Tresiba vs. Lantus: Similarities and Differences

Medically reviewed by Mary Choy, PharmD

Tresiba (insulin degludec) and Lantus (insulin glargine) are Food and Drug Administration (FDA)-approved synthetic insulins for glycemic control (blood sugar levels) in people with type 1 or type 2 diabetes.

As long-acting insulin products, Tresiba and Lantus are administered similarly (subcutaneous [under the skin] injection), share similar dosing instructions, work similarly (via their mechanism of action), and are used for the same conditions.

However, more than their differing active ingredients, these drugs share notable differences, such as how quickly each works (their onset of action) and how long they work to control blood sugar levels following administration.

For example, Tresiba works up to 42 hours, while Lantus works up to 24 hours.

This article will provide an in-depth analysis of Tresiba versus Lantus, focusing on their respective uses, dosing, potential side effects, and storage requirements, among other need-to-know points of information regarding their administration.

Rising Prevalence of Diabetes

The following discusses the definition of diabetes (officially known as diabetes mellitus) and notable statistics regarding its prevalence within the United States.

What Is Diabetes?

There are two primary types of diabetes: type 1 and type 2:

In type 1, the pancreas does not make insulin because the immune system attacks the cells in the pancreas that create insulin.

In type 2 diabetes, the pancreas produces less insulin over time, and your body becomes insulin-resistant.

Blood sugar levels can rise when a person is deprived of adequate insulin or when cells stop responding to insulin.

As a result, high blood sugar is damaging to the body and causes many of the symptoms and complications of diabetes.

Over time, diabetes can lead to severe health problems, including kidney failure and heart disease (HD).

Diabetes Statistics

Diabetes is a growing epidemic.

According to the World Health Organization (WHO), diabetes will be one of the world's leading causes of death and disability in the next quarter century.

At the current rate, some 300 million people will be affected by diabetes by the year 2025, as predicted by the WHO.

Currently, there are more than 17 million people with type 2 diabetes in the United States.

Type 1 diabetes is less common than type 2. Nearly 5% to 10% of people with diabetes have type 1.

Understanding Synthetic Insulin

Insulin is a pancreatic hormone that controls blood sugar.

Synthetic versions of natural insulins (human-made, artificial versions) are used when insulin hormones cannot control blood sugar levels. Human insulin is synthetically made in a lab using E. coli bacteria.

Synthetic insulin works by replacing the insulin usually produced by the body and helping move sugar from the blood into other body tissues used for energy.

Tresiba (insulin degludec) and Lantus (insulin glargine) are two long-acting synthetic insulin analogs, drugs used to regulate glucose metabolism by stimulating glucose uptake.

Long-acting synthetic insulin analogs also inhibit liver glucose production.

Insulin inhibits lipolysis (breakdown of fats) and proteolysis (breakdown of proteins into amino acids) and enhances protein synthesis (the process in which cells make proteins).

What Is Tresiba?

Tresiba is an FDA-approved, brand-name insulin degludec administered via subcutaneous injection.

Tresiba is approved to control blood sugar levels in adults and children 1 year and older with type 1 or type 2 diabetes.

For people with type 1 diabetes, Tresiba must be used with another type of short-acting insulin. In those with type 2 diabetes, it may be used with another insulin or oral diabetes drug.

This medication, however, is not recommended for the treatment of diabetic ketoacidosis (DKA, increased ketones in the blood or urine).

How It Works

Tresiba replaces the insulin usually produced by the body, helping move sugar from the blood into other body tissues for energy production.

Tresiba also stops the liver from producing excess levels of blood sugar.

Brand-Name Associations

Tresiba is available in different combinations with other insulins administered via subcutaneous (under the skin) injection.

Other brands that include insulin degludec include Xultophy (insulin degludec/liraglutide).

What Is Lantus?

Lantus is an FDA-approved, brand-name insulin glargine administered via subcutaneous injection. More specifically, Lantus can be classified as a long-acting synthetic insulin.

Lantus controls high blood sugar in adults and children 1 year and older with type 1 or type 2 diabetes.

For people with type 1 diabetes, Lantus must be used with another type of short-acting insulin. In those with type 2 diabetes, it may be used with another insulin or oral diabetes drug.

Like Tresiba, Lantus is not for use in diabetic ketoacidosis.

How It Works

Like Tresiba, Lantus works by replacing the natural insulin the pancreas produces.

It lowers blood sugar levels by stimulating its uptake by skeletal muscle and fat and inhibiting its production in the liver.

Brand-Name Associations

Lantus is available in different combinations with other insulins administered via subcutaneous injection.

Other brand-name products that contain insulin glargine include Basaglar and Toujeo.

Combinational brand-name products containing insulin glargine and other insulin include:

• Soliqua (Insulin glargine/lixisenatide)

• Rezvoglar (Insulin glargine-aglr)

• Semglee (insulin glargine-yfgn)
  

Which Is More Effective?

Tresiba and Lantus are safe and effective options for managing diabetes.

However, one study analyzing people new to diabetes medications demonstrated significantly improved blood sugar levels, more considerable rate reductions, and lower risk of treatment discontinuation when using insulin degludec versus insulin glargine (300 units per milliliter [U/mL]).

Furthermore, a different analysis showed that insulin degludec is associated with more significant reductions in blood glucose per a review of individual fasting plasma glucose levels (FPG, a test that measures your blood sugar after an overnight fast) and lower total insulin doses versus insulin glargine.

