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Long-acting insulin, also known as basal insulin, is a type of insulin used in diabetes management. It is designed to provide a steady and consistent release of insulin into the bloodstream over an extended period, typically up to 24 hours. The primary purpose of long-acting insulin is to help control blood sugar levels between meals and overnight.
People who have type 1 diabetes will always need insulin therapy, and many people who have type 2 diabetes will also need it. Basal insulin analogs are being used more and more to treat diabetes. Their goal is to be a better copy of the pattern of insulin release by the body at rest. With a flatter pharmacodynamic profile, a much lower peak of action, slow and continuous absorption into the systemic circulation, and longer duration, they work more like the body’s own insulin, which controls blood sugar levels naturally and allows for more flexible treatment with fewer hypoglycemic episodes. The basal analogs can be used in a variety of insulin regimens and have the same clinical effectiveness as regular insulins. They also help with high blood glucose and weight gain, and they may be an option for patients who are still having problems with hypoglycemia even after conventional insulin therapy has been optimized.
Long-acting insulin comes in several varieties, including:
1. Insulin Glargine (Lantus, Toujeo): After injection, this type of long-acting insulin produces a micro-precipitate in the subcutaneous tissue, allowing for a steady and consistent release of insulin.
2. Insulin Detemir (Levemir): Another long-acting insulin, Levemir operates by attaching to proteins in the blood, resulting in a slow and persistent release.
3. Tresiba (insulin degludec): Tresiba is a newer long-acting insulin with an ultra-long duration of action of up to 42 hours.
Long-acting insulin is normally given once day, while some people may need to take it twice daily based on their particular needs and the advice of their healthcare professional. It provides a baseline dose of insulin to keep blood sugar steady throughout the day, and it is frequently used in conjunction with short-acting or rapid-acting insulin to reduce post-meal blood sugar rises.
Long-acting Insulin has a long half-life:
- Is slowly absorbed, has a low peak effect, and a sustained plateau effect that lasts the majority of the day.
- Is used to regulate blood sugar levels overnight, when fasting, and between meals.
Long-acting insulin analogs (Insulin Glargine, Insulin Detemir) with an insulin action start time of 1 1/2-2 hours. The insulin impact peaks within a few hours, followed by a very flat duration of action lasting 12-24 hours for insulin detemir and 24 hours for insulin glargine.
|Detemir||1 hr.||Flat, Max effect in 5 hrs.||12-24 hr.||clear|
|Glargine||1.5 hr.||Flat, Max effect in 5 hrs.||24 hr.||clear|
Individuals with diabetes must collaborate closely with their healthcare team to establish the optimum type of insulin and dose plan for their personal needs and lifestyle.