Insulin

Insulin glargine

A long-acting insulin analogue injected once daily as basal (background) insulin for type 1 and type 2 diabetes.

Drug card

Class: Insulin
How it works: Activating insulin receptors, so muscle and fat take up glucose
Used for: Type 1 diabetes (adults and children)
Type 2 diabetes
Diabetes in pregnancy (gestational diabetes)
Known for: Low blood sugar (hypoglycemia)
Fat lumps or hollows where injected (lipodystrophy)

Study it as a flashcard, and it comes back before you forget it.

Mechanism of action

How does insulin glargine work?

Insulin glargine is human insulin with glycine in place of asparagine at A21 and two extra arginines on the B chain. After injection under the skin it is absorbed slowly and steadily, giving a fairly flat insulin level across about 24 hours with no marked peak. It is not given IV or by pump, and it is never mixed with other insulins.

Like other insulins: Insulins bind insulin receptors, mainly on muscle and fat cells, which then take up more glucose from the blood. Insulin also stops the liver releasing glucose from stored glycogen, blocks the breakdown of fat and protein, builds protein, and moves potassium into cells. Preparations differ mainly in how fast they are absorbed and how long they act.

See its molecule in 3DPDB 1MSO

Uses

What is insulin glargine used for?

Type 1 diabetes (adults and children)
Type 2 diabetes
Diabetes in pregnancy (gestational diabetes)

Side effects

Side effects of insulin glargine

Low blood sugar (hypoglycemia)Known forSerious
Fat lumps or hollows where injected (lipodystrophy)Known for
Weight gain
Redness, itching or pain where injected
Itching
Rash
Swelling from fluid retention (edema)
Severe allergic reaction (anaphylaxis)Serious
Low potassium (hypokalemia)Serious

Known for marks what an exam expects you to know it for.

Watch for

Cautions and what sets it apart

Not a treatment for diabetic ketoacidosis, which needs insulin by IV infusion.
Do not give it intravenously or by pump, and do not dilute it or mix it with any other insulin.
Any change of insulin type, brand or injection site calls for closer glucose monitoring.

Good to know: A basal insulin: its slow, steady absorption covers background needs, while a rapid- or short-acting insulin covers meals.

Remember it

A way to remember it

Insulin opens the door for sugar and potassium.

Insulin moves both glucose and potassium into cells. Too much causes low blood sugar and low potassium, and the same effect is why IV insulin with glucose brings a dangerously high potassium down.

Written for biofideX

Its class

Insulins

Other insulins with a card:

Easily mixed up with sulfonylureas and GLP-1 receptor agonists.

All about insulins

Sources

Checked against

Written for biofideX in plain words, after checking these references:

For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.

Practice it

Diabetes

Insulin glargine is one of 14 drugs practiced together here: their classes, how they work, what they treat and what they're known for.

Start Practicing

Or browse every drug card