Description

Simple

A medication used to control blood sugars in diabetes.

Clinical

A modified form of long-acting or basal insulin used to control hyperglycemia in diabetes mellitus.

Overview

Insulin glargine is a long-acting form of insulin used for the treatment of hyperglycemia caused by Type 1 and Type 2 Diabetes. Insulin is typically prescribed for the management of diabetes mellitus to mimic the activity of endogenously produced human insulin, a peptide hormone produced by beta cells of the pancreas that promotes glucose metabolism. Insulin is released from the pancreas following a meal to promote the uptake of glucose from the blood into internal organs and tissues such as the liver, fat cells, and skeletal muscle. Absorption of glucose into cells allows for its transformation into glycogen or fat for storage. Insulin also inhibits hepatic glucose production, enhances protein synthesis, and inhibits lipolysis and proteolysis.

Insulin is an important treatment in the management of Type 1 Diabetes (T1D), which is caused by an autoimmune reaction that destroys the beta cells of the pancreas, resulting in the body not being able to produce or synthesize the insulin needed to manage circulating blood sugar levels. As a result, people with T1D rely primarily on exogenous forms of insulin, such as insulin glargine, to lower glucose levels in the blood. Insulin is also used in the treatment of Type 2 Diabetes (T2D), another form of diabetes mellitus that is a slowly progressing metabolic disorder caused by a combination of genetic and lifestyle factors that promote chronically elevated blood sugar levels. Without treatment or improvement in non-pharmacological m... Read more

Pharmacology

Indication

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

Pharmacodynamic

Insulin is a natural hormone produced by beta cells of the pancreas. In non-diabetic individuals, the pancreas produces a continuous supply of low levels of basal insulin along with spikes of insulin following meals. Increased insulin secretion following meals is responsible for the metabolic change... Read more

Mechanism of action

Insulin glargine binds to the insulin receptor (IR), a heterotetrameric protein consisting of two extracellular alpha units and two transmembrane beta units. The binding of insulin to the alpha subunit of IR stimulates the tyrosine kinase activity intrinsic to the beta subunit of the receptor. The b... Read more

Absorption

Because of the modifications to the A and B chain, the isoelectric point shifts towards a neutral pH and insulin glargine is more stable in acidic conditions than regular insulin. As insulin glargine is less soluble at neutral pH, once injected, forms microprecipitates. Slow release of insulin glarg... Read more

Protein binding

Information currently not available.

Volume of distribution

Information currently not available.

Clearance

Information currently not available.

Half life

Information currently not available.

Route of elimination

Information currently not available.

Toxicity

Inappropriately high dosages relative to food intake and/or energy expenditure may result in severe and sometimes prolonged and life-threatening hypoglycemia. Neurogenic (autonomic) signs and symptoms of hypoglycemia include trembling, palpitations, sweating, anxiety, hunger, nausea and tingling. Ne... Read more

