Lantus (insulin glargine) is considered a peakless long-acting/basal insulin with comparative steady availability for 24 hours. As such, will it be better suited to type 2 diabetics with persistent chronic hyperglycemia who eat irregularly and occasionally? Will it take care of persistent hyperglycemia and overeating? In view of its continual and steady availability, can it also cause some side effects specific to it in view of many indicated actions of insulin especially related to increased synthesis and decreased breakdown of energy stores?

Insulin glargine is just one of several types of long-acting insulin available for treatment. It has been shown to be beneficial in patients with type 2 diabetes. However, it does not work well following meals. It may benefit the post-meal sugar somewhat. However, sugars may remain elevated after its use and it may require the use of a short-acting insulin to improve post-meal coverage further. I look at its use in a continuum. It is started. If results are good, you can stay with it without necessarily increasing insulin therapy to include rapid-acting insulin. However, if two hour post-meal glucose levels remain over 140 mg/dl [7.8 mmol/L], rapid-acting insulin should be considered as a next step. The long-acting insulins are usually titrated to the fasting glucose level.

JTL