Building Competency in Diabetes Education THE ESSENTIALS

BASAL-BOLUS INSULIN THERAPY | 12-41

Table 2. Comparison of basal insulins used in BBI therapy (84-886)

N/NPH

Glargine U100 Basaglar

Detemir

Glargine U300

Degludec U100/U200

• Relatively peakless • Time to steady state ~4 days • Duration in steady state up to 24 hours

•Relatively peakless • Time to steady state ~4 days. If BID, then after 2-3 injections • Duration in steady state 16-24 h dose dependent

• Peakless • Time to steady state ~4 days • Duration in steady state more than 30h • Will require higher dose

• Peakless • Time to steady state ~3-4 days • Duration in steady state 42h

Action

• Peak: 5–8 h • Duration: up to 18h

• Less

• Even less variability, more predictable

• Even less variability more

Variability in absorption

Yes

• Less variability, more predictability than NPH.

variability, more predictability than NPH and glargine.

predictable than glargine U100.

than glargine U100.

• Less than NPH and glargine.

• Even less

• Even less

Hypoglycemia

Yes

• Less than NPH. With similar or lower A1C.

overall and nocturnal hypo. With similar A1C.

overall and nocturnal hypo. With similar A1C.

With similar or lower A1C.

• Initiate once daily; May need twice daily.

• Once • Flexible dosing • Can be taken at any time of day. • Needs to have minimum 8 h between injections.

Once-or twice- daily injections

May need twice daily

• Initiate once

• Once daily

daily. May need twice daily. • Can be taken at any time of day.

preferably at the same time but can be up to +/- 3 h before or after usual time. • Flexible dosing: breakfast, lunch, dinner or bedtime. • 3 h grace

When stored at room temperature

28 days

28 days

42 days

42 days

56 days

Weight

Usual gain

Usual gain

Less gain, neutral or possible loss

Usual gain or less gained

Usual gain

Cost

$

$ ½ -$$

$$

$$$

$$$