Insulin Glargine

💊 What is Insulin Glargine used for?

• •The label says insulin glargine is used to improve blood sugar (glycemic) control in adult and pediatric patients with diabetes mellitus. The label says it is not recommended for treating diabetic ketoacidosis.

How it works

The label describes insulin glargine as a long-acting human insulin analog. It is made using recombinant DNA technology and is meant to lower blood sugar over a long period after each injection.

How it is usually taken

• •The label says it is injected under the skin (subcutaneously) of the thighs, upper arms, or abdomen (stomach area). It is given once a day at any time of day, but at the same time every day. Injection sites should be rotated, meaning a different spot is used each time, and injections should avoid areas that are pitted, thickened, lumpy, tender, bruised, scarred, or damaged. The label says not to mix it with any other insulin or liquid, not to use it in an insulin pump, and not to inject it into a vein. Check the insulin label before every injection, use a new needle each time, and use only solution that is clear and colorless. Needles are not included in the packs. Follow the instructions from your prescriber or pharmacist for how much to use and when.

Comes as

• •Injection, 100 units/mL (U-100), available as a 10 mL multiple-dose vial and a 3 mL single-patient-use prefilled pen.

⚠️ Insulin Glargine side effects

🛑 Who should not take Insulin Glargine, and who should be careful

The label says not to take it if

• 🚨You are having an episode of low blood sugar (hypoglycemia). The label says this medicine is contraindicated during these episodes.
• 🚨You are allergic to insulin glargine products or any of the ingredients in this medicine.

Tell your doctor before taking it if

• •Tell your healthcare provider about all your medical conditions, including liver or kidney problems, heart failure or other heart problems.
• •Tell your provider if you take thiazolidinediones (TZDs), since the label says heart failure may get worse with TZDs.
• •Tell your provider if you are pregnant, plan to become pregnant, or are breastfeeding.
• •Tell your provider about all medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
• •Talk with your provider about low blood sugar and how to manage it before you start.
• •Never share a prefilled pen, insulin syringe, or needle with another person, even if the needle is changed. The label says sharing can spread blood-borne infections.

🔀 Insulin Glargine with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Medicines that may increase the risk of low blood sugar include other antidiabetic agents, ACE inhibitors, angiotensin II receptor blockers, fibrates, fluoxetine, MAO inhibitors, salicylates, sulfonamide antibiotics, GLP-1 receptor agonists, DPP-4 inhibitors, and SGLT-2 inhibitors. The label says dose changes and more frequent glucose checks may be needed.
• •Medicines that may reduce the blood sugar lowering effect include atypical antipsychotics, corticosteroids, diuretics, estrogens, oral contraceptives, progestogens, thyroid hormones, somatropin, and sympathomimetic agents such as albuterol and epinephrine. The label says dose increases and more frequent glucose checks may be needed.
• •Alcohol, beta-blockers, clonidine, and lithium salts may either increase or decrease the blood sugar lowering effect. Pentamidine may cause low blood sugar, sometimes followed by high blood sugar.
• •Beta-blockers, clonidine, guanethidine, and reserpine may reduce or hide the signs and symptoms of low blood sugar.
• •TZDs can cause fluid retention and heart failure when used with insulin glargine.

Alcohol and food

The label lists alcohol among substances that may increase or decrease the blood sugar lowering effect of insulin glargine. Changes in meal patterns, such as the amount or timing of food, may require dosage adjustments, according to the label.

🤰 Insulin Glargine in pregnancy and breastfeeding

Pregnancy

The label says published studies have not reported a clear link between insulin glargine and adverse developmental outcomes. It also says poorly controlled diabetes in pregnancy carries risks to both the mother and the fetus. The label notes that it is not known if insulin glargine may harm an unborn baby.

Breastfeeding

The label says it is not known if insulin glargine may harm a breastfeeding baby.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store unused insulin glargine in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F). Keep it in the original sealed carton until use. The label also says not to freeze it. Keep it out of the reach of children.

If a dose is missed

The label does not say.

If too much is taken

The label says excess insulin may cause low blood sugar and low potassium. Mild low blood sugar can usually be treated with oral carbohydrates, and the dose may need to be lowered. More severe cases with coma, seizure, or neurologic impairment may be treated with emergency glucagon or concentrated intravenous glucose. Low potassium must be corrected appropriately.

🗒️ Questions to ask about Insulin Glargine

• How much insulin glargine should I use, and at what time of day?
• What should I do if my blood sugar drops low, and how will I know it is happening?
• Which injection sites are best for me, and how should I rotate them?
• Will this medicine interact with any of my current medicines or supplements?
• Should I change how I check my blood sugar, and how often?
• What should I do if I think I used too much insulin?
• Is it safe for me to drive or operate machinery while using this medicine?

❓ Insulin Glargine: frequently asked questions