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Lantus (Insulin Glargine) - Summary

 
 



LANTUS SUMMARY

LANTUS (insulin glargine [rDNA origin] injection) is a sterile solution of insulin glargine for use as a subcutaneous injection. Insulin glargine is a recombinant human insulin analog that is a long-acting (up to 24-hour duration of action), parenteral blood-glucose-lowering agent [ ]. LANTUS is produced by recombinant DNA technology utilizing a non-pathogenic laboratory strain of (K12) as the production organism. Insulin glargine differs from human insulin in that the amino acid asparagine at position A21 is replaced by glycine and two arginines are added to the C-terminus of the B-chain.

LANTUS is indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus.

Important Limitations of Use:

  • LANTUS is not recommended for the treatment of diabetic ketoacidosis. Intravenous short-acting insulin is the preferred treatment for this condition.

See all Lantus indications & dosage >>

NEWS HIGHLIGHTS

Media Articles Related to Lantus (Insulin Glargine)

Canadian study demonstrates new approach to achieving diabetes control
Source: The Doctors Lounge - Endocrinology and Diabetes
The INSIGHT study demonstrates early addition of insulin glargine therapy safely achieved better glycemic than adding oral agents.

more news >>

Published Studies Related to Lantus (Insulin Glargine)

Influence of insulin and glargine on outgrowth and number of circulating endothelial progenitor cells in type 2 diabetes patients: a partially double-blind, randomized, three-arm unicenter study. [2014]
aiming at similar glucose control between the groups... CONCLUSION: The study shows that a 4-month treatment with add-on insulin

Slow-release insulin in cystic fibrosis patients with glucose intolerance: a randomized clinical trial. [2011.11.08]
Minicucci L, Haupt M, Casciaro R, De Alessandri A, Bagnasco F, Lucidi V, Notarnicola S, Lorini R, Bertasi S, Raia V, Cialdella P, Haupt R. Slow-release insulin in cystic fibrosis patients with glucose intolerance: a randomized clinical trial... Further studies are necessary to test glargine at higher dosage and for a longer follow-up period.

Effects of initiation and titration of a single pre-prandial dose of insulin glulisine while continuing titrated insulin glargine in type 2 diabetes: a 6-month 'proof-of-concept' study. [2011.11]
AIM: Stepwise intensification of insulin treatment to match the progressive decline of endogenous insulin secretion has been shown to be an effective management strategy in type 2 diabetes mellitus (T2DM). The efficacy of initiating and titrating a single bolus dose of insulin glulisine to baseline insulin glargine plus oral hypoglycaemic agents (OHAs) was investigated... CONCLUSIONS: In people with T2DM inadequately controlled on basal insulin plus OHAs, adding a single injection of insulin glulisine prior to the main meal significantly improves glucose control without undesired side effects. (c) 2011 Blackwell Publishing Ltd.

Insulin injections in relation to meals in the hospital medicine ward: comparison of 2 protocols. [2011.09.01]
OBJECTIVE: To investigate whether changing the prandial regular insulin to rapid-acting insulin analogue in hospital medicine wards improves the timing of insulin delivery in relation to meals and improves patient safety and glucose control... CONCLUSIONS: The use of prandial insulin analogues in medicine wards allows better timing with meals than regular insulin and results in better hypoglycemic outcomes. Higher rates of hyperglycemia with prandial analogues may need adjustment in insulin doses.

Meal-induced increases in C-reactive protein, interleukin-6 and tumour necrosis factor alpha are attenuated by prandial + basal insulin in patients with Type 2 diabetes. [2011.09]
AIM: To determine if a regimen with prandial + basal insulin compared with basal insulin attenuates post-meal inflammatory and glycative biomarkers in patients with Type 2 diabetes... CONCLUSIONS: Controlling post-meal hyperglycaemia with prandial + basal insulin in patients with Type 2 diabetes attenuates meal-induced increases in high-sensitivity C-reactive protein, interleukin-6 and tumour necrosis factor alpha compared with basal insulin. The rise in post-meal glucose, but not triglycerides, significantly correlated with the rise in post-meal inflammatory and glycative biomarkers. (c) 2011 The Authors. Diabetic Medicine (c) 2011 Diabetes UK.

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Clinical Trials Related to Lantus (Insulin Glargine)

Conversion of Hyperglycemic Patients Being Treated With Intravenous Insulin Infusions to Lantus Insulin [Completed]
The primary objective of this study is to determine the optimal dose of glargine insulin when converting from intravenous short-acting continuous insulin infusions in surgical and intensive care unit patients using a prospective, controlled, parallel group, randomized study design. Note: Lantus insulin is the proprietary name for glargine insulin.

Insulin Glargine "All to Target" Trial [Completed]
The primary objectives were:

- To demonstrate the superiority of Lantus plus stepwise addition of mealtime Apidra®

(Lantus/Apidra-3) versus twice-daily Premixed insulin based on the proportion of patients achieving target glycemic control (as measured by hemoglobin A1c [HbA1c] <7. 0%) at Week 60

- To demonstrate the noninferiority of Lantus plus addition of 1 mealtime Apidra

injection (Lantus/Apidra-1) versus twice-daily Premixed insulin based on the reduction from Baseline to Week 60 in HbA1c

Glycemic Effects of Morning Only, Evening Only or Twice Daily Insulin Glargine in Patients With Type 1 Diabetes [Not yet recruiting]
This research is a prospective, randomized, cross-over study that is being done to compare the effect of morning only, evening only and twice daily insulin glargine (Lantus®) on hypoglycemia (blood glucose level <70 mg/dL) as measured by continuous glucose monitoring (CGM) in patients with type 1 diabetes.

