We break down two popular, long acting insulins: Lantus vs Tresiba. They’re both used to treat people with Type 1 diabetes or Type 2 diabetes and have a lot in common. But they also have some key differences you may want to be aware of. We go over what they have in common, how they differ, and why you may want to choose one over the other.
What is Insulin?
Insulin is an important hormone your body produces to control blood sugar levels. When you eat, the body breaks down carbohydrates in the food into sugar, which then enters the blood.
The pancreas releases insulin into the blood to absorb the sugar (or glucose) into cells. The body then either uses that glucose as energy or stores it in muscles or the liver as glycogen for later use.
The more sugar or carbs you eat, the more insulin the pancreas releases. So it’s a constant feedback loop between the pancreas and the amount of glucose in the blood.
How Insulin is Made
The history of injected insulin actually dates back over 100 years. Researchers in 1921 discovered how to extract and refine insulin from the pancreas of animals, and the first successful use of insulin on a person happened in 1922. It wasn’t until the 1980s that an engineered, synthetic insulin was developed that didn’t depend on animals (“human insulin”).
Today, human insulin is made mostly from common bacteria. The processes may differ but generally the bacteria is used to create protein, which is then modified to create the human protein that produces insulin.
Insulins are also designed to meet basal or bolus requirements. Basal type insulins are effective over long period of time to keep blood glucose levels at baseline. Bolus type insulins are effective within 1-2 hours of ingestion are meant to be taken before meals to minimize blood sugar spikes.
And because insulin contains protein, it needs to be kept cool to help prevent it from spoiling. So consider using an insulin cooler if you’ll be out for long periods of time or traveling.
Insulin and Diabetes
But problems happen when the pancreas can’t produce enough insulin or the body is not using insulin effectively. This is the case with diabetes , which is a condition when blood glucose exceeds normal or healthy levels. The most common are Type 1 and Type 2 diabetes:
- Type 1 occurs when the pancreas’ ability to create insulin is impaired because of an autoimmune condition.
- Type 2 occurs when the pancreas can’t produce enough insulin because it’s been overworked after years of high blood glucose. The cells also aren’t able to use insulin effectively, which is called “insulin resistance.”
As a result, people with uncontrolled diabetes are often prescribed insulin to help control blood sugar levels.
Lantus and Tresiba Similarities
Method of Delivery
Both insulins are liquids you inject and come in vials (for syringes) or disposable prefilled insulin pens. The FlexTouch pen is Tresiba’s version and the Lantus pen is called SoloStar. And both the Tresiba FlexTouch and Lantus SoloStar come in 3ml of 100 units/mL and more concentrated doses.
Like most prescription drugs, Lantus and Tresiba come with side effects. Hypoglycemia (or low blood sugar) is the most common side effect of insulin including Tresiba and Lantus. But studies have found lower instances of hypoglycemia with Tresiba.
Other common side effects associated with Tresiba and Lantus are weight gain, injection site reactions, or skin issues. These reactions are actually common with most insulins and some can be minimized by changing injection sites.
How Lantus and Tresiba Differ
The active ingredient in Lantus is insulin glargine. This was actually the first, once-a-day basal insulin used in clinical practice. Lantus is made by Sanofi/Aventis and it received FDA approval in 2000.
Insulin degludec is the active ingredient in Tresiba and is relatively newer. Novo Nordisk makes Tresiba, which received FDA approval in 2015.
Duration of Effect
While both are long acting insulin, Tresiba has a much longer effect. The duration of action of Lantus is up to 24 hours, while Tresiba is up to 42 hours. Still, the duration of both insulins are impressive and can help control blood glucose levels throughout the day and night.
Adults and Children
Tresiba can be prescribed to children as young as 1 year old, while Lantus can be prescribed for children 6 years and up.
Tresiba and Lantus are brand name drugs so both generally cost more than other generic insulins. But there is a notable cost difference between the two.
According to Goodrx.com, the price of Lantus is around $200 but Tresiba can be nearly 3x higher at around $600. While actual costs will depends on different factors like location, medical coverage and pharmacy, Tresiba is clearly the costlier option.
Lantus vs Tresiba: Which to Choose?
Talk With Your Doctor
First, always discuss with your doctor about potential medication or treatment options. Your care provider can assess your condition, possible drug interactions or allergic reactions, and provide other medical advice.
This is also important if you’re already on insulin but interested in switching. Sometimes people with diabetes may feel their insulin is not helping meet blood sugar targets. Consult your care provider to asses your blood sugar trends and see if changing insulins is an appropriate option. But it may surprise you that a simple insulin dose adjustment is all that’s needed.
Tresiba Lasts Longer
Let’s face it: injecting insulin can be uncomfortable and time consuming. Which is why an insulin that lasts a long time can mean fewer injections.
With that in mind, using Tresiba may be the better option since a single dose can last up to 42 hours and may be more convenient overall.
Lantus Has Been Around Longer
As we said above, Lantus (insulin glargine) was developed over 20 years ago and is still widely used today. This means there’s more information on Lantus which can help answer questions on its effectiveness or safety. Not to say that Tresiba is less safe or effective but Lantus has been around much longer.
Tresiba Has Lower Rates of Hypoglycemia
Tresiba has been shown to have a lower risk of hypoglycemia or low blood sugar. Hypoglycemia can be a serious event and is one reason why regularly monitoring blood sugar is important when on insulin.
An analysis of randomized clinical trials between insulin degludec (Tresiba) and insulin glargine (Lantus) showed lower rates of hypoglycemia with degludec. This reduction was also more noticeable at night and/or in people with Type 2 diabetes (than Type 1).
If you’re prone to having low blood sugar, your care provider may recommend Tresiba.
Lantus is More Affordable
Lantus is no doubt the more affordable option, which can be found at 3x lower than Tresiba. This price difference is probably because Tresiba is newer and Lantus has been around for decades. Insulin costs is an important factor for people with diabetes so this difference can limit your options.
Tresiba and Lantus are long acting insulins that are effective in controlling blood sugar levels. They have a lot of similarities like being available in disposable pens and have long lasting effects. But they’re difference in cost and duration are big enough to impact your decision.
Tresiba (insulin degludec) can last up to an impressive 42 hours! This can mean taking less injections throughout the day and overall more convenient. On the other hand, Lantus (insulin glargine) can last up to 24 hours yet is much more affordable – up to 3x less than Tresiba.
Whether you like Tresiba or Lantus, first get proper medical advice about these drugs. Hypoglycemia is a side effect of both insulins (though less cases with Tresiba) so talk with your doctor about your options.
But if you’re able to afford it, the prolonged effect of Tresiba is unmatched. A single injection of Tresiba can help control blood sugar for up to 42 hours – this means less injections and more convenient. And studies have shown that Tresiba has lower cases of hypoglycemia.
Insulin medications are a big part of diabetes self care so it’s important to choose an insulin that meets your needs.
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