What is LANTUS®?
What are the benefits of LANTUS® long-acting
basal insulin?
What are some of the possible risks or adverse
reactions of insulin therapy, including LANTUS®?
Is my patient ready for LANTUS®?
How does LANTUS® work?
What is the long-term safety of LANTUS®?
Can LANTUS® be mixed with other insulin?
What is LANTUS®?
LANTUS®, or insulin glargine, is a once-daily long-acting basal insulin for
patients with diabetes mellitus. It is indicated to improve glycemic control in
adults and children (6 years and older) with type 1 diabetes and in adults with
type 2 diabetes. LANTUS® should be administered once a day at the same time
each day. LANTUS® is not recommended for the treatment of diabetic ketoacidosis.
Use intravenous short-acting insulin instead.
A recombinant human insulin analog, LANTUS® provides 24-hour basal coverage with
no pronounced peak, mimicking the steady basal secretion of insulin provided by
a normal pancreas.3
Adapted from LANTUS® Prescribing Information3 and McKeage.4
LANTUS® is engineered to begin microprecipitation upon subcutaneous injection,
slowly releasing small amounts of basal insulin for the next 24 hours. This profile
allows LANTUS® to be dosed once a day as a patient's basal insulin.
The time course of action of insulin, including LANTUS®, may vary between individuals
and within the same individual.
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What are the benefits of LANTUS® long-acting basal insulin?
Long-acting basal insulins like LANTUS® mimic normal physiologic insulin secretion.15
As this chart demonstrates, to closely mimic normal physiologic insulin secretion,
a constant supply of basal insulin (glargine) and a mealtime dosing of prandial
insulin is essential.17
Long acting LANTUS® insulin:3
- Is relatively continuous over 24 hours
- Suppresses blood glucose production between meals and overnight
- Should contribute approximately 50% of daily insulin needs
- Has no pronounced peak19
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What are some of the possible risks or adverse reactions of insulin therapy, including
LANTUS®?
Hypoglycemia is the most common adverse reaction of insulin therapy, including LANTUS®,
which may be serious. Some of the other common adverse reactions associated with
LANTUS® include:3
- Allergic reactions
- Severe, life-threatening, generalized allergy, including anaphylaxis, can occur
- Rash, lipodystrophy, pruritus
- Weight gain
In order to limit the risk of hypoglycemia, it’s important for physicians to ensure
that patients are taking their insulin as directed. Patients should be made aware
of the activities that might alter blood glucose such as exercise, which stimulates
glucose removal from the blood.15
These are some of the side effects for insulins such as LANTUS®. See the full
Prescribing
Information for full details.
Useful tools for your LANTUS® patients
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Is my patient ready for LANTUS®?
LANTUS® is indicated to improve glycemic control in adults and children (6 years and older) with
type 1 diabetes, and adults with type 2 diabetes. After lifestyle management and
OADs alone have failed to yield target glycemic goals, the addition of insulin, such as LANTUS®, should
be considered in patients with type 2 diabetes. This stepwise approach to treatment
reflects the progressive nature of the disease.5
As type 2 diabetes progresses, pancreatic function declines, requiring intensification
of therapy. When diet, exercise, and oral therapies are no longer enough to achieve
the desired glycemic goal, it may be time to consider the addition of a basal insulin.
The option exists to further intensify insulin coverage to achieve glycemic goals
by progressively adding rapid-acting prandial insulin to select meals beginning
with the largest meal, and then ultimately full basal-bolus therapy for all meals
if necessary.5
Monitor blood glucose in all patients treated with insulin. Insulin regimens should
be modified cautiously and only under medical supervision. Changes in insulin strengths,
manufacturer, type, or method of administration may result in the need for a change
in insulin dose or an adjustment in concomitant OAD treatment.
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How does LANTUS® work?
Long-acting LANTUS® is a recombinant human insulin analog that works as a
parenteral blood-glucose-lowering agent.
LANTUS® is produced by using a non-pathogenic laboratory strain of Escherichia
coli (K12) as the production organism. Specific amino acids are then added or replaced,
shifting the isoelectric point and producing a solution that is completely soluble
at pH of approximately 4.3
When injected into the neutral pH environment of the subcutaneous tissue, the acidic
solution microprecipitates, slowly releasing insulin. This accounts for the lack
of a pronounced peak, which allows LANTUS® to be dosed once daily at the same time
each day.3
LANTUS® is metabolized at the injection site and in the systemic circulation
to two main active metabolites, designated M1 and M2. M1 and M2 are very close in structure and function
to human insulin, but have slightly weaker interactions with the insulin and IGF-1
receptors than human insulin. Both LANTUS® and its active metabolites have been
detected in systemic circulation.3
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.
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What is the long-term safety of LANTUS®?
Diabetes mellitus increases the lifetime risk of both cancer and retinopathy, and
it is important to establish that diabetes therapies do not increase that risk.
In a large, 5-year study of patients with type 2 diabetes, the risk of cancer
or retinopathy was no greater with LANTUS® than with human insulin.
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Can LANTUS® be mixed with other insulin?
LANTUS® cannot be diluted or mixed with any other solution, including insulin.
Diluting or mixing LANTUS® may produce a cloudy solution, and pharmacokinetic/
pharmacodynamic profiles may be altered in an unpredictable manner.3
If your patients' A1C goals are not being reached by a basal insulin alone, consider
timely intensification of insulin therapy to a basal-prandial regimen.5 If your patients are
on a basal-prandial regimen, know that LANTUS® may be taken in conjunction with
a rapid-acting insulin such as APIDRA®.
Hypoglycemia is the most common adverse reaction of insulin, including LANTUS®.
The risk of hypoglycemia increases with intensive glycemic control. Patients must
be educated to recognize and manage hypoglycemia.
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Useful tools for your LANTUS®
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