus are released into the body continuously, giving an almost peakless profile. |