How To Use Basaglar
Updated: Mar 10, 2020
I've been diabetic for over a decade now. It's been difficult to nail down a treatment that keeps my glucose down. Several months ago, I was put on basal insulin. My doctor wanted to put me on Lantus, but insurance refuses to cover it, even with prior authorization. So I was prescribed Basaglar, instead. This is extremely common, these days. You can find many reports from diabetics being switched due to insurance. Most reports you find rate Basaglar very poorly, causing glucose management to become far more difficult. Many report needing to take higher doses and still struggling. One report caught my eye: there's a lot of slop in the delivery mechanism that can result in far fewer units of drug being dispensed than requested, showing that one could occasionally try to dispense 5 units and get nothing.
My insurance won't cover anything except Basaglar. I could try for a Lantus coupon, but the coverage is only for a year, putting any kind of long term guarantee at risk. So I decided to try to figure out how to make the best of Basaglar. The result is I have far more consistent management of my glucose, and I've been able to dial down the dosage. Bear in mind, I'm on a low dosage to begin with (at 15 units at the moment). Before I started with this journey, I was getting ready to push it all the way to 20 units, but then had to back it off after figuring out a good routine.
The key that I've found is to not rush the process. Turn it into a ritual where every step, and the timing of each step matters. Because of the sloppy delivery mechanism (the pen), there's not much room to cut corners to make sure it dispenses as close to correctly as possible. Because there is a chance you will dose a higher amount than previously, it might be a good idea to dial it back a few clicks to try to avoid hypoglycemia.
Dial the dose to use
Attach needle and remove first cap
Prep area of injection with alcohol swab
Remove second cap
With needle facing upward, slowly press the plunger until fluid comes out, at least a drop or two
Redial the dose (you may need to dial back up 2-5 clicks, minimum of 2 for me but otherwise varies)
Insert needle and dispense
Leave needle in for a few seconds before removing (allow pressure from plunger to finish dispensing)
Recap the needle, remove, and dispose
Store the pen
Yes, you are priming it at every dose. Not just the first one. I've had first dose have to be primed beyond 15 units, whereas when I was on Victoza, it was never that high, and I only had to prime it once. I can't say how Lantus was because I've never been on it.
Following this procedure, which primarily focuses on priming every dose, I've been able to reduce my dose from 19 units to 15, and may be reducing it further as I am still in the process of figure out where I need to be. With this process, not only have I been able to reduce the dialed dose, but my daily sugar management has been much more consistent.
Basaglar's basal insulin is biosimilar to Lantus. It's produced in the same manner, but with a slightly different carrier fluid. Most of the carrier fluid is the same, and shouldn't affect the delivery of basal insulin. There's no reason that you should get different results between Lantus and Basaglar if delivery of the medicine is the same. Their dosing should be equivalent, converting 1 to 1. But here we are, with Basaglar being a more difficult basal insulin to use.