Introducing Patients to Insulin Therapy
Type 2 diabetes treatment can follow a stepwise approach, taking into account the
progressive nature of the disease.5
In type 2 diabetes cases, basal insulin therapy is typically initiated after lifestyle
changes and OADs fail to yield the glycemic goal set by a patient's physician.20
Timely Initiation of Insulin in Patients with A1C between 7% and 8% Achieved Greater
Reductions in A1C vs Intensified Lifestyle Management20
A higher percentage of patients receiving LANTUS® + OADs reached A1C goal of
<7%: 66% with LANTUS® + OADs vs 38% with LM + OADs (P<0.0001).
In a 9-month, 12-visit, open-label, multinational, multicenter, randomized study
to evaluate starting LANTUS® (n=103) or intensifying LM (n=108) in patients
with type 2 diabetes with A1C levels 7% to 8% treated with at least 2 OADs (including
1 sulphonylurea and metformin at the maximum tolerated dosages) for ≥ 2 years. Baseline
A1C: LANTUS®=7.6% vs LM=7.5%.
From Blickle.20
- Reductions in FPG from baseline to endpoint were also significantly greater in patients
treated with LANTUS® + OADs than in those receiving intensification of LM20
- From 170 mg/dL to 122 mg/dL in the LANTUS® + OADs group vs 167 mg/dL to 161
mg/dL in the LM + OADs group (P<0.0001)
- Two patients in the LANTUS® group experienced severe hypoglycemia over nine
months20
- Mean LANTUS® total daily dose at baseline was 0.12 Units/kg. LANTUS® dose was
titrated throughout the study, and at study end, mean LANTUS® dose was 0.27
Units/kg20
A basal insulin like LANTUS® can provide continuous 24-hour insulin with no
pronounced peak as part of an overall treatment plan, including diet, exercise, and
other diabetes medications.
- Hypoglycemia is the most common adverse reaction of Insulin therapy, including LANTUS®,
and may be life-threatening
- Severe life-threatening, general allergy, including anaphylaxis, can occur
Insulin therapy considerations
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CONTRAINDICATIONS
Lantus® is contraindicated in patients hypersensitive to insulin glargine or
one of its excipients.
WARNINGS AND PRECAUTIONS
Monitor blood glucose in all patients treated with insulin. Insulin regimens should
be modified 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. Insulin devices
and needles must not be shared between patients.
Hypoglycemia is the most common adverse reaction of insulin therapy, including Lantus®,
and may be life-threatening.
Severe life-threatening, generalized allergy, including anaphylaxis, can occur.
A reduction in the Lantus® dose may be required in patients with renal or hepatic
impairment.
DRUG INTERACTIONS
Certain drugs may affect glucose metabolism, requiring insulin dose adjustment and
close monitoring of blood glucose. The signs of hypoglycemia may be reduced in patients
taking anti-adrenergic drugs (e.g., beta-blockers, clonidine, guanethidine, and
reserpine).
ADVERSE REACTIONS
Other adverse reactions commonly associated with Lantus® are injection site
reaction, lipodystrophy, pruritus, and rash.
Lantus® SoloSTAR® is a disposable prefilled insulin pen. To help ensure
an accurate dose each time, patients should follow all steps in the Instruction
Leaflet accompanying the pen; otherwise they may not get the correct amount of insulin,
which may affect their blood glucose.
Lantus® is a long-acting insulin analog indicated to improve glycemic control
in adults and children (6 years and older) 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.
Important Limitations of Use: Lantus® is not recommended for the treatment of
diabetic ketoacidosis. Use intravenous short-acting insulin instead.
Lantus® SoloSTAR® is a disposable prefilled insulin pen.
Please click here for full prescribing information.
CONTRAINDICATIONS
Apidra® is contraindicated during episodes of hypoglycemia and in patients hypersensitive
to Apidra® or any of its excipients.
WARNINGS AND PRECAUTIONS
Closely monitor blood glucose in all patients treated with insulin. Change insulin
regimens 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. As
with all insulin preparations, the time course of Apidra® action may vary by
individual or at different times in the same individual and is dependent on many
conditions, including the site of injection, local blood supply, or local temperature.
Hypoglycemia is the most common adverse reaction of insulin therapy, including Apidra®,
which may be serious.
Severe life-threatening, generalized allergy, including anaphylaxis, can occur.
All insulins, including Apidra®, can cause hypokalemia, which if untreated,
may be serious.
A reduction in the Apidra® dose may be required in patients with renal or hepatic
impairment.
Apidra® for subcutaneous injection should not be mixed with insulins other than
NPH. Do not mix Apidra® with any insulin when used in the pump or for intravenous
administration. Insulin devices and needles must not be shared between patients.
DRUG INTERACTIONS
Certain drugs may affect glucose metabolism, requiring insulin dose adjustment and
close monitoring of blood glucose. The signs of hypoglycemia may be reduced in patients
taking anti-adrenergic drugs (e.g., beta-blockers, clonidine, guanethidine, and
reserpine).
ADVERSE REACTIONS
Other adverse reactions commonly associated with Apidra® include injection site
reactions, lipodystrophy, pruritus, and rash.
Apidra® is a rapid-acting insulin analog indicated to improve glycemic control
in adults with type 2 diabetes or adults and children (4 years and older) with type
1 diabetes.
When used as a mealtime insulin, the dose of Apidra® should be given within 15 minutes
before or within 20 minutes after starting a meal. Apidra® given by subcutaneous injection
should normally be used in regimens that include a longer-acting insulin.
Please click here for full prescribing information for Apidra®
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