Adverse Effects

Effect Regions Age Groups Incidences Evidence Type
Upper Respiratory Tract Infection US
  • adult
  • Kind: experimental
    • Percent: 29
  • Kind: comparator
    • Percent: 33.6
  • Clinical Trial
    Severe symptomatic hypoglycemia US
    • pediatric
  • Kind: experimental
    • Percent: 23.0
  • Kind: comparator
    • Percent: 28.6
  • Clinical Trial
    Upper Respiratory Tract Infection US
    • adult
  • Kind: experimental
    • Percent: 22.4
  • Kind: comparator
    • Percent: 23.1
  • Clinical Trial
    Edema peripheral US
    • adult
  • Kind: experimental
    • Percent: 20
  • Kind: comparator
    • Percent: 22.7
  • Clinical Trial
    Hypertension US
    • adult
  • Kind: experimental
    • Percent: 19.6
  • Kind: comparator
    • Percent: 18.9
  • Clinical Trial
    Influenza US
    • adult
  • Kind: experimental
    • Percent: 18.7
  • Kind: comparator
    • Percent: 19.5
  • Clinical Trial
    Sinusitis US
    • adult
  • Kind: experimental
    • Percent: 18.5
  • Kind: comparator
    • Percent: 17.9
  • Clinical Trial
    Cataract US
    • adult
  • Kind: experimental
    • Percent: 18.1
  • Kind: comparator
    • Percent: 15.9
  • Clinical Trial
    Infection US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 13.8
  • Kind: comparator
    • Percent: 17.7
  • Clinical Trial
    Arthralgia US
    • adult
  • Kind: experimental
    • Percent: 14.2
  • Kind: comparator
    • Percent: 16.1
  • Clinical Trial
    Upper Respiratory Tract Infection US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 13.8
  • Kind: comparator
    • Percent: 16
  • Clinical Trial
    Bronchitis US
    • adult
  • Kind: experimental
    • Percent: 15.2
  • Kind: comparator
    • Percent: 14.1
  • Clinical Trial
    Severe symptomatic hypoglycemia US
    • adult
  • Kind: experimental
    • Percent: 10.6
  • Kind: comparator
    • Percent: 15.0
  • Clinical Trial
    Upper Respiratory Tract Infection US
    • adult
  • Kind: experimental
    • Percent: 11.4
  • Kind: comparator
    • Percent: 13.3
  • Clinical Trial
    Pain in extremity US
    • adult
  • Kind: experimental
    • Percent: 13
  • Kind: comparator
    • Percent: 13.1
  • Clinical Trial
    Back Pain US
    • adult
  • Kind: experimental
    • Percent: 12.8
  • Kind: comparator
    • Percent: 12.3
  • Clinical Trial
    Cough US
    • adult
  • Kind: experimental
    • Percent: 12.1
  • Kind: comparator
    • Percent: 7.4
  • Clinical Trial
    Severe symptomatic hypoglycemia US
    • adult
  • Kind: experimental
    • Percent: 7.8
  • Kind: comparator
    • Percent: 11.9
  • Clinical Trial
    Infection US
    • adult
  • Kind: experimental
    • Percent: 10.4
  • Kind: comparator
    • Percent: 11.6
  • Clinical Trial
    Diarrhea US
    • adult
  • Kind: experimental
    • Percent: 10.7
  • Kind: comparator
    • Percent: 10.3
  • Clinical Trial
    Urinary Tract Infection US
    • adult
  • Kind: experimental
    • Percent: 10.7
  • Kind: comparator
    • Percent: 10.1
  • Clinical Trial
    Depression US
    • adult
  • Kind: experimental
    • Percent: 10.5
  • Kind: comparator
    • Percent: 9.7
  • Clinical Trial
    Severe symptomatic hypoglycemia US
    • adult
  • Kind: experimental
    • Percent: 8.7
  • Kind: comparator
    • Percent: 10.4
  • Clinical Trial
    Headache US
    • adult
  • Kind: experimental
    • Percent: 10.3
  • Kind: comparator
    • Percent: 9.3
  • Clinical Trial
    Infection US
    • adult
  • Kind: experimental
    • Percent: 9.4
  • Kind: comparator
    • Percent: 10.3
  • Clinical Trial
    Pharyngitis US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 7.5
  • Kind: comparator
    • Percent: 8.6
  • Clinical Trial
    Retinal vascular disorder US
    • adult
  • Kind: experimental
    • Percent: 5.8
  • Kind: comparator
    • Percent: 7.4
  • Clinical Trial
    Severe symptomatic hypoglycemia US
    • adult
  • Kind: experimental
    • Percent: 6.5
  • Kind: comparator
    • Percent: 5.2
  • Clinical Trial
    Accidental injury US
    • adult
  • Kind: experimental
    • Percent: 5.7
  • Kind: comparator
    • Percent: 6.4
  • Clinical Trial
    Severe symptomatic hypoglycemia US
  • Kind: experimental
    • Percent: 5.6
  • Kind: comparator
    • Percent: 1.8
  • Clinical Trial
    Headache US
    • adult
  • Kind: experimental
    • Percent: 5.5
  • Kind: comparator
    • Percent: 4.7
  • Clinical Trial
    Rhinitis US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 5.2
  • Kind: comparator
    • Percent: 5.1
  • Clinical Trial
    Injection site pain US
    • adult
  • Kind: experimental
    • Percent: 2.7
  • Kind: comparator
    • Percent: 0.7
  • Severe symptomatic hypoglycemia US
    • adult
  • Kind: experimental
    • Percent: 0.4
  • Kind: comparator
    • Percent: 2.3
  • Clinical Trial
    Severe symptomatic hypoglycemia US
    • adult
  • Kind: experimental
    • Percent: 1.7
  • Kind: comparator
    • Percent: 1.1
  • Clinical Trial
    Localized cutaneous amyloidosis US
    Clinical Trial
    Injection Site Reactions US
    Clinical Trial
    Acute painful peripheral neuropathy US
    Clinical Trial
    Worsening of diabetic retinopathy US
    Clinical Trial
    Transitory, reversible ophthalmologic refraction disorder US
    Clinical Trial
    Lipohypertrophy US
    Clinical Trial
    Lipoatrophy US
    Clinical Trial
    Weight Gain US
    Clinical Trial
    Lipodystrophy US
    Clinical Trial
    Peripheral Edema US
    Clinical Trial

    Contraindications

    • Regions: US
    • Patient Conditions:
        • Name: Episodes of hypoglycemia
        • Drugbank Id: DBCOND0107424

    Food Interactions

    Information currently not available.