Glargin

Glargin, also known as insulin glargine, is a long-acting basal insulin analog used in the management of diabetes mellitus. It is produced through recombinant DNA technology and is administered by subcutaneous injection to provide a steady level of insulin over an extended period.

Glargine's structure differs from human insulin by substitutions that promote its precipitation in subcutaneous tissue after injection, resulting in a slow, gradual release with a relatively flat pharmacodynamic profile. It typically begins to act within a few hours and provides up to 24 hours of relatively peakless insulin activity, supporting basal glucose control.

Administration and dosing: Glargin is usually injected once daily, or every 24 hours, and dosing is individualized based on fasting blood glucose, HbA1c target, and body weight. It is generally given at the same time each day. It should not be mixed with other insulins in the same syringe; separate injections are recommended if combined therapy is used with rapid-acting insulin at meals.

Safety and adverse effects: The most common adverse effect is hypoglycemia, especially during dose adjustments or concomitant illness, exercise, or reduced food intake. Other risks include weight gain, injection-site reactions, lipodystrophy, edema, and rarely allergic reactions. Caution is advised in kidney or liver disease and during pregnancy, where insulin remains the preferred therapy for glycemic control, with glargin used under medical supervision.

History and availability: Insulin glargine was developed to provide a long-acting basal insulin with a relatively flat action profile. It is marketed under multiple names, including Lantus and its biosimilars, and forms such as higher-concentration versions in some markets. It is one of several basal insulins used in type 1 and type 2 diabetes as part of a comprehensive treatment plan.