Enhancing Healthcare Team Outcomes
The increasing rates of type 2 diabetes and the relative paucity of endocrinologists mean that initiating glucose control in uncomplicated type 2 diabetes should be part of the routine practice of interprofessional healthcare teams. Ideally, these teams would be composed of clinicians , practice nurses, pharmacists, and certified diabetes educators. Some obstacles to implementing such care within a primary interprofessional team include ambiguity of roles, the uncertainty of competency, and poor communication. For example, there is some ambiguity in the role of the primary care versus specialist clinician in the initiation of insulin and determining which patients do or do not meet the criteria of ‘complicated.’ Furthermore, there are misunderstandings as to the ability to administer, educate, and adjust insulin between clinicians, practice nurses, and diabetes nurse educators.
How Do You Inject Insulin Glargine
Many patients taking insulin glargine will administer self-injections, due to the frequency at which they must take the drug. However, you mustnt begin self-injections before speaking with your doctor and knowing how to do it properly. If youve already spoken with your doctor and its been determined that you should proceed with self-injections, the following video from SingHealth may provide helpful information as a reminder for how to perform insulin injections in general.
Why Is There No Generic Insulin
These days, all sorts of medications seem to come in cheaper off-brand versions made of the exact same ingredients, known as generics. So why isnt this the case for insulin?
Especially at a time when people with diabetes are desperately rationing this life-sustaining drug due to astronomical pricing, this question becomes even more pressing.
The fact is that the term generic has been loosely applied to copycat versions of name brand insulins sold at lower prices, or to older, less reliable forms of human insulin. Some may believe generic insulins actually do exist, including insurance company reps, pharmacists, and others in the diabetes community who may echo this messaging.
But the reality is there are no true generic insulins available defined as chemically identical to brand-name products and with the same efficacy, but sold much at much cheaper prices.
The three main insulin manufacturers Eli Lilly, Novo Nordisk, and Sanofi can be blamed for some of this. But theyre not the only entities whove stood in the way of widespread availability of more affordable generic insulin. Thats too simple. Complexities of the drug itself, the use of the U.S. patent system, and the deeply flawed U.S. healthcare pricing system are all to blame as well.
Read on to learn why there arent cheaper insulins, which options are available, and who benefits most.
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What Is The Cost Of Tresiba And Lantus
Whether you have health insurance or not, cost may be a factor when youre considering these drugs. To see cost estimates for Tresiba and Lantus based on where you live, visit GoodRx.com. But keep in mind that what youll pay for either drug will depend on your treatment plan, health insurance, and the pharmacy you use.
Tresiba and Lantus are both brand-name medications. There isnt currently a generic version of either drug.
Lantus is a biologic medication, which means its made from living cells. Although there isnt a generic form of Lantus, theres a follow-on insulin glargine drug available called Basaglar. Follow-on insulins are biologic drugs that are very similar to the original brand-name drug. Basaglar is made with the same type of insulin as Lantus.
However, follow-ons arent considered true generic drugs. This is because the way biologic drugs are made is very complex, and true copies of the original drug cant be made.
Youll usually pay more for the original brand-name drugs than for generics or follow-on drugs.
If youre interested in using Basaglar instead of Lantus, talk with your doctor.
Tresiba and Lantus are both prescribed to help people with type 1 or type 2 diabetes manage their blood sugar. The American Diabetes Associations guidelines recommend both drugs as treatment options for certain people with either type of diabetes.
What Are The Side Effects Of Insulin Glargine
Insulin glargine may potentially cause side effects ranging from mild to severe. The list below includes some of the most common side effects but is not a complete list. Mild side effects may go away after a few days or weeks of consistent medication-taking, but if they persist or worsen you should speak with your doctor.
Common side effects:
- Mild irritation and redness around the injection site
- Weight gain
- Swelling of the face, lips, tongue, or throat
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Clinical Studies In Adults With Type 2 Diabetes
In a randomized, controlled clinical study , Lantus was evaluated for 52 weeks in combination with oral antidiabetic medications . The average age was 59.5 years. The majority of patients were White and 53.7% were male. The mean BMI was approximately 29.1 kg/m2. The mean duration of diabetes was 10.3 years. Lantus administered once daily at bedtime was as effective as NPH insulin administered once daily at bedtime in reducing HbA1c and fasting glucose . The rate of severe symptomatic hypoglycemia was similar in Lantus and NPH insulin treated patients .
In a randomized, controlled clinical study , in patients with type 2 diabetes not using oral antidiabetic medications , a basal-bolus regimen of Lantus once daily at bedtime or NPH insulin administered once or twice daily was evaluated for 28 weeks. Regular human insulin was used before meals, as needed. The average age was 59.3 years. The majority of patients were White and 60% were male. The mean BMI was approximately 30.5 kg/m2. The mean duration of diabetes was 13.7 years. Lantus had similar effectiveness as either once- or twice-daily NPH insulin in reducing HbA1c and fasting glucose with a similar incidence of hypoglycemia .
| Study E |
|---|
| 4.8 |
Lantus Timing of Daily Dosing
| Study H |
|---|
| 2.9 |
Five-Year Trial Evaluating the Progression of Retinopathy
The Origin Study
Hyperglycemia or Hypoglycemia
Medications Errors
Toujeo And Lantus Doses
While Lantus contains 100 units per milliliter, Toujeo is three times more concentrated, yielding 300 units per milliliter of fluid. However, this doesnt mean you should take a lower dosage of Toujeo than you would take of Lantus.
