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Actions Profiles of LANTUS® Long-Acting Insulin, NPH, and Detemir

Recognize the Time-Action Profiles of Different Basal Insulins

LANTUS® is the Only 24-Hour Insulin Approved Exclusively for Use Once a Day3

Link to reference Link to reference Profile of LANTUS® vs. NPH in Patients with Tpe 1 Diabetes

a Glucose utilization rate in mg/kg/min, determined as the amount of glucose infused to maintain constant plasma glucose levels (hourly mean values); indicative of insulin activity.

A double-blind, randomized, crossover, euglycemic clamp study involving 20 patients with type 1 diabetes.

From Lepore19 and LANTUS® Prescribing Information.3

  • LANTUS® has no pronounced peak, so it mimics the steady rate of physiologic basal insulin secretion3,19
  • LANTUS® should be taken at the same time each day
  • The time course of action of insulins, including LANTUS®, may vary between individuals and within the same individual

Action Profiles of LANTUS® and Detemir in Patients with Type 1 Diabetes

Link to reference Profile of LANTUS® vs. detemir

Twenty-four subjects with type 1 diabetes naive to glargine and detemir were studied twice in a randomized, double-blind crossover study. Plasma glucose was clamped at 100 mg/dL for 24 hours after subcutaneous injection of 0.35 Units/kg of either glargine or detemir.

From Porcellati.30

Action profiles of detemir and NPH in patients with type 1 diabetes

Link to reference Profile of detemir vs. NPH

dGlucose infusion rate (mg/kg/min).

In a single-center, double-blind, 6-period, randomized, dose-response trial, 12 isoglycemic (130 mg/dL), C-peptide–negative (<0.03 nmol/L) subjects with type 1 diabetes were randomized to a specific treatment sequence encompassing 5 dose levels of insulin detemir (0.1, 0.2, 0.4, 0.8, and 1.6 Units/kg; 1 Unit=24 nmol) and 1 dose level of NPH insulin (0.3 Units/kg;1 Unit=6 nmol).

From Plank31 and Levemir Prescribing Information.29

  • Detemir can be administered once or twice daily29
  • The mean duration of action of detemir ranged from 5.7 hours at the lowest dose to 23.2 hours at the highest dose (sampling period of 24 hours)

LANTUS® efficacy >

Important Safety Information for Lantus®

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.

In clinical studies in adult patients there was a higher incidence of treatment-emergent injection-site pain (2.7% Lantus® vs. 0.7% NPH) The reports of pain at the injection site were usually mild and did not result in discontinuation of therapy.

Indications and Usage for Lantus®

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.


Important Safety Information for Apidra®
(insulin glulisine [rDNA origin] injection)

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.

Indications and Usage for Apidra®

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® 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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