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Tresiba vs Lantus
Introduction
For patients with diabetes, either Type 1 or Type 2, certain insulin therapies can play a crucial role in managing blood sugar levels. Tresiba and Lantus are two such long-acting insulins that assist in the regulation of glucose. They both work by mimicking the body's natural basal insulin production, but they have different time-release mechanisms and duration of action.
Tresiba (Insulin Degludec) is an ultra-long-acting basal insulin characterized by an extended duration of action up to 42 hours, providing consistent blood sugar control throughout the day. On the other hand, Lantus (Insulin Glargine) is a long-acting basal insulin with a duration of roughly 24 hours.
Both insulins help lower HbA1c levels—a measure of average blood glucose over the past three months—however, their specific pharmacokinetic profiles may make one more suitable than another depending on individual patient needs.
Tresiba vs Lantus Side By Side
| Attribute | Tresiba | Lantus |
|---|---|---|
| Brand Name | Tresiba | Lantus |
| Contraindications | Severe hypoglycemia, diabetic ketoacidosis, allergies to insulin products, hypersensitivity reactions | Severe hypoglycemia, diabetic ketoacidosis, allergies to insulin products, hypersensitivity reactions |
| Cost | Around $500 for 5 pens (3 mL each) of Tresiba FlexTouch (100 units/mL) | Around $275 for a similar amount (5 mL vial) |
| Generic Name | Insulin Degludec | Insulin Glargine |
| Most Serious Side Effect | Signs of allergic reactions, rapid heartbeat, shortness of breath, swelling in your face, lips, tongue or throat, changes in vision, fluid retention, low potassium levels | Severe allergic reaction, low potassium levels, severe hypoglycemia, changes in vision, mood swings and confusion |
| Severe Drug Interactions | Not specified in the article, but typically includes interactions with other medications that affect blood glucose levels | Not specified in the article, but typically includes interactions with other medications that affect blood glucose levels |
| Typical Dose | Started at the same unit dose as current basal insulin, adjusted based on response | 0.2 units/kg/day, adjusted to achieve target fasting blood glucose levels |
What is Tresiba?
Insulin degludec (the generic name for Tresiba) is a novel, ultra-long-acting basal insulin analogue that was first approved by the FDA in 2015. It provides stable and consistent levels of basal insulin over a long period of time, effectively maintaining blood sugar levels in diabetic patients for longer than usual. It is prescribed to control high blood sugar in adults with diabetes mellitus. Insulins like Tresiba have selective influence on glucose metabolism with only minor influence on lipid metabolism.
On the other hand, insulin glargine (the generic name for Lantus), another long-acting human insulin analogue, has been available since its approval by the FDA in 2000. Both medications are used to improve glycemic control but they differ slightly: while both provide comparable efficacy, Tresiba offers more flexibility as it can be taken at any time of day whereas Lantus should be taken at the same time each day. Also, some studies suggest that Tresiba might carry a lower risk of hypoglycemia compared to Lantus.
What conditions is Tresiba approved to treat?
Tresiba is approved for the treatment of both Type 1 and Type 2 diabetes:
- It provides a basal level of insulin, meaning it is designed to cover your body's needs for insulin throughout the entire day.
- Tresiba has a longer duration of action than Lantus, lasting up to 42 hours. This allows greater flexibility in dosing times.
- It can be used by adults and children as young as one year old.
How does Tresiba help with these illnesses?
Tresiba helps to manage diabetes by mimicking the function of insulin in regulating blood glucose levels. It accomplishes this by binding to the insulin receptors on cells, promoting the uptake of glucose from the bloodstream and its utilization or storage within these cells. Insulin is a hormone that plays a vital role in carbohydrate metabolism, fat storage and protein synthesis among other things. Individuals with type 1 diabetes produce insufficient amounts of insulin whereas those with type 2 may have sufficient quantities but their body's response to it is diminished (insulin resistance). Therefore, by providing an external source of insulin-like action, Tresiba can help regulate blood glucose levels and mitigate symptoms associated with hyperglycemia such as frequent urination, increased thirst and unexplained weight loss.
