There are many different types of insulin glargine, but the two most popular are Randas and Basagler.
Lantus was introduced to the market in 2000, while Basaglar was introduced as a “biosimilar” option in 2015
Lantus and Basaglar are both prescribed to treat patients with type 1 and type 2 diabetes and are very similar, but not always compatible.
This article explains these two common types of insulin, their uses. This may be a better option for you.
Need for basal insulin
All people need insulin to survive, whether they have diabetes or not. However, people with diabetes cannot produce their own insulin or use insulin, which the body produces properly (some people with type 2 experience this in the form of insulin resistance).
Those who choose not to use insulin pump therapy and therefore need multiple daily injections (MDIs) will need both basal and bolus insulin.
Basal insulin or “background” insulin has one major job. Keep it overnight when you’re not eating (when fasting) or sleeping.
Long-term (basal) insulin is unique in the sense that it slowly releases long-term infusion insulin, in contrast to short-acting insulin, which is released and absorbed much faster in the body.
Long-acting insulin works well with bolus insulin (short-acting insulin) that is collected for all foods consumed (particularly carbohydrates).
Because all humans always need insulin without eating anything, people with diabetes experience severe hyperglycemia (hyperglycemia) without taking basal insulin.
There are many categories of long-acting insulin.
- Intermediate action insulin (NPH), peaking for 8 hours, lasting 12-16 hours
- Long-acting insulin (detemir or glargine), no peak, lasting about 24 hours
- Super long acting insulin (degrudec), no peak, lasting up to 42 hours
The most common form of long-acting insulin is glargine. Glargine has two brand names: Basaglar and Lantus.
What is Lantas?
Lantus was first developed in 2000 by insulin maker Sanofi and is used to treat both type 1 and type 2 diabetes.
Lantus was one of the first long-acting insulins on the market, creating modern carbohydrate counts, taking food insulin (rather than the reverse) and making the carbohydrate-carbohydrate ratio a reality.
The introduction of Lantus has been innovative for those receiving multiple daily injections to remove the snacks needed throughout the day that are needed to counter the peaks of intermediate-acting insulin such as NPH.
Introduction of Randas into the market has significantly reduced the number of nocturne hypoglycemic events experienced by people with diabetes, significantly reducing the stable, slow release of insulin over a 24-hour period, and improving the longevity of many people living with diabetes. This is still a very popular option for those participating in MDI.
Lantus comes in both insulin vials and insulin pen versions.
What is a Basagler?
Developed by Eli Lilly & Company, Basaglar was first introduced in 2015. The reason for the 15-year delay is that because Lantus was patent protected for the first 15 years, other insulin manufacturers were unable to create similar insulins that competed for market share until those patents expired.
Basaglar was the first “biosimilar” insulin approved by the Food and Drug Administration, the first to be launched in the US, paving the way for more affordable options in the insulin market.
Other pharmaceutical companies, such as Mylan/Biocon and Merk/Samsung Bioepis, are also working on biosimilar glargine insulin, which should lower prices as competition rises.
Like Lantus, Basaglar is slowly released over a 24-hour period with no peaks.
Although the two insulins work very similarly (including the same protein sequence and the lowering effect of blood glucose), their chemical formulas are very slightly different, so diabetics cannot simply switch between other types of insulin without the guidance of a doctor.
Basaglar is only available via an insulin pen called Kwikpen.
What is the difference between these two insulins?
These insulins are very similar, but people may react differently to the composition of chemicals.
Adverse events (although rarely, it can happen) such as late absorption times, skin irritation, and slight peaks, can occur if you try one insulin and not another.
Always work with your provider to see what your best option is.
Another major difference between these two insulins is cost. The out-of-pocket costs for each US are as follows:
- Lantus: $425 for 5 pens (300 pieces) or about $285 for one vial (1,000 units)
- Basaglar: $326 for 5 pens (300 units)
This makes sense. This is because Basagler was introduced as a more affordable option for Lantus.
Is Lantus or Basaglar effective for glycemic control?
Two insulins are equally effective in controlling glycemic glucose. The difference you may experience is the result of individual reactions to insulin, not because one brand is superior to the other.
Can I replace Lantas with a Basagler?
Basaglar is not a general equivalent to Lantus, so the two are not interchangeable.
Lantus and Basaglar contain the same active ingredients, but they are made differently and are made by different companies. This means that the Basagler is not an exact replica of Lantas.
If you have been prescribed it and want to switch to the other, your doctor will need to write a new prescription. Your pharmacist cannot replace one with another without your doctor’s approval.
What are the side effects of these two insulins?
The main side effect of these two insulins is hypoglycemia. Symptoms of hypoglycemia include:
- headache
- Weakness
- sweating
- Increased heart rate
- Awkward concentration
- Hungry
- syncope
- Shakakkes
- In severe cases, seizures
Other common side effects of glargine include:
- Skin irritation at the injection site
- Redness at the injection site
- Pain and swelling at the injection site
- Thickening or indentation of the skin at the site of injection
If you are pregnant, plan to get pregnant or breastfeeding and talk to a doctor who wants to start glargine. Insulin requirements vary during and after pregnancy.
Which type of insulin is the right type for me?
There are many reasons why people choose one of these insulins over the other. There may be very specific preferences for the long-acting insulin type of choice.
Perhaps you don’t want to use an insulin pen (and want to go with Lantus), or just use an insulin pen (make Basaglar your chosen insulin).
Maybe you have experienced side effects on one type of insulin, not another type of insulin (pain, swelling, itching, redness, or swelling at the site of injection are common side effects of both Lantas and Basagler).
Perhaps your body metabolizes one insulin better than the other. Some people may find that one insulin or another does not last completely for 24 hours and that the dosage needs to be split.
To ensure you know, you need to work with your provider to see what they recommend.
We’ll talk about your lifestyle and health goals and ask for their advice, but both insulins are highly appreciated, and choosing the best for you and your diabetes management is ultimately up to you!
