Insulin-deficient hospitalized diabetes patients need a constant supply of basal
insulin—even if NPO
18Normoglycemic insulin secretion has basal and prandial components
15Adapted from Leahy in Insulin Therapy, 2002.15
Physiologic basal insulin:
- Is relatively continuous over 24 hours15,19
- Suppresses blood glucose production between meals and overnight15
—By controlling hepatic glucose output, even during fasting
- Is approximately 50% of daily insulin output15
— Mealtime spikes in insulin may account for the remaining output
ACE/ADA recommendations for hyperglycemic inpatients with diabetes who are eating
15,20
- Basal-bolus therapy to cover both fasting and prandial glucose
- Prandial insulin must balance food; schedule dosing only with meals and not at fixed times
- To reduce the risk of hyperglycemia, use rapid-acting analogs with or even after meals
To closely mimic physiologic blood glucose control, a constant supply of basal insulin
is essential.
15How basal insulin therapy affects 24-hour glucose levels
From Galloway and Chance21 and Skyler.19
IMPORTANT SAFETY INFORMATION FOR LANTUS®
LANTUS® is indicated for once-daily subcutaneous administration, at the same
time each day, for the treatment of adult and pediatric patients (6 years and older)
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® SoloSTAR® is a disposable prefilled insulin pen. Needles and the Lantus® SoloSTAR® pen must not be shared.
LANTUS® MUST NOT BE DILUTED OR MIXED 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.
LANTUS® is contraindicated in patients hypersensitive to insulin glargine or
the excipients.
Hypoglycemia is the most common adverse effect of insulin, including LANTUS®.
As with all insulins, the timing of hypoglycemia may differ among various insulin
formulations. Glucose monitoring is recommended for all patients with diabetes.
Any change of insulin type and/or regimen should be made cautiously and only under
medical supervision. Concomitant oral antidiabetes treatment may need to be adjusted.
Other adverse events commonly associated with LANTUS® include the following:
lipodystrophy, skin reactions (such as injection-site reaction, pruritus, rash),
and allergic reactions.
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.
Please click here for full prescribing information.
