BASAGLAR (Insulin Glargine)

What is this medication?

Insulin glargine, Lantus/Basaglar/Toujeo
Long Acting Insulin

Insulin glargine/Lantus/Basaglar/Toujeo is indicated for diabetes mellitus types 1 and 2.

How does this medication work? 

Insulin glargine/Lantus/Basaglar/Toujeo works on liver, muscle and adipose (fat) tissue to regulate the metabolism of carbohydrates, protein, and fats.  In the liver and muscles, it increases glycogen synthesis which is the immediate storage form of glucose.  It increases fat production by increasing fatty acid release from the liver in the form of lipoproteins which adipose tissue converts to fatty acids then to triglycerides for storage whilst also stopping the metabolism of triglycerides (fat).  Insulin also increases the cellular uptake of amino acids and some electrolytes such as potassium into the cell.  In muscle tissue protein synthesis is increased.

Normally insulin is produced by the pancreas however insulin products for pharmaceutical use have been produced via recombinant DNA technology using certain bacteria (they splice the gene for insulin production into bacterial DNA so the cell produces insulin – a gene is a portion of DNA or RNA that produces one specific protein).  Insulin glargine is different from human insulin as it has some modifications to make it last longer.  It involves the addition of two arginine molecules and the substitution of an asparagine for a glycine (these are all names of amino acids which are the building blocks of proteins such as insulin).

How should I take this medication?

Insulin glargine is long acting or basal insulin.  It is given by subcutaneously in one, or sometimes two, daily injections.  In type 2 diabetes someone usually starts around 10 units per day or 0.1-0.2mg/kg/day and the dosage is slowly increased until glucose control is achieved.  In type 1 diabetes 40-50% of total daily insulin is given as intermediate or long acting with the rest divided into fast acting mealtime insulin.  If converting from another insulin the number of units given may need to be lowered as a precaution

How to Take: Follow instructions provided by physician/pharmacy label, use consistently at same times each day unless otherwise directed, refrigerate product not in use (36-46 Fahrenheit, 2-8 Celsius), the vial in use may be kept at room temperature (below 86 Fahrenheit, 30 Celsius) for up to 28 days (discard if not used by this point).  Injection generally into abdomen, thighs, buttocks, or arms with absorption rates varying from site to site.  Be consistent with the part of body you inject into but rotate injection site to avoid redistribution of fat and excessive irritation to the area.  For example, if you choose abdomen which is the most common, inject in circular order at least 2 inches from navel.

You Need to Avoid: Do not use if solution seems viscous (thick) or appears cloudy, only use if clear, colorless and with no visible particles.  Avoid injecting cold insulin as it may be painful.  

What should I watch for while using this medication? 

Before starting Insulin glargine/Lantus/Basaglar/Toujeo make sure your physician is aware of any allergies or medications you currently take, if you have had bariatric surgery, cardiovascular disease, have kidney disease, liver disease, diabetic ketoacidosis, are pregnant or breastfeeding.

What if I miss a dose?

If you forget to inject your dose, you should do so as soon as you remember. If it’s almost time for your next dose, skip your missed dose and inject your next dose at your usual time. If you missed your dose and aren’t sure what to do, talk with your doctor or pharmacist. But don’t use more than one dose per day, unless your doctor recommends it.

If you have missed a dose or if you have not injected enough insulin, your blood sugar level may become too high (hyperglycemia). Check your blood sugar frequently.

How should I store this medication?

Refrigerate and use until expiration date, or store at room temperature and use within 28 days.

Keep this medicine in its original container protected from heat and light. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen.

What are the possible side effects of using this medication?

Increased blood pressure, peripheral edema (fluid retention), diarrhea, hypoglycemia, urinary tract infection, antibody development, infection, cataracts, muscle pain, joint pain, depression

Note- this is not a complete list of side effects, only common ones, are dose dependent and vary based on other medical conditions or state of health.