What is Lantus?
Lantus, also known by its generic name insulin glargine, is a long-acting basal insulin analog that helps regulate glucose levels over a 24-hour period. It was first approved by the FDA in 2000. Lantus works similarly to naturally occurring human insulin but has been modified slightly to slow down its absorption and provide steady blood sugar control throughout the day and night.
Unlike Tresiba, which can last up to 42 hours, Lantus consistently lasts for about 24 hours with no pronounced peak. This makes it more predictable and less likely to cause hypoglycemia (low blood sugar), making it an essential tool in managing Type 1 or Type 2 diabetes effectively. However, as it only covers basal needs (background insulin), mealtime rapid-acting insulins are usually still required.
Common side effects of Lantus include low blood sugar episodes, weight gain and reactions at the injection site—similar issues often faced with other types of injectable insulin therapies like Tresiba.
What conditions is Lantus approved to treat?
Lantus is approved for the long-term management of diabetes and has been a trusted name in insulin therapy. Here are some of the conditions it helps manage:
- Type 1 Diabetes Mellitus: It's often used as a basal insulin, providing consistent glucose control throughout the day and night.
- Type 2 Diabetes Mellitus: Lantus is also an important part of managing type 2 diabetes, where it can be used alongside diet modification and regular exercise to maintain optimal blood sugar levels.
How does Lantus help with these illnesses?
Just like Tresiba, Lantus is a long-acting insulin used to manage blood sugar levels in people with diabetes. Insulin is a hormone that controls the amount of glucose in your body and ensures it's properly utilized for energy production. It plays roles much like norepinephrine does in affecting various processes within the body such as metabolism, energy storage, and control of blood sugar levels. Lantus works by mimicking the action of natural insulin, slowly releasing over time to maintain a steady level of insulin throughout the day and night. This helps keep blood glucose levels under control for those who have difficulties producing sufficient or effective insulin naturally. It's often prescribed when shorter acting insulins are not successful in maintaining stable blood glucose levels or may be combined with them for better management.
How effective are both Tresiba and Lantus?
Both insulin degludec (Tresiba) and insulin glargine (Lantus) are long-acting insulins with well-documented effectiveness in managing blood glucose levels for patients with diabetes. They were approved by the FDA several years apart, with Lantus gaining approval in 2000, followed by Tresiba in 2015.
Direct comparisons between Tresiba and Lantus have been conducted, including a study published in Diabetes Care journal where both drugs showed similar efficacy regarding glycemic control. The trial concluded that both medications had comparable safety profiles and provided effective basal insulin coverage over a 24-hour period.
However, some differences emerge upon closer look at these two insulins. A meta-analysis from 2018 suggested that patients taking Tresiba may experience fewer nocturnal hypoglycemia episodes compared to those on Lantus. This can be particularly important for individuals who struggle with overnight low blood sugar levels.
Tresiba's formulation also allows it to last up to 42 hours which gives added flexibility if doses need to be adjusted or missed whereas Lantus lasts around 24 hours. However, this extended duration should not encourage irregular dosing patterns as maintaining consistent daily administration is key for optimal effect of the medication.
Similarities exist too; both medications have demonstrated reduction of HbA1C values – an indicator of average blood sugar level over time - suggesting their reliable role in long-term management of diabetes across different patient populations.
As always though individual factors such as patient lifestyle, comorbid conditions and personal preferences play vital roles when choosing between these two options.
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At what dose is Tresiba typically prescribed?
Dosages of Tresiba (insulin degludec) can vary greatly based on the individual's need, but it is typically started at the same unit dose as current basal insulin. It can be administered once daily at any time of day. For children and adolescents who are new to insulin therapy or switching from another long-acting insulin like Lantus, starting doses may depend on their weight and overall medical condition. The dosage can be adjusted after a few days if there is no adequate response in controlling blood sugar levels. Unlike some other insulins, there is no set maximum dosage for Tresiba; its use should be tailored to meet the specific needs of each patient under professional medical supervision.
At what dose is Lantus typically prescribed?
