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Lantus

Lantus is a long-acting basal insulin analogue, usually given once or twice daily to help control the blood sugar level of those with diabetes. Its theoretical advantage is that it has a 24 hour duration of action, with a "peakless" profile. Thus, it more closely resembles the basal insulin secretion of the normal pancreatic beta cells. In type 2 diabetes and in combination with a short acting sulphonylurea (drugs which stimulate the pancreas to make more insulin), it can offer moderate control of serum glucose levels. more...

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In the absence of endogenous insulin (Type 1 diabetes or depleted type 2), Lantus needs the support of a fast acting insulin taken with food to reduce the effect of prandially derived glucose. It is post-prandial glucose elevation which more significantly affects HbA1c and thus determines the progression of the long-term complications of diabetes mellitus.

The peakless profile of Lantus also enables the dose to be relatively higher than standard NPH insulin. Because standard NPH is normally administered at night, its peak of action tends to coincide with the lower serum glucose levels associated with nocturnal metabolism. This can induce nocturnal hypoglycaemia. Lantus offers the benefit of a more consistent pharmacological dynamic without nocturnal hypoglycaemia. The result of this is a patient who feels more confident and more comfortable with a lower pre-bed and pre-breakfast capillary glucose level.


Lantus is formulated at pH4, whereby it is completely soluble. Upon injection, it is neutralized leading to the release small precipitates. This ensures that small amount of Lantus is released into the body continuously, giving a peakless profile

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Lantus
From OB/GYN News, 6/15/00 by Elizabeth Mechcatie

(insulin glargine injection, Aventis) A long-acting human insulin analogue for adults and children with type 1 diabetes and adults with type 2 diabetes. This is the first long-acting human basal insulin analogue that is steadily absorbed over 24 hours and has no peak.

* Recommended Dosage: Individually determined dose administered subcutaneously once daily at bedtime.

* Special Considerations: As with all insulins, hypoglycemia is the most common adverse effect, but the risk is lower than with NPH insulin. Should never be diluted or mixed with other insulins.

* Comment: Once injected, Lantus is slowly released from the subcutaneous tissue over 24 hours in a reproducible and predictable absorption pattern, with no peaks and a flat glycemic curve, said Dr. Robert Ratner, medical director of Med-Star Clinical Research Center, Washington. This reproducibility is "the major advantage" of Lantus over human ultralente, the absorption pattern of which, "clearly has a peak, and causes erratic hypoglycemia," he explained.

Lantus can be used in patients who are candidates for an overnight dose of NPH or ultralente, in combination with regular insulin or the more rapidly acting Humalog (lispro insulin) before meals in type 1 diabetics, and with short-acting insulin or oral agents in type 2 diabetics, he advised. Dr. Ratner, the principal investigator in studies of Lantus in type 1 diabetics, has received research funds from Aventis, Lantus won't be available until later this year.

COPYRIGHT 2000 International Medical News Group
COPYRIGHT 2001 Gale Group

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