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March 6, 2002

Insulin Analogs

Question from Perrysburg, Ohio, USA:

In a four year old, how does Lantus work? Why do you sometimes have a low reading in the morning? Can your snacks be at any time or must they be regulated?

Answer:

Lantus (insulin glargine) is an insulin analog designed to be longer lasting than other insulin formulations. It has a peak in some folks at about six to eight hours, it usually lasts about 24 hours, and it seems to have more consistent effect than other insulin with less variability from day to day. However, as with all medications, this is different for each person and must be determined by frequent blood glucose testing.

In our experience, especially in young children but also in some adolescents and young adults, Lantus does not last 24 hours, and we usually use a small amount of NPH at lunchtime to get the last part of the 24 hour cycle covered. Sometimes this can also be done with afternoon Humalog as well. In some people the peak is too harsh so we then switch to other times of the day. Again, all based on frequent blood glucose monitoring.

SB