Basaglar (insulin glargine) is popular for a reason: it is generally both safe and effective for the treatment of type 1 diabetes in adults and children and type 2 diabetes in adults. However, sometimes this drug will not be the right choice for everyone. In these cases, the following Basaglar alternatives are worth considering.
Medications to discuss with a doctor include the following options.
For Type 1 Diabetes
Type 1 diabetes is commonly known as juvenile diabetes, as it is most commonly diagnosed in childhood or adolescence. However, adults are diagnosed with type 1 diabetes, too. Many options are fortunately available for the treatment of this condition. One such option is Levemir, or insulin detemir (rDNA origin). Both children and adults with either type 1 or type 2 diabetes can use this medication.
Like glargine, detemir is a long-lasting insulin. Unlike glargine, though, detemir (as Levemir) comes in either a 3 mL pen or 10 mL vial [100 units/mL (U-100)]. Additionally, the FDA lists hypoglycemia episodes as contraindications for both Lantus and Basaglar (both insulin glargine); the FDA does not list hypoglycemia episodes as a contraindication for Levemir.
For Type 2 Diabetes
When Basaglar is not an option, the similar drug Toujeo may be an alternative for adults with either type 1 or type 2 diabetes mellitus. It also contains insulin glargine, although it is much more concentrated than either Basaglar or Lantus (both of which contain glargine as well).
Toujeo injections (300 units/mL) are available in either 1.5 mL or 3 mL prefilled pens.
Gestational diabetes is a form of diabetes that develops during pregnancy. Typically, doctors only prescribe Basaglar during pregnancy if they believe the potential benefits outweigh the risks. In cases where Basaglar use is not appropriate during pregnancy, a doctor may instead prescribe either glyburide (glibenclamide, Glynase) and/or metformin (Glucophage, Glumetza, Riomet) to help manage blood sugar levels.
Glyburide helps stimulate the pancreas to produce insulin and metformin helps reduce how much glucose the liver produces.
For Weight Loss
Weight management is a crucial part of treating diabetes. Fortunately, some diabetic medications may make losing weight a little easier than others. Take, for example, Ozempic (semaglutide). It is not FDA approved for weight loss, but rather for treating type 2 diabetes mellitus in adults. However, compared to drugs like Bydureon (exenatide), Januvia (sitagliptin), and Trulicity (dulaglutide), patients taking Ozempic noticed greater weight loss.
To be clear: Ozempic will not make patients magically shed fat. However, with proper diet and exercise, patients with type 2 diabetes may be more likely to lose more weight than if they had taken other medications.
For Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA), or diabetic acidosis, occurs when your body has an excessive buildup of both ketones and glucose. Many diabetic medications–including Basaglar–are not indicated for the treatment of this serious condition. Instead, the FDA advises that treatment for this condition should be a short or fast-acting insulin IV injection.
Which insulins work best for this condition will vary by individual. Experts from the University of Tennessee Health Science Center, though, have recommended “an initial bolus of regular insulin of 0.1 U/kg followed by continuous insulin infusion” to treat DKA.