Lantus is usually started at a dosage based on the patient's weight, typically 0.2 units/kg/day. The dose can then be adjusted to achieve target fasting blood glucose levels. Lantus is administered once daily at any time of day but should be given at the same time every day for best results. It's important to note that more frequent blood sugar monitoring may be required during dosage adjustment or if there is no response to treatment after a few weeks. Regular check-ups are recommended as your doctor might adjust your dose depending on your needs and reactions to the medication.
What are the most common side effects for Tresiba?
Common side effects of Tresiba and Lantus include:
- Hypoglycemia (low blood sugar), symptoms may involve shakiness, sweating, fast heartbeat
- Injection site reactions such as redness, swelling or itching
- Weight gain
- Headache
- Upper respiratory tract infection (common cold symptoms)
- Back pain
- Flu-like symptoms (fever, body aches)
- Sinusitis (inflammation of the sinus cavities in the head)
While these are some shared side effects between Tresiba and Lantus insulin medications, it's important to note that individual experiences can vary significantly. Always consult your healthcare provider for personalized advice.
Are there any potential serious side effects for Tresiba?
While Tresiba and Lantus are both long-acting insulins designed to help people with diabetes maintain steady blood sugar levels, they can sometimes cause side effects. For Tresiba, these can include:
- Signs of allergic reactions: itching, rash, trouble breathing or swallowing
- Rapid heartbeat or palpitations
- Shortness of breath or difficulty breathing
- Swelling in your face, lips, tongue or throat.
- Changes in vision such as blurred vision
- Fluid retention causing swelling (edema) particularly noticeable in the ankles and feet Low potassium levels - symptoms may include dry mouth, increased thirst and urination; irregular heartbeats; muscle pain or weakness.
For a small percentage of users there is also the risk of systemic allergic reaction known as anaphylaxis which manifests as severe skin rashes/hives along with fever.
If you experience any such symptoms while using Tresiba it is important to seek medical attention immediately.
What are the most common side effects for Lantus?
Lantus, a long-acting insulin, has its own set of potential side effects that are important to consider:
- Injection site reactions such as pain, redness or swelling
- Low blood sugar (hypoglycemia)
- Weight gain
- Allergic reactions like rash or itching
- Swelling of the hands and feet (edema)
- Muscle pain or weakness
- Headache, dizziness
- Blurred vision While most people tolerate Lantus well, these side effects can occur and it's essential to address any concerns with your healthcare provider.
Are there any potential serious side effects for Lantus?
While Lantus is generally safe and effective for managing blood sugar in diabetes, it's important to be aware of potential serious side effects. These can include:
- Signs of a severe allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Low potassium levels (hypokalemia), which may cause muscle weakness or irregular heartbeats
- Severe hypoglycemia (low blood sugar) that can lead to seizures, unconsciousness or even death if not treated promptly
- Symptoms indicating changes in vision like blurred vision or other visual disturbances
- Mood swings and confusion might also indicate shifts in your blood glucose levels which require immediate attention Remember that these are very rare side occurrences but should you experience any of them while on Lantus therapy - get medical help immediately.
Contraindications for Tresiba and Lantus?
Both Tresiba and Lantus, along with most other insulin medications, may cause low blood sugar (hypoglycemia) in some people. If you notice symptoms of hypoglycemia such as shaking, sweating, rapid heartbeat or blurred vision, please seek immediate medical attention.
Neither Tresiba nor Lantus should be used if you are experiencing an episode of severe hypoglycemia or diabetic ketoacidosis. Always inform your physician about all the medications you are taking; this includes both prescription drugs and over-the-counter medicines. Certain oral diabetes medications could increase your risk for serious or life-threatening complications when taken in conjunction with Tresiba or Lantus.
You must also share information about any allergies to insulin products as well as past experiences with hypersensitivity reactions to ensure that either medication is safe for your use. Both these medications take a while to act so they cannot replace fast-acting insulins during emergencies.
How much do Tresiba and Lantus cost?
For the brand name versions of these drugs:
- The price of 5 pens (3 mL each) of Tresiba FlexTouch (100 units/mL) averages around $500, which works out to about $1.67 per injection, depending on your dose.
