Managing Glucose Levels with Basal and Prandial Insulin and GLP-1 Receptor Agonist

Understanding the Components

Lantus is a long-acting basal insulin with no peak action time and duration of up to 24 hours, providing stable background insulin levels 1
Typically administered once daily at the same time each day to maintain consistent fasting glucose levels 2, 1
Dosage should be adjusted based on fasting blood glucose readings, targeting normal range 1
Ozempic is a GLP-1 receptor agonist administered once weekly 3
No dosage adjustments required for kidney function 3
Helps improve glycemic control, promotes weight loss, and can reduce insulin requirements 3, 4

Administer Lantus once daily, preferably at the same time each day 2, 1
Initial dosing typically 0.1-0.2 units/kg/day, with titration based on fasting glucose levels 1
Self-titration algorithm: increase by 2-4 units every 3-4 days until fasting glucose target is reached 1
Administer Ozempic subcutaneously once weekly at any time of day, with or without meals 3
Initial dose of 0.25 mg weekly for 4 weeks, then increase to 0.5 mg weekly 3
May further increase to 1 mg weekly after 4 weeks if additional glycemic control is needed 3

Check fasting glucose daily to guide Lantus adjustments 1
Target fasting glucose <130 mg/dL and postprandial glucose <180 mg/dL 2
Check HbA1c every 3 months to assess overall glycemic control 2
Target HbA1c <7.5% for most patients, individualizing based on hypoglycemia risk 2

If fasting glucose remains elevated despite adequate Lantus dosing, consider increasing the evening Humalog 75/25 dose 5
If hypoglycemia occurs, identify the timing and reduce the corresponding insulin dose 6
Treat mild-moderate hypoglycemia with 15-20g of fast-acting carbohydrates 6
Recheck blood glucose after 15 minutes and repeat treatment if necessary 6
Wear medical alert identification indicating diabetes treatment 6
During periods of stress or illness, more frequent monitoring is recommended 6
May need temporary insulin dose increases during illness or stress 6

Administer Lantus at the same time daily for consistent basal coverage 1
Failure to check both fasting and postprandial glucose can lead to suboptimal control 2
Physical activity may require insulin dose reduction to prevent hypoglycemia 6