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Updated: Apr 29, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
The evolution of insulin glargine and its continuing contribution to diabetes care
Rolf Hilgenfeld1, Gerhard Seipke, Harald Berchtold
1Institute of Biochemistry, Center for Structural and Cell Biology in Medicine and Center for Brain, Behavior and Metabolism, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany, hilgenfeld@biochem.uni-luebeck.de.
Abstract:
The epoch-making discovery of insulin heralded a new dawn in the management of diabetes. However, the earliest, unmodified soluble insulin preparations were limited by their short duration of action, necessitating multiple daily injections. Initial attempts to protract the duration of action of insulin involved the use of various additives, including vasoconstrictor substances, which met with limited success. The subsequent elucidation of the chemical and three-dimensional structure of insulin and its chemical synthesis and biosynthesis allowed modification of the insulin molecule itself, resulting in insulin analogs that are designed to mimic normal endogenous insulin secretion during both fasting and prandial conditions. Insulin glargine was the first once-daily, long-acting insulin analog to be introduced into clinical practice more than 10 years ago and is specifically designed to provide basal insulin requirements. It has a prolonged duration of action and no distinct insulin peak, making it suitable for once-daily administration and reducing the risk of nocturnal hypoglycemia that is seen with intermediate-acting insulins. Insulin glargine can be used in combination with prandial insulin preparations and non-insulin anti-diabetic agents according to individual requirements.
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