Definition: Basal insulin is long-acting insulin, usually injected once a day, that gives a steady background level of insulin. Examples with current US labels are insulin glargine (Lantus, Toujeo) and insulin degludec (Tresiba). In type 1 diabetes it is paired with mealtime insulin.
| Product | Strengths | When to inject |
|---|---|---|
| Lantus (glargine) | U-100 | Once daily, any time of day but the same time every day |
| Toujeo (glargine) | U-300 | Once daily |
| Tresiba (degludec) | U-100 and U-200 | Adults once daily at any time of day; children at the same time every day |
The Lantus label starts type 2 diabetes not already on insulin at 0.2 units/kg or up to 10 units once daily, and type 1 at about one-third of total daily insulin. The Tresiba label has an 8-hour rule for a missed adult dose; Lantus has no missed-dose rule.
The labels warn that changing insulin strength, maker or type can cause high or low blood sugar, so changes are made under close supervision. The Toujeo label says that unit for unit it lowers glucose less than Lantus, people switching needed higher doses in trials, and the full effect may take at least 5 days. None of these is recommended for treating diabetic ketoacidosis.
Long action means a low can last longer: the labels say recovery from hypoglycemia may be delayed. A log with the time of each basal dose shows whether you are keeping the same time and makes a missed or doubled dose easy to spot.
Read more on Dose Track: Lantus side effects · Toujeo side effects · Tresiba side effects · Lantus vs Tresiba