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Insulin glargine sold under the brand name Lantus among others is a long-acting modified form of medical insulin, used in the management of type 1 and type 2 diabetes. [7] It is injected just under the skin . [ 7 ]
This is an ultralong-acting insulin analogue developed by Novo Nordisk, which markets it under the brand name Tresiba. It is administered once daily and has a duration of action that lasts up to 40 hours (compared to 18 to 26 hours provided by other marketed long-acting insulins such as insulin glargine and insulin detemir).
Faster-acting insulins peak quickly and are subsequently metabolized, while longer-acting insulins tend to have extended peak times and remain active in the body for more significant periods. [5] Examples of rapid-acting insulins (peak at ~1 hour) are: [citation needed] Insulin lispro (Humalog) Insulin aspart (Novolog) Insulin glulisine (Apidra)
Ultralente insulin was a long-acting form of insulin. It has an onset of 4 to 6 hours, a peak of 14 to 24 hours, and a duration of 28 to 36 hours. [ 1 ] Ultralente insulin, along with lente insulin , were discontinued in the US by manufacturers in the mid-2000s.
Novo has another long-acting insulin, Tresiba, on the market. "Novo Nordisk will phase out, then permanently discontinue Levemir in the U.S. on December 31, 2024," the company said in a statement.
The long acting insulin is given once (usually glargine, Lantus) or twice (usually detemir, Levemir) daily to provide a base, or basal insulin level. Rapid acting (RA) insulin is given before meals and snacks. A similar profile can be provided using an insulin pump where rapid acting insulin is given as the basal and premeal bolus insulin.
An older insulin used for this purpose is ultralente, and beef ultralente in particular was considered for decades to be the gold standard of basal insulin. Long-acting insulin analogs such as insulin glargine (brand name Lantus, made by Sanofi-Aventis) and insulin detemir (brand name Levemir, made by Novo Nordisk) are also used, with insulin ...
Insulin degludec is an ultra-long acting insulin that, unlike insulin glargine, is active at a physiologic pH.The addition of hexadecanedioic acid via an amide linkage to lysine at the B29 position allows for the formation of multi-hexamers in subcutaneous tissues. [16]