Dosing Guidelines

Tresiba is available as a clear and colorless injection solution in the following strengths:

• 100 units/mL: 3 mL single-person-use FlexTouch prefilled pen

• 100 units/mL (U-100): 10 mL multiple-dose vial

• 200 units/mL (U-200): 3 mL single-person-use FlexTouch prefilled pen

Lantus is available as a clear and colorless injection solution in the following strengths:

• 100 units/mL (U-100) 10 mL multiple-dose vial

• 100 units/mL (U-100) 3 mL single-person-use Lantus SoloStar prefilled pen

General Dosing Guidelines

The following provides general guidelines for the safe and effective administration of Tresiba versus Lantus:

• Administer Tresiba and Lantus subcutaneously once daily at any time of day but at the same time every day.

• Your healthcare provider may individualize and adjust the dosage of Tresiba and Lantus based on the person's metabolic needs, blood glucose monitoring results, and blood sugar control goals.

• In people with type 1 diabetes, Tresiba and Lantus must be used alongside a short-acting insulin medication.

Ask your child's healthcare provider to determine the most suitable dose of Tresiba or Lantus.

How Quickly Do They Work?

Tresiba begins working within 30 to 90 minutes of administration.

Meanwhile, Lantus begins working within 30 to 60 minutes of administration.

Safe Use Guidelines

The following guides on how to administer Tresiba or Lantus:

• Follow the directions on your prescription label carefully, and ask your healthcare provider or pharmacist to explain any part you do not understand.

• Inject Tresiba and Lantus under the skin. Do not inject in veins or muscles. Inject once a day, preferably at the same time each day.

• Use Tresiba and Lantus as directed. Do not use more or less than prescribed. Also, never double up on the dose, as it may lead to severe hypoglycemia (low blood sugar levels).

• Both these insulins control diabetes but do not cure it. Continue to use these even if you feel well. Do not stop using without talking to your healthcare provider.

• Do not dilute Tresiba and Lantus products, and do not mix these products with any other type of insulin.

• Only switch to another brand or type of insulin or change the dose after talking to your healthcare provider.

Potential for Interaction

Tell your healthcare provider about all other drugs that you take to determine the risk of a drug-drug interaction as a byproduct of your current drug regime(s).

Examples of drugs that may negatively interact with Tresiba or Lantus if taken simultaneously include:

• Angiotensin-converting enzyme (ACE) inhibitors, such as Lotensin (benazepril) and Altace (ramipril)

• Monoamine oxidase inhibitors (MAOIs), such as Marplan (isocarboxazid) and Nardil (phenelzine)

• Antibiotics, such as Bactrim (trimethoprim/sulfamethoxazole)

• Diuretics, such as Aldactone (spironolactone)

• Beta-blockers, such as such as Tenormin (atenolol)

• Medications used for treating bipolar disorder (BD), such as Lithobid (lithium)

• Other antidiabetic agents

This is not a complete list of drugs that interact with Tresiba and Lantus.

Before you use either product, alert your healthcare provider to all current medications you take before beginning treatment.

When to Avoid Tresiba or Lantus

Do not use Tresiba or Lantus if you currently or have previously experienced:

• Episodes of hypoglycemia

• Allergy to insulin degludec, insulin glargine, or any of the ingredients in either product

• Liver or kidney problems

• Low potassium in the blood (hypokalemia)

• Various cardiovascular conditions

• Pregnant, planning to become pregnant, or breastfeeding. It is not known if these drugs may harm a fetus or breastfeeding baby.

Side Effects and Precautions

Tresiba and Lantus are commonly used and are safe and effective. However, like all other drugs, they may cause side effects.

Side effects associated with these drugs are listed below.

Common Side Effects

Examples of common side effects associated with the use of Tresiba and Lantus include:

• Low blood sugar

• Weight gain

• Allergic reactions

• Reactions at the injection site, such as skin thickening
  

Severe Side Effects

Tresiba and Lantus may sometimes cause severe side effects that should be immediately addressed upon identification.

Alert your healthcare provider if you experience any of the following side effects:

• Severe hypoglycemia marked by dizziness, sweating, confusion, headache, blurred vision, dysarthria (slurred speech), tachycardia (rapid heartbeat), anxiety, irritability, and/or hunger pains

• Anaphylaxis, a severe allergic reaction marked by swelling of the face, tongue, or throat, sweating, extreme drowsiness, dizziness, or confusion.

• Hypokalemia

• Heart failure (HF)

Alternative Treatment Options

People with diabetes increasingly seek alternative therapies.

Herbal medications are commonly used as an alternative therapy for blood sugar control. However, their safety and effectiveness need to be further evaluated.

Some non-medical potential alternative treatments for diabetes include acupuncture, hydrotherapy, massage therapy, yoga, and chromotherapy, to name a few.

Regardless of the type of diabetes, you must control your blood glucose with medication and by adhering to an exercise program and a dietary plan.

Type 2 diabetes mellitus is becoming a significant health problem.

People with type 2 diabetes mellitus are usually placed on a restricted diet and exercise routine to control weight.

Summary

The prevalence of all types of diabetes is estimated to be 2% to 3% of the world's population. The number of people with diabetes is increasing by nearly 5% annually.

Tresiba (insulin degludec) and Lantus (insulin glargine) are long-acting synthetic versions of human insulins. They are FDA-approved to manage blood sugar levels in people with type 1 or type 2 diabetes.

Both these drugs belong to the same class and have similar mechanisms of action. However, they differ in their active ingredients and the duration of action.

Depending on your metabolic requirements, your healthcare provider will determine the most suitable insulin for you.

They are safe and effective; however, they may cause hypoglycemia as a side effect.

Always use as prescribed at the same time daily in the recommended dose. Ask your healthcare provider before altering the dose.

Frequently Asked Questions

How long can either drug be left unrefrigerated?

Tresiba can be unrefrigerated from heat and light for up to 56 days.

Conversely, Lantus can be unrefrigerated for up to 28 days.

Does either drug cause weight gain?

Yes, weight gain is a common side effect of both Tresiba and Lantus.

Read the original article on Verywell Health.