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.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.