Abasaglar ® (basal insulin glargine)

This information is intended for UK registered healthcare professionals only as a scientific exchange in response to your search for information. Please refer to the link for full prescribing information: Abasaglar Summary of Product Characteristics (SmPC)

How is Abasaglar® (insulin glargine) therapy initiated and titrated?

The recommended initial dose of Abasaglar is approximately one-third of the total daily insulin requirement for type 1 diabetes and up to 10 units once daily for type 2 diabetes. A titration schedule of 1 unit per day was used for type 2 diabetes.

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Initiation of Abasaglar Therapy

The recommended initial dose of Abasaglar (insulin glargine) 100 units/mL differs between patients with  type 1 or  type 2 diabetes (Table 1).1

Initiation of  Abasaglar Therapy in Patients With Type 1 or Type 2 Diabetes1

If treating patients with...

Then the recommended initial dose of Abasaglar is...

type 1 diabetes

approximately 1/3 of the total daily insulin requirement.

type 2 diabetes

0.2 units/kg or up to 10 units once daily.

Abbreviations: Abasaglar = Abasaglar® (insulin glargine) 100 units/mL.

Patients with type 1 diabetes should use short- or rapid-acting premeal insulin for their remaining daily insulin requirements.1

Patients with type 2 diabetes may need to adjust the dose of their concomitant antihyperglycemic medications.1

Titration of Abasaglar in ELEMENT 2 Study

ELEMENT 2 (a prospEctive, randomized, doubLE-blind coMparison of a long-acting basal insulin analog LY2963016 to Lantus® in adult patiENTs with type 2 diabetes mellitus) was a phase 3 study that compared the efficacy and safety of Abasaglar vs Lantus® (insulin glargine) 100 units/mL in patients with type 2 diabetes.2

The initial dose of Abasaglar and Lantus for insulin-naïve patients was 10 units once daily.2

Patients previously prescribed Lantus initiated Abasaglar or Lantus at the prestudy Lantus dose.2

Patients followed a patient-driven titration schedule to increase their initial insulin dose by 1 unit daily until a fasting plasma glucose concentration of ≤5.6 mmol/L (≤100 mg/dL) was achieved.2,3

The insulin dose could be

  • increased if deemed necessary by the investigator, or
  • decreased if patients experienced hypoglycemia.4

Approximately 50% of patients in each treatment group

  • injected their basal insulin in the daytime, or
  • injected their dose in the evening or at bedtime.4

Titration of Insulin Glargine in INSIGHT Study

The Canadian INSIGHT (Implementing New Strategies with Insulin Glargine for Hyperglycemia Treatment) study was conducted in 405 insulin-naïve patients with type 2 diabetes.3

The initial dose of insulin glargine was 10 units once daily.3

A simple protocol of 1 unit per day was used for introduction of insulin glargine and self-titration of the glargine.3

Insulin glargine was injected at the same time each evening. 3

This insulin glargine protocol was 1.7 times more likely to safely achieve near-physiological control, defined as 2 consecutive HbA1c levels less than 6.5%,  than conventional therapy with oral antihyperglycemic medications.3

References

1Abasaglar [summary of product characteristics]. Eli Lilly Nederland B.V., The Netherlands.

2Rosenstock J, Hollander P, Bhargava A, et al. Similar efficacy and safety of LY2963016 insulin glargine and insulin glargine (Lantus®) in patients with type 2 diabetes who were insulin-naïve or previously treated with insulin glargine: a randomized, double-blind controlled trial (the ELEMENT 2 study). Diabetes Obes Metab. 2015;17(8):734-741. https://doi.org/10.1111/dom.12482

3Gerstein HC, Yale JF, Harris SB, et al. A randomized trial of adding insulin glargine vs. avoidance of insulin in people with type 2 diabetes on either no oral glucose-lowering agents or submaximal doses of metformin and/or sulphonylureas. The Canadian INSIGHT (Implementing New Strategies with Insulin Glargine for Hyperglycaemia Treatment) study. Diabet Med. 2006;23(7):736-742. http://dx.doi.org/10.1111/j.1464-5491.2006.01881.x

4Data on file, Eli Lilly and Company and/or one of its subsidiaries.

Date of Last Review: July 27, 2021


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