【藥品性質提示】 #高警訊藥品 【藥品訊息】 Lantus SoloStar 胰島素筆 紫 衛教單張

糖尿病 (基礎胰島素) Type 1 and type 2 diabetes mellitus

Insulin, Long-Acting
Insulin acts via specific membrane-bound receptors on target tissues to regulate metabolism of carbohydrate, protein, and fats. Target organs for insulin include the liver, skeletal muscle, and adipose tissue.

1. Onset of action: 3 to 4 hours
2. Duration: Generally 24 hours or longer
3. Absorption: Slow; upon injection into the subcutaneous tissue, microprecipitates form which allow small amounts of insulin glargine to release over time
4. Metabolism: Partially metabolized in the subcutaneous depot at the carboxyl terminus of the B chain to form two active metabolites, M1 (21A-Gly-insulin) and M2 (21A-Gly-des-30B-Thr-insulin)
5. Time to peak, plasma: subtle peak at ~10 to 12 hours

1. Hypoglycemia
2. Hypersensitivity to insulin glargine or any component of the product

Because insulin glargine has an increased affinity to the insulin-like growth factor (IGF-I) receptor, there are theoretical concerns that it may contribute to adverse events when used during pregnancy.

According to the manufacturer, the decision to breastfeed during therapy should consider the risk and benefits.

Common:
1. Dermatologic: Injection site pain, Pruritus, Rash
2. Endocrine metabolic: Hypoglycemia, Lipodystrophy, Nocturnal hypoglycemia
3. Respiratory: Nasopharyngitis
4. Other: Infectious disease
Serious:
1. Cardiovascular: Edema
2. Endocrine metabolic: Hyperglycemia, Hypoglycemia, Severe symptomatic, Hypokalemia
3. Immunologic: Hypersensitivity reaction
4. Other: Body fluid retention

Diabetes mellitus, type 1: SUBQ
1. Initial TDD: 0.4 to 0.5 units/kg/day in divided doses; conservative initial doses of 0.2 to 0.4 units/kg/day may be considered to avoid hypoglycemia
2. Usual TDD maintenance range: 0.4 to 1 units/kg/day in divided doses
Diabetes mellitus, type 2, treatment: SUBQ
1. Initial 10 units once daily or 0.1 to 0.2 units/kg once daily
2. For persistently elevated fasting plasma glucose: Increase daily dose by 2 to 4 units or by 10% to 20% every 2 to 3 days to achieve fasting plasma glucose target while avoiding hypoglycemia
3. For hypoglycemia: Consider decreasing daily dose by 10% to 20%; for severe hypoglycemia, consider reducing by 20% to 50%
4. For elevated HbA1c despite achieving fasting plasma glucose target: Consider intensification of lifestyle modifications and/or medications that target postprandial glucose rather than increasing the insulin glargine dose; higher insulin glargine doses (eg, >0.5 units/kg/day) may provide diminishing additional improvements in HbA1c

Children ≥6 years and Adolescents:
1. Approximately one-third of the total daily insulin requirement administered once daily
2. A rapid-acting or short-acting insulin should also be used to complete the balance (~2/3) of the total daily insulin requirement; Adjust dosage according to patient response.

There are no dosage adjustments provided in the manufacturer's labeling; insulin requirements may be reduced due to changes in insulin clearance or metabolism; monitor blood glucose closely.

There are no dosage adjustments provided in the manufacturer's labeling; insulin requirements may be reduced due to changes in insulin clearance or metabolism; monitor blood glucose closely.