Lantus® (insulin glargine) is a new, very long acting insulin marketed by Aventis. Like other new insulins, Lantus is an insulin analog, meaning that its molecular structure has been changed slightly, and it is this change that gives it the long lasting effect. Other insulin analogs, such as Humalog, are engineered to provide a very rapid effect. Lantus is designed for once-a-day use and will provide a 24-hour basal dose of insulin. Lantus has been approved for use in children with diabetes as young as six.
Unlike other long acting insulins (NPH and UltraLente, for example), Lantus is clear. It’s the first clear long-acting insulin; all the others are “cloudy” (i.e., suspensions). With a very low pH of 4 (acidic), Lantus also differs from other insulins which are generally neutral (pH of 7). When Lantus is injected, the acidic solution is neutralized by the body, causing insulin glargine crystals to precipitate out. From those crystals, the insulin is slowly absorbed over 24 hours. Since Lantus lasts for 24 hours, it can be taken once a day.
Lantus, because it has essentially no peak, reduces the risk of nightime hypoglycemia compared with NPH, according to a study published in Diabetes Care. Another study concluded that Lantus was a better basal insulin than NPH when used as part of a basal-bolus regimen for patients with Type 1 diabetes.
Because of the acid its pH, Lantus cannot be mixed with other insulins. In addition, some people report feeling a burning sensation at the injection site.
For More Information
- Lantus information from the Diabetes Monitor
- Prescribing information from Aventis
- Color slide showing Lantus activity level compared to NPH
- Color slide showing reduced risk of hypoglycemia compared to NPH
- PubMed citations:
♦Basal insulin glargine (HOE 901) versus NPH insulin in patients with type 1 diabetes on multiple daily insulin regimens
♦Less nocturnal hypoglycemia and better post-dinner glucose control with bedtime insulin glargine compared with bedtime NPH insulin during insulin combination therapy in type 2 diabetes
♦Pharmacokinetics of 125I-labeled insulin glargine (HOE 901) in healthy men: comparison with NPH insulin and the influence of different subcutaneous injection sites
♦Time-action profile of the long-acting insulin analog insulin glargine (HOE901) in comparison with those of NPH insulin and placebo
♦Less hypoglycemia with insulin glargine in intensive insulin therapy for type 1 diabetes. U.S. Study Group of Insulin Glargine in Type 1 Diabetes
♦Long-acting insulin analogs