The Effect of Exenatide Compared to Lantus Insulin on Vascular Function in Type 2 Diabetes [Completed]
The main goals of the study are to evaluate the effect of Exenatide on endothelial-dependent vasodilation, as measured by flow mediated dilation (FMD), to evaluate the effect on endothelial-independent vasodilation, as measured by nitroglycerin (TNG) response, and to evaluate the effect on arterial stiffness, as measured by pulse wave analysis (PWA). We will also measure the effects on various markers of endothelial function, subclinical inflammation, fibrinolysis, and oxidative stress. The control group for the study will receive Lantus insulin, with a goal of similar glycemic control between the treatment and control groups. Specific Aims We will test the following hypotheses: 1. Treatment of patients with type 2 diabetes who are inadequately controlled by monotherapy with a Sulfonylurea (SU) or Metformin, or on combination therapy of a SU and Metformin with Exenatide (GLP-1 mimetic) will result in improved endothelial dependent vasodilation, as measured by FMD, as compared to the control group, who will be treated with Lantus insulin to achieve comparable HbA1c levels. 2. Treatment with Exenatide (GLP-1 mimetic) will result in improved arterial stiffness, as measured by AI by PWA, as compared to the control group, who will be treated with Lantus insulin to achieve comparable HbA1c levels. 3. Endothelial dependent vasodilation, as measured by FMD, and arterial stiffness, as measured by AI, measured in the postprandial state (following a standard test meal) will be improved following treatment with Exenatide as compared to treatment with once daily basal insulin (Lantus). 4. Treatment will result in no improvement in endothelial-independent vasodilation, as measured by a response to TNG, as compared to the control group, who will be treated with Lantus insulin to achieve comparable HbA1c levels. 5. Treatment with Exenatide, compared with treatment with Lantus, will result in a reduction in various plasma markers of inflammation (CRP, TNFA, IL6), endothelial activation (ICAM, VCAM, endothelin 1), fibrinolysis (PAI-1 protein, PAI-1 activity), and oxidative stress (FOX2).

Insulin Glargine in Type I Diabetes Mellitus> Main Study "AT.LANTUS": A Trial Comparing Lantus Algorithms to Achieve Normal Blood Glucose Targets in Subjects With Uncontrolled Blood Sugar. Sub-study: "HALT"(Hypoglycaemia Avoidance With Lantus Trial) [Completed]
Primary objective: AT. LANTUS main study*

- To determine the optimal treatment algorithm for insulin glargine based on the

incidence of severe hypoglycaemia.(*Target Number of patients for the main study: 2346) HALT Sub-study**

- To test the hypothesis that titration regimens involving insulin glargine are

associated with changes in the rate of symptomatic hypoglycaemic episodes together with changes in Fear of Hypoglycaemia as measured by the HFS-98 Questionnaire in Type I diabetes.(**Target Number of patients for the Sub-study: 250) Secondary objectives: AT. LANTUS main study To determine:

- the incidence of symptomatic, asymptomatic and nocturnal hypoglycaemia with each

treatment regimen

- the difference in glycemic control as measured by HbA1c and fasting blood glucose with

each treatment regimen

- the difference in glycemic control as measured by HbA1c and fasting blood glucose

between baseline and end of treatment

- the safety on the use of insulin glargine in each treatment algorithm

- the change in subject weight with each treatment regimen

- the change in insulin doses with each treatment regimen

- the change in Diabetes Treatment Satisfaction (Diabetes Treatment Satisfaction

Questionnaire, sub-study only) with each treatment regimen HALT Sub-study (baseline to study end)

- To estimate the relationship between change in HbA1c and incidence of hypoglycaemia

- To examine the effect of insulin glargine on Quality of Life (EQ-5D) in relation to

incidence of hypoglycaemia

- To examine the effect of insulin glargine on the Hospital Anxiety and Depression Scale

(HADS) in relation to the incidence of hypoglycaemia

- To examine the use of the Prescription Plan versus standard management (no Prescription

Plan)

more trials >>

Reports of Suspected Lantus (Insulin Glargine) Side Effects

Device Malfunction (462)Blood Glucose Increased (396)Product Quality Issue (272)Hyperglycaemia (254)Hypoglycaemia (240)Cerebrovascular Accident (109)Death (103)Blood Glucose Decreased (101)Fall (90)Renal Failure (90)more >>


PATIENT REVIEWS / RATINGS / COMMENTS

Based on a total of 1 ratings/reviews, Lantus has an overall score of 9. The effectiveness score is 10 and the side effect score is 8. The scores are on ten point scale: 10 - best, 1 - worst.
 

Lantus review by 27 year old male patient

  Rating
Overall rating:  
Effectiveness:   Highly Effective
Side effects:   Mild Side Effects
  
Treatment Info
Condition / reason:   Insulin Dependent Diabetes Mellitus
Dosage & duration:   45 units per day (dosage frequency: twice a day) for the period of four years, still on going
Other conditions:   None
Other drugs taken:   Insulin Lispro
  
Reported Results
Benefits:   I experienced markedly improved fasting blood glucose levels, and greater stability of blood sugar before and after meals. I had found with other treatment options, such as the insulin pump and the nph insulins that my morning blood sugars were always high, even with increased dosages.
Side effects:   The only side effects were increased weight gain and increased hypoglycemia in the late evenings/early mornings. The side effect is because Lantus has a 22 hour duration after injection and as a result whenever I experience a greater than usual amount of activity, my insulin sensitivity increases dramatically.
Comments:   Treatment consisted of a morning and evening dose of lantus split up as 30 units in the evening and 15 units in the morning. It took approximately two years of playing with the dosage amounts to find this as the "best fit" as all dosages either resulted in extremely low evening blood sugars or extremely high morning blood sugars. Also, changes in activity result in severe blood sugar swings as well.

See all Lantus reviews / ratings >>

Page last updated: 2015-08-10

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