Insulin glargine and its role in glycaemic management of Type 2 diabetes

Expert Opin Drug Metab Toxicol. 2008 Aug;4(8):1099-110. doi: 10.1517/17425255.4.8.1099.

Abstract

Background: Insulin glargine (Lantus) was the first recombinant-DNA long-acting insulin analogue to be licensed for use in the treatment of diabetes mellitus.

Objective: This review considers the use of insulin glargine in the treatment of type 2 diabetes (T2DM).

Methods: Medline, Cochrane and Embase databases were searched for relevant papers from the year 2000 onwards.

Results/conclusion: Overall glargine provides at least equivalent glycaemic control and is associated with less hypoglycaemia, especially nocturnal hypoglycaemia owing to its 24 h peakless profile, which allows more aggressive titration to achieve glycaemic targets. Glargine has been shown to be safely initiated both individually and within a group setting and titration algorithms self-managed by patients are effective in achieving diabetes control. Despite these advantages, caution is needed as clinical guidelines do not advocate its use in all people with T2DM until clinical efficacy and cost effectiveness have been proved. However, insulin glargine is a welcome addition to the plethora of treatment options available for T2DM.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Clinical Trials as Topic
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Dose-Response Relationship, Drug
  • Humans
  • Hypoglycemia / chemically induced
  • Hypoglycemia / epidemiology
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / administration & dosage
  • Insulin / adverse effects
  • Insulin / analogs & derivatives*
  • Insulin / therapeutic use
  • Insulin Glargine
  • Insulin, Long-Acting

Substances

  • Hypoglycemic Agents
  • Insulin
  • Insulin, Long-Acting
  • Insulin Glargine