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Insulin glargine: a new basal insulin
Terri L Levien1, Danial E Baker, John R White
1College of Pharmacy, Washington State University Spokane, 99202-1675, USA. levient@wsu.edu
The Annals of Pharmacotherapy
|May 23, 2002
Summary
Insulin glargine, a long-acting insulin analog, offers 24-hour basal coverage for diabetes management. It demonstrates comparable efficacy to NPH insulin with a potentially lower risk of hypoglycemia, especially nocturnal hypoglycemia.
Area of Science:
- Pharmacology and Endocrinology
- Diabetes Mellitus Therapeutics
Background:
- Insulin glargine is a novel, long-acting recombinant human insulin analog.
- It is designed for once-daily subcutaneous administration to provide basal insulin coverage.
Purpose of the Study:
- To comprehensively review the pharmacology, pharmacokinetics, dosing, adverse effects, drug interactions, and clinical efficacy of insulin glargine.
- To evaluate its role in the management of type 1 and type 2 diabetes mellitus.
Main Methods:
- Systematic review of primary and review articles identified through MEDLINE, Institute for Scientific Information Web of Science, and American Diabetes Association abstracts.
- Inclusion of product information for insulin glargine.
Main Results:
- Insulin glargine offers a slower onset and longer duration of action than NPH insulin, with no peak activity.
- Once-daily insulin glargine shows comparable efficacy to NPH insulin in basal-bolus regimens for both type 1 and type 2 diabetes.
- Incidence of hypoglycemia is comparable to or less than NPH insulin, with a notable reduction in nocturnal hypoglycemia in some studies.
Conclusions:
- Insulin glargine provides effective 24-hour basal insulin coverage with a once-daily bedtime dose.
- Its peakless profile mimics endogenous basal insulin, potentially reducing hypoglycemia risk, particularly at night.
- Optimal glycemic control typically requires combination with rapid-acting insulin for mealtime coverage.