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Long Acting Insulins for Diabetes

Using Basal Dosing Helps Cut Down on the Number of Daily Injections

Aug 30, 2009 Melissa Murfin

Various types of long acting insulins are used for diabetes patients. Learn more about the similarities and differences in these insulins.

Long acting insulins have helped to change therapy for patients with diabetes. They are designed to act as a basal insulin, providing a low level of insulin all day just like the pancreas does. Many patients are able to control their blood sugar with only one or two injections daily instead of three to four injections that are required with shorter acting insulins.

There are two types of long-acting insulin, glargine (Lantus) and detemir (Levemir).

Glargine (Lantus)

Insulin glargine (Lantus) is a synthetic insulin made by Sanofi Aventis. Both adults and children as young as 6 years old may use Lantus. It is approved for type 1 and type 2 diabetes. For most people, it lasts 24 hours in the body and only one daily injection is needed. Some patients do require two injections daily. Lantus starts to work in the body about one hour after the injection is given.

Lantus has the same side effects as other insulins. Hypoglycemia or low blood sugar can occur with any insulin. Patients should watch for:

dizziness
confusion
fatigue
shakiness
sweating
hunger
headache
moodiness

Many patients also notice weight gain and fluid retention when they start taking insulin, no matter what type they use. This is somewhat dependent on the dose of insulin. The higher the dose, the more likely people will gain weight.

One difference with Lantus is that some patients report slight burning during the injection. Lantus is slightly acidic which causes this sensation.

Pregnant women and nursing mothers should not use Lantus. There are currently no studies in humans using long-acting insulins during pregnancy or nursing. They may be safe, but right now the jury is still out.

Lantus cannot be mixed in the same syringe with other insulins. Patients should always check the vial before preparing an injection. If Lantus is not clear and colorless, it should be discarded. Lantus can be refrigerated or stored at room temperature. Once the vial is opened, it should be thrown away after 28 days.

A handy pen device is also available. This is great for kids or people with vision problems or arthritis that makes it difficult to prepare an insulin injection from a vial. Pen cartridges should be stored in the refrigerator.

Lantus costs slightly more than $100 for each vial which contains 1000 units. The pen cartridges cost just under $200 for 5 cartridges which are 300 units each.

Detemir (Levemir)

Insulin detemir (Levemir) is very similar to Lantus. It is made by Novo Nordisk and can be used for both adults and children with type 1 or type 2 diabetes. Most people take one dose daily at dinner or bedtime. Some people require two doses daily. It starts working one to two hours after the injection.

Side effects are also similar. Levemir is not acidic and less likely to burn during the injection. It also should not be used in pregnant or nursing women. Studies show patients on Levemir have slightly less weight gain than patients on Lantus, but this only amounts to approximately three less pounds per year.

Levemir costs about the same as Lantus. It is also available in a pen device called the FlexPen. Recently, vials of Levemir were stolen and have been resurfacing and causing problems in some patients. Check here to be sure you didn't inadvertently receive on of the stolen vials.

The copyright of the article Long Acting Insulins for Diabetes in General Medicine is owned by Melissa Murfin. Permission to republish Long Acting Insulins for Diabetes in print or online must be granted by the author in writing.

Levemir Flex Pen