How is basal insulin used to treat diabetes?

Basal insulins are long-lasting. There are two basal insulins: Lantus and Levemir. Although they differ chemically, the net result is the same: this is a once a day shot for most people.

The effect of the insulin lasts for approximately 24 hours. Lantus is the older of the two. Each little super-micro drip of the Lantus insulin is wrapped in bubble wrap.

Once in your body, the bubble wrap begins to dissolve, releasing the insulin into your system a little at a time. Levemir acts the same way, except that it uses the black magic of molecular chemistry rather than bubble wrap. Depending on dosing, we often find that the Levemir gives patients a “flatter” BGL profile than Lantus does; a between-meal blood sugar graph of a Lantus shooter looks like a washboard road.

Levemir drivers are on the Autobahn; but in many folks it won’t last the full 24-hours, requiring two shots per day. That said, they are both damn good drugs. Although intended in both cases for once-a-day dosing, we’ll often have patients take both a bedtime and morning shot.

By making one dose larger than the other we can play games with the dosing that can help us give our patients more control. Most T-2s start with basal insulin. It will “lower the bar” for the whole day.

Every T-1 needs basal to keep BGLs in target between meals and overnight.

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