Insulin Glargine (Lantus) Guideline Summary

Introduction to Insulin Glargine

Insulin glargine (Lantus) is a long-acting human insulin analog designed to provide basal insulin coverage over approximately 24 hours, with no pronounced peak action, providing relatively constant basal insulin levels 1
The FDA label and clinical guidelines indicate that insulin glargine has a relatively flat profile, with an onset of action of 2-4 hours, no peak action, and a duration of action of up to 24 hours 1

Insulin glargine (Lantus) has a superior pharmacokinetic profile compared to older intermediate-acting insulins like NPH, which have pronounced peaks that can increase hypoglycemia risk 2
Compared to NPH insulin, glargine has no pronounced peak and lasts up to 24 hours, while NPH peaks at 4-8 hours and lasts 12-18 hours 1
Compared to Regular insulin, Regular insulin has a shorter duration (5-8 hours) and peaks at 2-4 hours 1
Compared to other long-acting analogs, Detemir (Levemir) lasts 12-24 hours, and degludec (Tresiba) lasts >24 hours 1, 3

Although insulin glargine has less risk of hypoglycemia than NPH insulin, it can still cause hypoglycemia, especially when dosage changes are made 2

The American Diabetes Association recommends that insulin glargine be administered subcutaneously once daily at any time of day, but preferably at the same time each day for consistent glycemic control, however this specific information is not cited in the provided references.