Long Acting Insulin

Insulin is used in the treatment of both type I and type II diabetes. Insulin treats these conditions by increasing uptake of serum glucose into cells, which lowers plasma glucose levels.  Insulin comes in short-acting, intermediate-acting, and long-acting forms.  Care must be taken on dosing to avoid hypoglycemic states, which can result in seizures and coma.  Potassium shifts into cells with administration of insulin, so hypokalemia can result from administration.

Class Drugs

• Insulin Glargine

• Insulin Detemir

• Insulin Degludec

Class Mechanism of Action

Mostly constant action over the course of 18 to 24 hours

Insulin increases uptake of serum glucose into cells, which lowers plasma glucose levels

• Insulin receptor is a transmembrane tyrosine kinase receptor

• Receptor activation results in glucose transporters moving from the cytoplasm to the cell membrane, which promotes glucose uptake.

Long-acting insulin begin working in 1-2 hours and last for 12-24 hours.

Class Applications

Diabetes mellitus

• Provides baseline glycemic control

Class Adverse Effects

Hypoglycemia

Injection site reactions

Drug Table

Drug Name	Application	Comments	Image
Insulin Glargine		Pharmacokinetics; No Peak Effect	"Large G"
Insulin Detemir		Pharmacokinetics; Slowly rises to peak at about 12 hours after injection, then decreases	"Determinant Tomato"
Insulin Degludec			"De-glue" "Deck of Cards"