Dosages may change for other reasons, such as fluctuations in weight or diet, but Toujeo and Lantus dosages should be the same or very close. In fact, studies show that people typically end up needing about 10 to 15 percent more Toujeo than Lantus to maintain the same fasting glucose readings.
Your doctor will inform you what dosage is right for you. The Toujeo will only appear to be a lesser volume within the pen because it is immersed in a smaller amount of carrier liquid. Its like getting the same amount of caffeine in a tiny shot of espresso or a large latte.
If you need a high dose of insulin, you may need fewer injections with Toujeo than you would need with Lantus, simply because the Toujeo pen can hold more.
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Warnings Of Tresiba And Lantus
Tresiba and Lantus carry the risk of hypoglycemia, or low blood glucose levels. Patients on Tresiba or Lantus should know the signs and symptoms of hypoglycemia, which include shakiness, lightheadedness, mental confusion, nausea, blurred vision, and headache.
Hypokalemia, or low potassium levels, is also a possible adverse event related to Tresiba or Lantus use. This is especially important to consider in patients who have impaired renal function or may be on potassium-wasting medications such as furosemide.
Insulin delivery devices, such as Flextouch or Solostar pens, as well as pen needles and syringes, should not be shared between patients. There is a risk of cross-contamination with bloodborne pathogens and diseases. Patients should receive education and counseling on basic diabetes care, including the safe use of needles.
Tresiba and Lantus are intended for subcutaneous dosing only. They should never be administered intramuscularly or intravenously.
What Is It Used For
Lantus is used for the treatment of adults with type 2 diabetes, and also adults and children aged six and older with type 1 diabetes for the control of high blood sugar. It supplies a steady release of insulin to help control your blood sugar levels overnight and between meals.
Treatment with Lantus may also need the support of faster-acting mealtime insulin that helps reduce the effects of blood sugar spikes that occur during and after meals. It is usually taken in the evening or night time by people having type 1 diabetes, latent autoimmune diabetes of adults but rarely with those with type 2 diabetes. It is typically self-injected subcutaneously once daily. Lantus is not to be used to treat diabetic ketoacidosis .
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What Is Generic Insulin
When researching generic insulin, youll inevitably be confronted with a lot of technical language that regulatory folks toss around. Have no fear. There are just a few terms you really need to know:
- Biologic: Modern manufactured insulin is a biologic, a category of medications with large, complex molecules, made from material that comes from living organisms.
- Biosimilar: When one company tries to copy another companys biologic, the new one is not technically a generic drug. Rather, its called a biosimilar or a follow-on terms often used interchangeably that indicate a copy of a biologic that is approved by the U.S. Food and Drug Administration .
- This is another complicated term, because it specifically uses the word generic but does not refer to a true generic as most people know them. Per the FDA , an authorized generic is an approved brand name drug that is marketed without the brand name on its label. Otherwise, it is the exact same drug as the branded product. Think of it like water coming out of the same tap, but one going into a brand name bottle and the rest going into a separate container with a different label.
Whats important to know is the difference between these formulations and true generics: Generic medications use the same active ingredients and work the same way as brand-name medications, according to the FDA .
You can learn more about the specifics of these terms in this
Fda Approves Generic Swap For Brand
Angela Underwood’s extensive local, state, and federal healthcare and environmental news coverage includes 911 first-responder compensation policy to the Ciba-Geigy water contamination case in Toms River, NJ. Her additional health-related coverage includes death and dying, skin care, and autism spectrum disorder.
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Pharmacist Tips For Lantus
Read the detailed âInstructions for Useâ that comes with Lantus to ensure that you understand proper administration.
For either vials or insulin pens, they can be kept at room temperature for 28 days.
Inject at the same time each day, but rotate injection sites to prevent skin irritation or deformity.
For proper use, inject Lantus under your skin in your upper arm, abdomen , or thigh .
Never inject it into a vein or muscle. This can cause severely low blood sugar levels and infections.
Do not dilute or mix with other types of insulin it will not work as intended and you may lose blood sugar control, which could be serious. However, your doctor may prescribe other short-acting insulins to use at different times of the day depending on your blood sugar control.
Keep a consistent meal and exercise schedule to prevent any fluctuations in your blood sugar.
Do not re-use needles. Always use a new needle for each injection. Reusing needles increases your chance of having blocked needles, which can cause you to get the wrong dose of Lantus . Using a new needle for each injection also lowers your risk of getting an infection.
