Insulin Injections

Using Insulin Glargine As Once-Daily Basal Insulin For Diabetes Management

To systematically review the literature regarding insulin use in patients with type 1 and type 2 diabetes mellitus (DM). Insulin glargine demonstrates a slow, prolonged absorption and a relatively constant concentration/time profile over 24 hours. People with type 2 diabetes treated with insulin glargine LANTUS [rDNA origin] injection), a 24-hour basal insulin, achieved optimal glucose control – defined by the American Diabetes Association (ADA) as an A1C of less than 7 percent(A1C<7%) – with a low risk of hypoglycemia (low blood sugar). These findings, as well as data that demonstrates flexible dosing options with LANTUS were presented in three separate poster abstracts at the ADA’s 63rd Annual Scientific Sessions.

According to a meta-regression analysis of 1,786 type 2 diabetes patients treated with a once-daily injection of insulin glargine or NPH insulin, people treated with this experienced a lower rate of events by 23 percent for all hypoglycemias and by 39 percent for nocturnal hypoglycemias. This poster was presented by Hannele Yki-Jarvinen, MD, FRCP, Professor of Medicine, Division of Diabetes at the University of Helsinki, Finland. The prediction model, based on the data from three different trials, suggests that patients using insulin glargine LANTUS would be able to achieve significantly lower A1C levels than patients using NPH, with a similar rate of hypoglycemia.

Patient and physician concerns about experiencing hypoglycemia may result in a delay or inadequate dosage of insulin therapy, and many patients may not receive the most effective treatment plan to reduce A1C levels and subsequent complications. In another study, it shows that there can be less fear of hypoglycemic events when LANTUS is prescribed. LANTUS (in the morning or at bedtime) was associated with a lower incidence of fear about, and rate of nocturnal lower rates of hypoglycemia and a lower A1C. In other studies whether LANTUS was taken in the morning or at bedtime vs. NPH insulin, suggesting that LANTUS offers people with diabetes flexibility in managing their disease.

The 24-hour based stable profile with no pronounced peak that is associated with LANTUS may enable people to easily transition to once daily injection of LANTUS and multiple premeal injections of lispro with similar glycemic control from continuous subcutaneous insulin infusion with insulin lispro (insulin pump). No significant differences in rates of hypoglycemia or any other adverse event were seen in patients switched to LANTUS plus multiple premeal injections of lispro suggesting that it provides a safe transition for patients taking a “pump holiday” over the seven day course of this trial.

These findings demonstrate that tight control through aggressive treatment is possible and can be achieved safely with the addition of or transition to LANTUS, regardless of when it is dosed. Physicians should consider these findings when prescribing a diabetes management strategy and consider a more aggressive treatment approach with basal insulin to help their patients achieve glycemic control was told by Poul Strange, MD, PhD, Senior Medical Director, Aventis Metabolism Medical Affairs.