Home Drug Guide Insulin Glargine

Drug Guide

Generic Name

Insulin Glargine

Brand Names Basaglar, Semglee

Classification

Therapeutic: Antidiabetic, Hormone

Pharmacological: Long-acting Insulin

FDA Approved Indications

Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus (for glycemic control)

Mechanism of Action

Insulin glargine is a long-acting insulin analog that provides a steady level of insulin activity, facilitating glucose uptake into tissues and inhibiting hepatic glucose production, thereby lowering blood glucose levels over 24 hours.

Dosage and Administration

Adult: Initial dose varies based on individual needs; usually, 10 units once daily or adjusted based on blood glucose levels.

Pediatric: Dosage individualized based on child's needs and response; close monitoring required.

Geriatric: Start at lower doses; titrate carefully considering comorbidities and renal function.

Renal Impairment: Adjust doses based on blood glucose response; monitor closely.

Hepatic Impairment: Use with caution; lack of specific dose adjustment but monitor closely.

Pharmacokinetics

Absorption: Absorbed slowly from injection site, providing a peakless profile.

Distribution: Plasma protein binding is minimal.

Metabolism: Metabolized by proteolytic enzymes into amino acids.

Excretion: Excreted as amino acids via renal clearance.

Half Life: Approximately 24 hours, providing basal insulin coverage.

Contraindications

Hypoglycemia
Allergy to insulins or any component of the formulation

Precautions

Use with caution in hypoglycemia unawareness, during illness, or stress; monitor blood glucose levels regularly. Pregnancy category C; benefits should be weighed against risks during pregnancy.

Adverse Reactions - Common

Hypoglycemia (Common)
Local allergic reactions (redness, swelling at injection site) (Common)

Adverse Reactions - Serious

Severe hypoglycemia (Uncommon)
Lipodystrophy at injection site (Less common)
Anaphylaxis (Rare)

Drug-Drug Interactions

Other antidiabetic agents (may increase hypoglycemia risk)
Corticosteroids (may increase blood glucose)
Diuretics and beta-blockers (may mask hypoglycemia signs)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels regularly, especially when initiating or adjusting dose.

Diagnoses:

Risk for unstable blood glucose levels
Risk for hypoglycemia

Implementation: Administer subcutaneously at the same time each day, rotate injection sites, educate patient on proper injection technique.

Evaluation: Assess blood glucose levels and review insulin regimen effectiveness.

Patient/Family Teaching

Teach how to administer insulin properly.
Recognize signs and symptoms of hypoglycemia and hyperglycemia.
Importance of regular blood glucose monitoring.
Maintain consistent diet and physical activity.
Carry quick-acting carbohydrate for hypoglycemia episodes.

Special Considerations

Black Box Warnings:

None specific for insulin glargine, but caution about hypoglycemia.

Genetic Factors: Genetic variations in insulin sensitivity may affect dosing.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Severe hypoglycemia, including confusion, seizures, coma.

Treatment: Administer oral glucose if conscious; if unconscious, give IV glucose or glucagon as per protocol, monitor until stable.

Storage and Handling

Storage: Unopened vials in refrigerator (36°F to 46°F); do not freeze.

Stability: Once open, vials may be at room temperature (below 86°F) for up to 28 days, depending on manufacturer instructions.