• Although Tresiba and Lantus and similar, there are differences between them.
• Tresiba and Lantus are both insulin analogs but Tresiba contains insulin degludec and Lantus contains insulin glargine.
• Tresiba is an ultra-long acting insulin that lasts 42 hours. Lantus is a long-acting insulin that lasts 24 to 36 hours depending on its concentration.
• Tresiba is approved for use in adults and children older than one year. Lantus is approved in adults and children older than six years.
• Tresiba is slightly more expensive than Lantus.
• Both Tresiba and Lantus are available as a prefilled pen and also as a vial.
• Tresiba is made by NovoNordisk and Lantus is made by Sanofi.
• Both are injected under the skin (subcutaneously) once a day.

Tresiba (insulin degludec)

Tresiba is an ultra-long-acting human insulin analog (insulin degludec) that is given by subcutaneous injection (under the skin) for the treatment of diabetes in adults and children over the age of one year.

• Starts to work within 60 minutes after injection
• Peaks in 12 hours after administration
• Keeps working for up to 42 hours.

Tresiba costs approximately $363.36 for 10ml vial of 100 units/mL.

There are two types of Tresiba FlexTouch pen:

• Tresiba FlexTouch U-100: Contains 300 units of insulin. Units can be increased by 1 unit at a time. Maximum dosage each use is 80 units.
• Tresiba FlexTouch U-200: Contains 600 units of insulin. Units can be increased by 2 units at a time. Maximum dosage each use is 160 units.

Tresiba is also available in a 10mL vial. The vial contains 1000 units of Tresiba.

Lantus (insulin glargine)

Lantus is a long-acting human insulin analog (insulin glargine) that is given by subcutaneous injection (under the skin) for the treatment of diabetes in adults and children over the age of six years.

• Starts to work within 70 minutes after injection
• Has no pronounced peak but full blood sugar lowering effects can take 6 hours to develop after administration
• Keeps working for up to 24 to 36 hours depending on its concentration.

Lantus is available as

• Lantus Solostar U-100 prefilled pen single patient-use: This 3mL pen contains 300 units of insulin. Units can be increased by 1 unit at a time by moving the dial on the pen. Maximum dosage each use is 80 units.

Lantus is also available in a 10mL vial. The vial contains 1000 units of Lantus.

A 10ml vial of Lantus U-100 costs approximately $305.53.

How is Tresiba made?

Tresiba (insulin degludec) is made using genetic engineering technology. Although it resembles human insulin in most of its structure, the amino acid threonine in position B30 has been replaced by a side chain containing glutamine and a C16 fatty acid. Tresiba exists as stable insulin dihexamers bonded by zinc.

Once Tresiba is injected, the insulin dihexamers form multihexamers. The rate of insulin absorption depends on the size of the insulin molecules, so these large insulin hexamers stay in place, creating an insulin depot (storage). With time the zinc diffuses, which releases insulin monomers from each end of the chain. These monomers are the correct size for absorption into the bloodstream.

Because of the slow and steady way Tresiba breaks up and diffuses under the skin, it lasts for at least 42 hours. This means Tresiba can be dosed once a day, at any time of the day.

How is Lantus made?

Lantus (insulin glargine) is made using genetic engineering technology. Although it resembles human insulin in most of its structure, the amino acid arginine in position A21 has been replaced by glycine and two arginines have been added to the C-terminus of the B-chain.

Lantus was formulated to have a low insulin solubility at neutral pH which means it forms microprecipitates once injected subcutaneously from which insulin glargine is slowly released.

It is released relatively slowly over 24 hours with no pronounced peak. The primary activity of insulin, including Lantus, is to allow cells throughout the body to uptake glucose (sugar) and convert it into a form that can be used by these cells for energy.