Insulin Glargine is given subcutaneously once a day. It may be administered at any time during the day, however, at the same time every day. It is not intended for intravenous administration. The desired blood glucose levels as well as the doses and timing of Insulin Glargine, must be determined and adjusted individually by the physician. Insulin is usually administered in the abdominal wall, the thigh, the gluteal region or the deltoid region. Although absorption of Insulin Glargine does not differ between the injection sites, as with all insulin, injection sites must be rotated from one injection to the next to avoid lipodystrophy. The average range of total daily insulin requirement for maintenance in type 1 diabetic patients ranges between 0.5 and 1.0 IU/kg. Further, in insulin resistance, the daily requirement of insulin may be substantially higher. In patients with type 2 diabetes treated with insulin and other oral antidiabetic agents, the requirements of insulin are lower i.e. approximately 0.3-0.6 IU/kg/day. Dose adjustment may be required, if patients undertake increased physical activity or change their usual diet or if the patient's weight or lifestyle change or other circumstances arise that increase susceptibility to hypo or hyperglycemia. Any change of insulin dose should be made cautiously and only under medical supervision.
Changeover to Insulin Glargine: The initial dose of Insulin Glargine should be determined individually, depending on the desired blood glucose levels. When changing from a treatment regimen with intermediate- or long-acting insulin to a regimen with insulin Glargine, the amount and timing of short-acting insulin or fast-acting insulin analogue or the dose of any oral antidiabetic drug may need to be adjusted. A close metabolic monitoring under medical supervision is recommended during changeover and in the initial weeks thereafter. With improved metabolic control and resultant increase in insulin sensitivity (reduced insulin requirements), further adjustment of the dose of Insulin Glargine and other insulin or oral antidiabetic agents in the regimen may become necessary. Internationally accepted label of Insulin Glargine suggest that on transferring patient from twice daily NPH human insulin to Insulin Glargine Injection once daily, to reduce the risk of hypoglycemia the initial dose (IU) was usually reduced by approximately 20% (compare to total daily IU of NPH human insulin) and then adjusted based on patient response.
Paediatric Use: Insulin Glargine can be administered to children aged 6 years and older. Administration to children less than 6 years of age has not been studied.