When changing to Lantus from other basal insulins you may experience higher average fasting blood sugar levels in the first weeks of therapy. Monitor sugar levels daily to ensure that they are within a healthy range.
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Hypersensitivity And Allergic Reactions
Severe, life-threatening, generalized allergy, including anaphylaxis, can occur with insulin products, including Lantus. If hypersensitivity reactions occur, discontinue Lantus treat per standard of care and monitor until symptoms and signs resolve . Lantus is contraindicated in patients who have had hypersensitivity reactions to insulin glargine or one of the excipients .
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What Are Side Effects Associated With Using Insulin Glargine
Common side effects of Insulin Glargine include:
- low blood sugar,
- thickening or hollowing of the skin where the injection was given
Serious side effects of Insulin Glargine include:
- redness or swelling at the injection site,
- itchy skin rash over the entire body,
- trouble breathing,
- swelling of the tongue or throat,
- rapid weight gain,
- swelling in the feet or ankles,
- leg cramps,
Rare side effects of Insulin Glargine include:
- none
How To Use Lantus Solostar Insulin Pen
Read the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor, diabetes educator, or pharmacist.
Follow all package directions for proper use/injection/storage of the particular type of device/insulin you are using. Your health care professional will teach you how to properly inject this medication. If any of the information is unclear, consult your doctor or pharmacist.
Do not inject cold insulin because this can be painful. The insulin container you are currently using can be kept at room temperature . Wash your hands before measuring and injecting insulin. Before using, check the product visually for particles, thickening, or clumps. If any are present, discard that container. Insulin glargine should be clear and colorless. To avoid damaging the insulin, do not shake the container.
The dosage is based on your medical condition and response to treatment. Measure each dose carefully, and use exactly as prescribed by your doctor. Even small changes in the amount of insulin may have a large effect on your blood sugar. If you are using the cartridge form of this insulin and a special injecting device with a digital display, take care to read the display right-side up. If you read the display upside-down, you may inject the wrong amount of insulin. Ask your pharmacist if you are unsure how to properly use this type of injecting device.
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Fda Oks Automatic Use Of Cheaper Generic Insulin
July 29, 2021 — The FDA has approved the first interchangeable insulin, Semglee, which can be substituted for the much more expensive brand name Lantus at the pharmacy without the need for a separate prescription.
The approval will allow Semglee to function like a generic drug in the market and should reduce insulin costs. Under the new rule, a pharmacist could recommend Semgless instead of Lantus without a doctorâs approval.
Semglee is for patients with either type 1 or type 2 diabetes.
< p> Originally in June 2020, Semglee is now an “interchangeable biosimilar,” meaning that it has no clinically meaningful difference from the brand name drug and may be substituted for Lantus, just as generic drugs typically are
To be approved as an interchangeable biosimilar, manufacturers must provide additional data that shows how it may be used in the marketplace.
These types of products, like other generics, may significantly reduce drug costs. The FDA said other biosimilars in the U.S. launched with prices 15% to 35% lower than brand name drugs.
A typical month’s supply of Semglee injector pens cost about $150 to $190 without insurance, compared to $340 to $520 for Lantus, The Associated Press reported.
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Why Are Insulins And Lantus So Expensive
The case of insulin prices is an interesting one. In the 1920s, insulin was extracted from cattle pancreas, which led to negative reactions in some patients. So, scientists made it better. In the 1970s a new type of insulin was developed using a technique called recombinant DNA technology. This technique uses human DNA to create the insulin needed and ultimately reduced complications.
But the catch? After the new insulin with human DNA was created, the older and more affordable insulin was taken off the market in the US. Since then, the demand for diabetes medications has increased, and the cost of insulin has skyrocketed, leaving many paying an anywhere from $300-$900 per month for their life-saving injection.
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What Are The Typical Dosages Of Lantus
The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
The typical dosage of Lantus your doctor prescribes will depend on whether you have type 1 or type 2 diabetes. If you have questions about the normal dosage of Lantus for your condition, talk with your doctor.
Youll likely inject Lantus once per day. You can inject it at any time of day, but it should be done at the same time every day.
Dosage for type 1 diabetes
If you have type 1 diabetes, your starting dose of Lantus is about one-third of your total daily insulin dose. The rest of this daily insulin total is made up of a fast-acting insulin thats given at mealtimes.
Your doctor will use weight-based dosing to determine your total daily insulin dose. The usual dosage range for type 1 diabetes is 0.4 units to 1 unit of insulin per kilogram * of body weight.
For example, a doctor might prescribe 0.5 units per kg daily to a person weighing 66 kg . So their total daily insulin would be 33 units. Their Lantus dosage would be one-third of this total, meaning theyd take 11 units of Lantus daily. The remaining 22 units would be given as a fast-acting insulin with each meal.
For details about possible dosage adjustments with Lantus, see the Dosage adjustments section below.
* One kg is about 2.2 pounds.
Dosage for type 2 diabetes
* One kg is about 2.2 pounds.