Long-acting insulin

Long-acting insulin is a type of insulin therapy used in the management of diabetes mellitus, a condition characterized by high blood sugar levels. Unlike rapid-acting or short-acting insulin, which are used to manage blood sugar levels around meal times, long-acting insulin mimics the insulin release of a healthy pancreas by providing a steady, low level of insulin throughout the day and night. This article provides an overview of long-acting insulin, including its types, mechanism of action, administration, and considerations.

Types of Long-Acting Insulin

There are several types of long-acting insulin available, each with different onset times, peak times, and durations of action. The most commonly used types include:

• Insulin glargine (Lantus, Basaglar, Toujeo): Begins to work several hours after injection and tends to last for about 24 hours.
• Insulin detemir (Levemir): Has a somewhat variable duration of 18 to 23 hours, depending on the dose.
• Insulin degludec (Tresiba): Known for its ultra-long action, lasting over 42 hours, providing a very stable insulin level.

Mechanism of Action

Long-acting insulin works by mimicking the basal insulin secretion of the pancreas. It is absorbed slowly, providing a constant supply of insulin to help control blood glucose levels throughout the day and night. This type of insulin helps to maintain a stable, baseline insulin level, reducing the risk of both high and low blood sugar levels.

Administration

Long-acting insulin is typically administered once or twice daily, depending on the specific insulin formulation and the individual's needs. It is injected subcutaneously, usually in the thigh, abdomen, or upper arm. The timing of the injection should be consistent from day to day to maintain stable blood glucose levels.

Considerations

When using long-acting insulin, several considerations should be taken into account:

• Dosing: The dose of long-acting insulin is determined based on the individual's weight, diet, activity level, and current blood sugar control.
• Timing: It is crucial to inject long-acting insulin at the same time each day to maintain consistent blood glucose levels.
• Hypoglycemia: While less common with long-acting insulin, there is still a risk of low blood sugar, especially if meals are skipped or delayed.
• Adjustments: The dose of long-acting insulin may need to be adjusted based on changes in routine, diet, or health status.

Conclusion

Long-acting insulin is a cornerstone in the management of diabetes, providing a stable, basal level of insulin to help control blood sugar levels throughout the day and night. Its use must be carefully managed and tailored to the individual's needs, with regular monitoring and adjustments as necessary.