Lantus®, officially known as insulin glargine, is a long-acting insulin that is commonly used to treat patients with diabetes mellitus. This medication has a long-acting effect on the body's blood sugar levels, and is therefore typically given as a once-daily injection. The proper dose of this medication varies depending on what type of diabetes the patient has. Patients with kidney dysfunction typically need to be given reduced doses of this medication.
One important factor affecting Lantus® dosage is what type of diabetes the patient has. Type 1 diabetes mellitus develops when the pancreas is unable to make insulin, which is a hormone important in decreasing the level of glucose, or sugar, in the blood. The body typically has a normal response to insulin that is administered as a pharmaceutical agent. These patients therefore only require enough insulin to replace the function of the pancreas, and often this amount is calculated based on body weight and daily carbohydrate intake.
Patients with type 2 diabetes mellitus require different Lantus® dosage as compared to patients with type 1. These patients have resistance to insulin, and although their pancreas can make its own insulin, the organs and tissues of the body to not have an appropriate response to this insulin. As a result, they need supplemental insulin in order to maintain normal blood glucose levels. Due to the body's insulin resistance, they often require an increased dose compared to patients with type 1. An adequate dose is often determined on a trial-and-error basis, and often this dose has to be increased over time as the body becomes less and less sensitive to the effects of insulin.
When uncontrolled for years, diabetes can often reduce the function of the kidneys. For this reason, many patients taking insulin to treat their diabetes might have coexisting problems with their renal function. The Lantus® dosage must be decreased in patients with impaired kidney function. Although often the correct dose is titrated over time by observing how a patient's blood sugar levels respond to a given dose of insulin, an initial suggestion for dosing patients with impaired renal function is to give them 75% of what a person with normal kidneys would be given.
Another factor affecting Lantus® dosage is how often the medication needs to be administered. In most cases, the insulin is given once daily, typically at the same time everyday. The medication can be given in this fashion because it exerts a constant, low-level effect on how the body controls its blood sugar levels. Some physicians or other health care providers prefer to give the medication twice daily in order to obtain better blood glucose control in patients who continue to have elevated levels on a once-daily Lantus® dosage.