- The price for a similar amount (5 mL vial) of Lantus is about $275, working out to approximately $0.91 per injection.
Thus, if you are in the higher dosage range for Tresiba (i.e., more than one injection per day), then brand-name Lantus is less expensive on a per-injection basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
Currently there are no generic forms available for either insulin detemir (Tresiba) or insulin glargine (Lantus). Both medications remain patented and therefore costs remain relatively high compared to other types of insulin. Prices may vary significantly depending upon insurance coverage and location.
Popularity of Tresiba and Lantus
Insulin degludec, in generic form as well as brand names such as Tresiba, was estimated to have been prescribed to about 1.6 million people in the US in 2020. Insulin degludec accounted for just over 11% of long-acting insulin prescriptions in the US. However, it appears to be increasingly favored due to its extended duration and more flexible dosing times compared with other long-acting insulins.
Insulin glargine, including brand versions such as Lantus, was prescribed to around 7.5 million people in the USA during the same year. In terms of overall long-acting insulin prescriptions, Lantus accounts for nearly half (48%). The prevalence of Lantus has shown a slight decrease since reaching peak usage around 2013 but remains a popular choice among clinicians due to its extensive clinical experience and reliable performance.
Conclusion
Both Tresiba (insulin degludec) and Lantus (insulin glargine) are long-acting insulins used in the management of both type 1 and type 2 diabetes. They have been widely studied, with clinical trials showing their efficacy in controlling blood glucose levels compared to placebo treatments. While they can be used together under certain circumstances, it requires careful consideration by a healthcare provider due to potential risks such as hypoglycemia.
Tresiba has a longer duration of action than Lantus — up to 42 hours compared to approximately 24 hours for Lantus. This gives Tresiba more flexibility in terms of dosing time, which might suit some patients' schedules better.
Both medications come in pen form for easy self-injection but only Lantus is available in generic form (Lantus biosimilar: Basaglar), which may represent significant cost savings especially for those paying out-of-pocket.
The side effect profiles between the two drugs are similar and generally well-tolerated, although there may be individual variations. The most common side effect is low blood sugar (hypoglycemia). It's important that patients closely monitor their blood sugar levels when starting treatment or adjusting doses, and seek medical help immediately if they notice signs of severe hypoglycemia such as confusion, unconsciousness or seizures.
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Refrences
- Wakil, A., & Atkin, S. L. (2012, February 15). Efficacy and safety of ultra-long-acting insulin degludec. Therapeutic Advances in Endocrinology and Metabolism. SAGE Publications.http://doi.org/10.1177/2042018812437181
- Stokes, V., & Gough, S. C. (2014, May 9). Recent advances with insulin degludec for the treatment of Type 2 diabetes. Expert Review of Endocrinology & Metabolism. Informa UK Limited.http://doi.org/10.1586/17446651.2014.917045
- Yki‐Järvinen, H. (2004, June). Insulin therapy in type 2 diabetes: role of the long‐acting insulin glargine analogue. European Journal of Clinical Investigation. Wiley.http://doi.org/10.1111/j.1365-2362.2004.01356.x
- Elrishi, M., Jarvis, J., Khunti, K., & Davies, M. (2008, August). Insulin glargine and its role in glycaemic management of Type 2 diabetes. Expert Opinion on Drug Metabolism & Toxicology. Informa Healthcare.http://doi.org/10.1517/17425255.4.8.1099
- Fadini, G. P., Feher, M., Hansen, T. K., de Valk, H. W., Koefoed, M. M., Wolden, M., … Jendle, J. (2019, August 9). Switching to Degludec From Other Basal Insulins Is Associated With Reduced Hypoglycemia Rates: A Prospective Study. The Journal of Clinical Endocrinology & Metabolism. The Endocrine Society.http://doi.org/10.1210/jc.2019-01021
- Keating, G. M. (2013, April 26). Insulin Degludec and Insulin Degludec/Insulin Aspart: A Review of Their Use in the Management of Diabetes Mellitus. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-013-0051-1