Products
Insulin glargine is commercially available as an injectable (Lantus). It has been approved in many countries since 2002. The biosimilar Abasaglar (LY2963016) was approved in the EU in 2014 and in many countries in 2015. The drugs must be stored between 2 to 8°C in a refrigerator. In 2015, Toujeo was additionally approved in many countries. The solution for injection contains 300 units per ml instead of 100 U/ml (Lantus). Toujeo has a flatter action profile than Lantus and induces less hypoglycemia. Insulin glargine is also combined with lixisenatide (Suliqua). See iGlarLixi. This combination was registered in many countries in 2017.
Structure and properties
Insulin glargine (C267H404N72O78S6, Mr = 6063 g/mol) has the same primary structure as human insulin, with the following exceptions:
- A-chain: glycine instead of asparagine at position 21.
- B-chain: Additionally two arginines at position 31 and 32.
The active ingredient is produced by biotechnological methods.
Effects
Insulin glargine (ATC A10AE04) has blood glucose-lowering and antidiabetic properties. It is a long-acting insulin analog with a uniform concentration-time profile without peaks. Insulins lower blood glucose levels by promoting glucose uptake into skeletal muscle and adipose tissue and inhibiting gluconeogenesis in the liver. They inhibit lipid and protein breakdown and promote protein synthesis. Insulin glargine has a long duration of action of at least 24 hours.
Indications
For the treatment of diabetes mellitus (type 1 or 2).
Dosage
According to the SmPC. The injectable is administered subcutaneously (under the skin) once daily at the same time of day using an insulin pen. Possible injection sites include the abdominal wall, thigh, and deltoid muscle. The injection site should be changed daily.
Contraindications
- Hypersensitivity
For complete precautions, see the drug label.
Interactions
Numerous drugs affect glucose metabolism and may increase or decrease insulin requirements.
Adverse effects
The most common potential adverse effects include hypoglycemia, injection site reactions such as redness, pain, itching, and lipohypertrophy.