Mytus

Indications

Insulin Glargine is a long-acting (basal) insulin used to control high blood sugar in adults and children with type 1 diabetes, and in adults with type 2 diabetes when diet, exercise and tablets are not enough. It provides a steady background level of insulin over about 24 hours.

How It Works

Insulin is a hormone that lets sugar (glucose) move from the blood into the body's cells, where it is used for energy, and stops the liver from releasing too much sugar. After injection under the skin, Insulin Glargine forms tiny deposits that release insulin slowly and evenly, without a strong peak, which helps keep blood sugar stable between meals and overnight.

Dosage and Administration

The dose is individual and is set and adjusted by your doctor according to your blood sugar readings, weight, diet and other treatment. It is usually injected once a day at the same time each day. Inject under the skin of the abdomen, thigh or upper arm, changing the injection spot each time to avoid lumps. A doctor or nurse will train you to inject with the pen or syringe. Never inject it into a vein or muscle, do not mix it with other insulins, and never share pens or needles. Check the insulin is clear and colourless before use. Monitor your blood sugar as advised.

Interactions

• Other diabetes medicines (such as Sulfonylureas or other insulins) and alcohol increase the risk of low blood sugar.
• Corticosteroids, thiazide diuretics, thyroid hormones, some antipsychotics (such as Olanzapine), Salbutamol and oral contraceptives can raise blood sugar.
• Beta-blockers (such as Propranolol) can hide warning signs of low blood sugar.
• Pioglitazone with insulin may increase the risk of fluid retention and heart failure.
• ACE inhibitors, Fluoxetine and some antibiotics may lower blood sugar.

Contraindications

• Allergy to Insulin Glargine or any ingredient.
• During an episode of low blood sugar (hypoglycaemia).
• Not used to treat diabetic ketoacidosis (a fast-acting insulin into a vein is used instead).

Side Effects

The most common side effect is low blood sugar (hypoglycaemia): shaking, sweating, hunger, fast heartbeat, headache, confusion or irritability. Treat it straight away with sugar, glucose tablets or a sweet drink, then a snack. Other effects include weight gain, redness, itching or swelling at the injection site, and lumps or dents in the skin if the same spot is used repeatedly (always rotate sites).

Less common effects include low potassium, swelling of the ankles, temporary changes in vision when starting, and allergic reactions.

Get urgent medical help if someone with diabetes becomes very drowsy, confused, has a fit or cannot swallow (severe low blood sugar: do not give food by mouth if unconscious), or if there is a widespread rash, swelling of the face or difficulty breathing.

Pregnancy and Lactation

Good blood sugar control is very important in pregnancy, and insulin is the preferred treatment. Insulin Glargine can be used in pregnancy under close supervision; insulin needs usually change during pregnancy and fall sharply after delivery. It can be used while breastfeeding; the dose may need adjusting.

Precautions and Warnings

Do not change your dose or insulin type without medical advice. Check blood sugar more often during illness, travel, changes in diet or exercise, and when drinking alcohol. Carry glucose with you. Kidney or liver problems may lower insulin needs. Take care when driving; check your blood sugar before driving and do not drive if it is low.

Overdose

Too much insulin causes low blood sugar, which may be severe and long-lasting with a long-acting insulin. Take sugar immediately and seek medical help; severe cases need glucose into a vein or a Glucagon injection, and close monitoring for many hours.

Therapeutic Class

Long-acting human insulin analogue; antidiabetic.

Storage

Store unopened pens, cartridges and vials in a refrigerator at 2 to 8°C, do not freeze, and keep in the carton away from light. Once in use, keep at room temperature below 30°C (not in the fridge) and use within the time stated on the leaflet, usually 4 weeks. Do not use if frozen, cloudy or past expiry. Keep out of the reach of children.