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Biologic
RCSB PDB 6K59

Insulin glargine

Lantus
Mechanism of action
Insulin (long-acting )
In plain language
A lab-made insulin that attaches to insulin receptors on muscle and fat cells so they pull sugar out of the blood, while also telling the liver to stop releasing extra sugar, with its slow-dissolving formula keeping this effect steady for about a full day.
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How it works
Insulin glargine binds to and activates the insulin receptor, a transmembrane , on skeletal muscle, adipose, and hepatic cells. Receptor activation triggers glucose transporter translocation that increases peripheral glucose uptake into muscle and fat, while simultaneously suppressing hepatic gluconeogenesis and glycogenolysis to lower hepatic glucose output. Unlike regular human insulin, glargine is formulated as a clear, acidic (pH 4) solution that forms microprecipitates upon subcutaneous injection into the neutral pH of tissue; these microprecipitates dissolve slowly and continuously, producing a relatively flat, peakless plasma insulin profile lasting up to 24 hours rather than the sharper peak-and-decline kinetics of regular or NPH insulin. This prolonged, steady release lets glargine serve as a basal insulin, providing consistent background glycemic control with once-daily dosing and less peak-related hypoglycemia risk than intermediate-acting formulations.
Therapeutic applications
Indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus, and in adults with type 2 diabetes mellitus, used as a once-daily basal insulin component of a diabetes treatment regimen; not indicated for treatment of diabetic ketoacidosis, for which intravenous short-acting insulin is preferred.
Class
analog
Therapeutic area
Metabolic / Diabetes
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