Insulin glargine recombinant

A long-acting insulin analog used in the treatment of diabetes mellitus

Insulin glargine recombinant
INN
Drug class
Routes of administration	Subcutaneous
Pregnancy category
Bioavailability
Metabolism	Liver
Elimination half-life	12-19 hours
Excretion
Legal status
CAS Number	160337-95-1
PubChem	16134948
DrugBank	DB00047
ChemSpider	none
KEGG	D04477

Insulin glargine recombinant is a long-acting insulin analog used in the management of diabetes mellitus. It is designed to provide a steady level of insulin over a 24-hour period, helping to control blood sugar levels in individuals with type 1 and type 2 diabetes.

Mechanism of Action

Insulin glargine is a modified form of human insulin. It is produced by recombinant DNA technology using a non-pathogenic laboratory strain of Escherichia coli. The modifications involve the substitution of glycine for asparagine at position A21 and the addition of two arginine residues at the C-terminus of the B-chain. These changes result in a shift in the isoelectric point, making the insulin less soluble at physiological pH, which leads to a slow and prolonged absorption from the subcutaneous tissue.

Pharmacokinetics

Upon subcutaneous injection, insulin glargine forms microprecipitates in the subcutaneous tissue, from which small amounts of insulin are slowly released, providing a relatively constant concentration/time profile over 24 hours with no pronounced peak. This allows for once-daily dosing, which can be administered at any time of day, although it should be administered at the same time each day.

Clinical Use

Insulin glargine is indicated for the treatment of adults and children with type 1 diabetes and adults with type 2 diabetes who require basal (long-acting) insulin for the control of hyperglycemia. It is often used in combination with short-acting insulins or oral hypoglycemic agents.

Side Effects

Common side effects of insulin glargine include hypoglycemia, injection site reactions, lipodystrophy, and allergic reactions. Hypoglycemia is the most common adverse effect and can be severe. Patients should be educated on recognizing and managing hypoglycemia.

Comparison with Other Insulins

Insulin glargine is one of several long-acting insulin analogs, including insulin detemir and insulin degludec. Compared to NPH insulin, insulin glargine has a longer duration of action and a more predictable absorption pattern, which can reduce the risk of nocturnal hypoglycemia.

History

Insulin glargine was first approved for use in the United States in 2000. It was developed by Sanofi-Aventis and is marketed under the brand name Lantus, among others. It has since become a widely used basal insulin analog due to its efficacy and safety profile.

Also see

• Diabetes mellitus
• Insulin therapy
• Insulin analog
• Hypoglycemia