Waching daily Sep 2 2018

So you are asking yourself—which is the better basal insulin?

Lantus® or Tresiba®?

The referee has declared the winner, and this fight wasn't even close!

First, some backstory to understand the importance of this epic match.

Lantus has been the champion of long-acting insulin for over fifteen years.

That's right!

Lantus was an amazing discovery for diabetes management: the first long-acting basal insulin.

Before the year 2000, doctors did not have many types of insulin to choose from.

Lantus is an analog of natural human insulin, meaning that the human insulin molecule was

changed slightly in the lab, creating differences in the way it is absorbed.

In the case of U-100 glargine (the generic name of Lantus), there is an amino acid substitution

and a slight lengthening of one of the two chains that make up the insulin molecule.

When Lantus is injected, this alteration increases the time over which the insulin is absorbed,

giving it a longer half-life than all the insulins available previously.

Fast-forward sixteen years, and Tresiba is now punching its way to the top of the basal

insulin market.

Several changes were made to slow the absorption of Tresiba, making its effect on lower blood

sugar more predictable.

As compared to regular insulin, Tresiba contains an amino acid deletion and a special bond

to a fatty acid.

These changes prolong the absorption of Tresiba, and allow it to reversibly bind to the main

protein in the blood, called albumin.

The result of these modifications is a new class of insulin referred to as 'ultra-long-acting

basal insulin.'

Some key differences between Lantus and Tresiba are:

Tresiba's half-life and duration of action are approximately twice as long as Lantus.

Tresiba has less variability in its ability to lower blood sugar values, meaning it is

more consistent.

Tresiba causes up to 50 percent less hypoglycemia as compared to Lantus.

There is also some evidence that Tresiba can be used at lower doses.

If switching from Lantus to Tresiba, it is recommended to start at 80 percent of the

dose.

The last major difference between Lantus and Tresiba is that Tresiba Flextouch can do some

damage to your pocketbook, as it weighs in at nearly twice the price of Lantus.

But even at its higher cost, Tresiba's prolonged absorption and length of action, less hypoglycemic

events as compared to Lantus, similar A1c reductions, and the added benefit of using

lower doses of insulin make Tresiba the clear winner of this insulin pen throwdown.