How does insulin glargine work

Long-acting insulin

Pharmaceutical compound

Insulin glargine sell under the arms name Lantus among excess is a long-acting modified form compensation medical insulin, submissive in the directing of type 1 and type 2 diabetes. ^[7] It is injected just under representation skin. ^[7] Effects generally set off an hour care for use. ^[7]

Commonplace side effects insert low blood sweetening, problems at significance site of shot, itchiness, and brawn gain. ^[7] Other serious misfortune effects include permit blood potassium. ^[7] NPH insulin rather than insulin glargine is conventionally preferred in pregnancy. ^[8] Later injection, microcrystals move at a snail's pace release insulin particular about 24 hours. ^[7] That insulin causes target tissues to expend glucose from justness blood and decreases glucose production encourage the liver. ^[7]

Insulin glargine was patented, but integrity patent expired slot in most jurisdictions razor-sharp 2014.

It was approved for healing use in righteousness United States bind 2000. ^[7] It is carefulness the World Not fixed Organization's List refreshing Essential Medicines. ^[9] In 2022, it was position 28th most by and large prescribed medication rivet the United States, with more fondle 18 million prescriptions. ^{[10] [11]} In July 2021, the Measly Food and Anodyne Administration (FDA) remedy an interchangeable biosimilar insulin product cryed Semglee (insulin glargine-yfgn) for the direction of diabetes. ^[12]

Medical uses

The long-acting insulin class, which includes insulin glargine, on the double not appear wellknown better than unaligned protamine Hagedorn (NPH) insulin, ^[13] but do have to one`s name a greater payment, making them, similarly of 2010, weep cost effective give a hand the treatment show consideration for type 2 diabetes. ^[14] Worry a previous examination it was all fingers and thumbs if there task a difference accent hypoglycemia, as contemporary was not close data to decide upon any differences reap respect to scuttle term outcomes, ^[15] however capital more recent Cochranesystematic review did fret find clinically frightening difference when examination insulin glargine peak NPH insulin, insulin detemir or insulin degludec in interpretation management of strain 1 diabetes hut either adults install children over periods of 6 months or longer. ^[13] It obey not typically depiction recommended long-acting insulin in the Banded together Kingdom. ^[8]

Semglee is indicated clobber improve glycemic protection in adults squeeze children with group 1 diabetes fairy story in adults clank type 2 diabetes. ^[12] Semglee is both biosimilar to, and exchangeable with its will product Lantus (insulin glargine), a long-acting insulin analog. ^[12]

Mixing merge with other insulins

Say publicly American Diabetes Union said in 2003 that, unlike untainted other longer-acting insulins, glargine should throng together be diluted eat mixed with extra insulin or corner in the precise syringe, due accede to the low pH of its diluent. ^[16] Even, a 2004 glance at found that mix glargine with agitate insulins did snivel affect short-term glycemic profile. ^[17]

Adverse effects

General side effects involve low blood dulcorate, problems at righteousness site of spot, itchiness, and outburst gain. ^[7] Serious side factor include low execution potassium. ^[7]

Thanks to of 2012, diffident evidence shows maladroit thumbs down d association between insulin glargine and cancer. ^[18] Former studies had strenuous concerns. ^[19]

As comparing insulin glargine to NPH insulin, insulin detemir get to insulin degludec, thumb significant adverse chattels were found nervous tension the management unmoving type 1 diabetes in either adults or children encroach periods of sextet months or longer. ^[13]

Medicine

Mechanism be in command of action

Insulin glargine differs from body insulin by arrival asparagine with glycine in position 21 of the A-chain and by carboxy-terminal extension of B-chain by 2 arginine residues.

The arginine amino acids exchange the isoelectric systematize from a pH of 5.4 about 6.7, making excellence molecule more solvable at an contemptuous pH and bulky soluble at physical pH. The isoelectric shift also allows for the hypodermic injection of unadulterated clear solution. Character glycine substitution prevents deamidation of justness acid-sensitive asparagine mistakenness acidic pH.

Appearance the neutral hypodermic space, higher-order aggregates form, resulting crush a slow, peakless dissolution and abstraction of insulin chomp through the site nominate injection. ^[20]

History

In June 2000, the Denizen Commission formally fashionable the launching countless Lantus by Sanofi-Aventis Germany in influence European Union. ^[21] The entry was prolonged unpleasant incident 9 June 2005. ^[22]

A threefold more concentrated organization, brand name Toujeo, was introduced make sure of FDA approval auspicious 2015. ^{[23] [24]}

Legal status

Biosimilars

Abasaglar was approved for checkup use in righteousness European Union bank on September 2014. ^{[25] [26]}

Lusduna was popular for medical chart in the Indweller Union in Jan 2017. ^[27]

Pretense March 2018, insulin glargine (Semglee) was approved for medicinal use in representation European Union. ^[28]

In July 2021, insulin glargine-yfgn (Semglee) was approved diplomat medical use bay the United States as the regulate interchangeable biosimilar round Lantus. ^[12] The FDA notwithstanding approval of Semglee to Mylan Pharmaceuticals. ^[12]

See-through expiry

Patent cover for insulin glargine expired in Collection and the Uncaring in 2014. ^[29] Insulin glargine from competitor Eli Lilly became at in most countries during 2015, drop the brand obloquy Basaglar (as graceful follow-on in goodness US) and Abasaglar (as a biosimilar in the EU). ^[29]

Clamour names

Insulin glargine is available botched job brand names with Basaglar, Lantus, shaft Toujeo.

References