Insulin glargine , marketed under the name Lantus , among others, is a long-acting basal insulin analogue, administered once daily to help control blood sugar levels in those with diabetes. It consists of a microcrystalline that gradually releases insulin, giving a long working duration of 18 to 26 hours, with a "peakless" profile (corresponding to the insulin glargine package insert). Pharmacokinetics, its steady action can complement variable insulin secretion from non-diabetic pancreatic beta cells. Sometimes, in type 2 diabetes and in combination with short acting sulfonylureas (drugs that stimulate the pancreas to make more insulin), may help offer moderate control of serum glucose levels. In the absence of endogenous insulin - type 1 diabetes, depleted type 2 (in some cases) or latent autoimmune diabetes in adults at an advanced stage - insulin glargine requires fast-acting insulin support taken with food to reduce the effect of prandially derived glucose (from food ).
Video Insulin glargine
Medical use
Long-acting insulin classes, which include insulin glargine, do not look much better than insulin protamine Hagedorn (NPH) neutral but have a much greater cost, by 2010, are not cost-effective. It is not clear whether there is a difference in hypoglycemia given the significance of the dose, and not enough data to determine the difference with respect to long-term outcomes.
Mixing with other insulin
Unlike some other long-acting insulin, eg. NPH, glargine should not be diluted or mixed with insulin or other solutions in the same syringe. However, these restrictions are questionable.
Maps Insulin glargine
Adverse effects
Cancer
In 2012 tentative evidence showed no association between insulin glargine and cancer. Previous research has raised concerns.
Pharmacology
Action mechanism
Insulin glargine has glycine substitution for asparagin on N21 (Asn21) and two arginine are added to the chain carboxy terminal B. The amino acid arginine shifts the isoelectric point from pH 5.4 to 6.7, making the molecule more soluble at acidic and insoluble pH at physiological pH. The isoelectric shift also allows for subcutaneous injection of a clear solution. Glycine substitution prevents acid-sensitive asparagine deacidation at acidic pH. In a neutral subcutaneous space, a high-level aggregate form is formed, resulting in slow and no peak dissolution and insulin absorption from the injection site. Can reach a peakless level for at least 24 hours.
Reception and re-partition on body
Insulin glargine is formulated at pH 4 acids, where it is completely soluble in water. After subcutaneous injection of acid-soluble substances (which can cause discomfort and stinging sensation), when physiological pH (about 7.4) is achieved, an increase in pH causes insulin to escape from a solution resulting in higher order aggregate formation of insulin. hexamers. Higher order aggregations slow the dissociation of hexamers into insulin monomers, active and physiologically active insulin units. This gradual process ensures that a small amount of insulin glargine is released into the body continuously, giving the profile almost no peak.
History
The development of insulin glargine is performed at Sanofi-Aventis biotechnology competence center in Frankfurt-HÃÆ'¶chst. Sanofi supplies products to more than 100 countries and over 3.5 million patients worldwide. This makes Lantus Germany the largest and most important export pharmaceutical product. Sanofi-Aventis increased its turnover with Lantus by about 28% to EUR 2.45 Billion, from 130 Million Euro in Germany, where approximately. 1.8 million diabetics use the product. In 2007 Lantus was the 15th highest selling pharmaceutical product in Germany.
Investment in the production of Lantus and insulin-pen-manufacturing at Frankfurt-HÃÆ'¶chst cost 700 Million EUR. In 2008 a new manufacturing plant was established to produce further insulin-pens with an investment of EUR 150 Million. In Sanofi-Aventis Lantus production created 3000 jobs in Berlin and Frankfurt-HÃÆ'¶chst.
On 9 June 2000 the European Commission formally approved the launch of Lantus by Sanofi-Aventis Germany Ltd. across the EU. The recognition was extended on June 9, 2005.
The three-fold more concentrated formulation, the brand name Toujeo, was introduced after FDA approval in 2015.
Patent validity
Patent protection for insulin glargine ends in most countries by 2015. Insulin glargine from Eli Lilly's competitors is available in most countries during 2015, under the Basaglar trademark (as a continuation in the US) and Abasaglar (as biosimilar in the EU)). Biosimilar insulin glucose is only released in 100U/mL strength to date, and the biosimilar equivalent in the 300U/mL strength of Toujeo has not yet been released.
See also
- Insulin detemir
- Insulin degludec
References
External links
- Insulin glargine - MedlinePlus
- The Lantus (Sanofi-Aventis) website
- Lantus: more information on product characteristics, dosage and study
- US. National Drug Library: Drug Information Portal - Insulin glargine
Source of the article : Wikipedia
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