A 26- Week, Multicenter, Open-Label, Single-Arm, Phase 4 Study to Assess The Safety of Lyumjev in Adult Patients With Type 2 Diabetes Mellitus in India

The purpose of this study is to assess the safety of insulin lispro-aabc in adult participants with Type 2 diabetes mellitus in India.
The study will last about 33 weeks for each participant, including screening (1 week), Lead-in period (4 weeks), treatment period (26 weeks) and follow up period (2 weeks).

Start Date18 Apr 2024

Sponsor / Collaborator

Eli Lilly & Co.

[+1]

NCT06717191

/ CompletedPhase 4IIT

Evaluating the Impact of Introducing Basaglar, a Long-acting Analog Insulin, on Clinical and Quality of Life Outcomes in Youth With Diabetes in Pakistan

This study aimed to determine the effect of introducing Basaglar and insulin pen injection devices on clinical and quality of life (QOL) parameters in children and young adults with type 1 diabetes in Pakistan

Start Date09 Jun 2022

Sponsor / Collaborator-

NCT06674135

/ CompletedPhase 4IIT

Evaluating the Impact of Introducing Basaglar, a Long-acting Analog Insulin, on Clinical and Quality of Life Outcomes in Youth with Diabetes in Bangladesh

Start Date01 Jun 2022

Sponsor / Collaborator

Bangladesh Institute of Research and Rehabilitation for Diabetes Endocrine and Metabolic Disorders

[+1]

100 Clinical Results associated with Insulin Glargine(Boehringer Ingelheim)

100 Translational Medicine associated with Insulin Glargine(Boehringer Ingelheim)

100 Patents (Medical) associated with Insulin Glargine(Boehringer Ingelheim)

Literatures (Medical) associated with Insulin Glargine(Boehringer Ingelheim)

01 Jul 2025·DIABETES OBESITY & METABOLISM

What do the guidelines say about use of biosimilar insulin therapy? Simple practical considerations to guide clinicians in different patient subgroups—Sharing Canadian perspectives

Review

Author: Chu, L. ; Abitbol, A.

Abstract:

Background:

The rising cost of insulins are significantly impacting health care expenditure, thereby limiting access to treatment for more people affected by diabetes. Fear and misunderstanding of insulin therapy have worsened with the emergence of biosimilar insulins. Biosimilars are not the same as generic medications. Generic medication contains identical ingredients to the reference, whereas biosimilar medication is highly comparable but not necessarily identical to the reference.

Results:

There are five biosimilar insulins currently available in Canada: insulin glargine (U‐100) as the biosimilar insulins, Basaglar® and Semglee®, insulin lispro (U‐100) as the biosimilar insulin, Admelog® and insulin aspart (U‐100) as the biosimilar insulins, Trurapi® and Kirsty ™. Recent clinical trials have demonstrated comparable efficacy, safety and immunogenicity for biosimilar insulins compared with reference insulins. The dosing of biosimilar insulins is also the same as the reference for initiating, switching (1:1) and titrating. Regulatory agencies, payors and clinical practice guideline committees are initiating biosimilar initiatives aimed at reducing costs, impacting more patients worldwide. While few studies have evaluated biosimilar insulin use in a real‐world clinical practice setting, the descriptive patterns retrieved from the LMC Diabetes Registry reflect the Ontario Ministry of Health's changes in biologic drug policy that were implemented to promote the use of biosimilar insulins.

Conclusion:

Many health care providers are largely unfamiliar with biosimilar insulins. This limits the acceptance of biosimilar insulins by patients, as it is related to the comfort of health care providers in educating patients. Tailoring effective conversations to patient needs ensures the best possible therapeutic outcomes.

Plain Language Summary:

This review article intends to review the efficacy and safety data from pivotal clinical trials with biosimilar insulins, as well as the regulatory and health economic considerations which underpin the safe and cost‐effective use of biosimilar insulin therapy. Biosimilars are not the same as generic medications. Generic medication contains identical ingredients to the reference, whereas biosimilar medication is highly comparable but not necessarily identical to the reference. There are five biosimilar insulins currently available in Canada: insulin glargine (U‐100) as the biosimilar insulins, Basaglar® and Semglee®, insulin lispro (U‐100) as the biosimilar insulin, Admelog® and insulin aspart (U‐100) as the biosimilar insulins, Trurapi® and Kirsty™. Data for biosimilars must be submitted in a stepwise approach to demonstrate similarity to the reference biologic under the following categories: structure & function, human clinical trials, comparative studies evaluating efficacy and safety and manufacturing quality control. Recent clinical trials have demonstrated comparable efficacy, safety and immunogenicity for biosimilar insulins compared with reference insulins. The dosing of biosimilar insulins is also the same as the reference for initiating, switching (1:1) and titrating. Health care providers are encouraged to stay up to date on the latest guidelines and recommendations regarding biosimilar insulin interchangeability to ensure safe and cost‐effective use of these products. Regulatory agencies, payors and clinical practice guideline committees are initiating biosimilar initiatives aimed at reducing costs, impacting more patients worldwide. While few studies have evaluated biosimilar insulin use in a real‐world clinical practice setting, the descriptive patterns retrieved from the LMC Diabetes Registry reflect the Ontario Ministry of Health's changes in biologic drug policy that were implemented to promote the use of biosimilar insulins. A summary of adults with diabetes from this registry showed 3.8% of individuals with T1D were prescribed Basaglar® before April 2023 compared to 12.0% after January 2024. For the T2D cohort, the use of basal biosimilar insulins, Basaglar® and Semglee®, similarly increased by approximately 10% and 2% after January 2024, respectively. The use of bolus biosimilar insulins also increased after January 2024 by approximately 28% in the T1D cohort and 60% in the T2D cohort using insulin therapy. Many health care providers are largely unfamiliar with biosimilar insulins. This limits the acceptance of biosimilar insulins by patients, as it is related to the comfort of health care providers in educating patients. People living with diabetes must have access to safe and effective treatment options, and they should be able to obtain appropriate medications at an affordable price and in a fair and timely manner.

01 Feb 2025·The Journal of the Association of Physicians of India

Safety and Efficacy of Biosimilar Insulin Glargine (Basaglar) in Indian Patients with Type 2 Diabetes Mellitus: Results from a Multicenter, Open-Label, Single-Arm, Phase 4 Trial (ABEX)

Article

Author: Shah, Parag ; Arora, Rohit ; Bhattacharya, Indranil ; Shamanna, Paramesh ; Spaepen, Erik ; Brahme, Keyur ; Saboo, Banshi ; Desai, Piyush ; Khandelwal, Deepak

BACKGROUND:

Basaglar^®, a biosimilar of glargine, was approved in India for the treatment of diabetes in patients aged >2 years. The efficacy and safety of biosimilar insulin glargine (Basaglar) have been previously established in Phase 3 clinical trials, ELEMENT-1, -2, and -5. This study assessed the safety and efficacy of Basaglar in Indian patients with type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS:

This multicenter, open-label, single-arm, phase 4 trial included Indian patients with insulin-naïve T2DM with glycated hemoglobin A1c (HbA1c) ≥7.0 to <11.0% who were receiving ≥2 oral antihyperglycemic drugs and/or a glucagon-like peptide-1-receptor agonist. Patients received Basaglar once daily for 24 weeks, excluding 4 weeks of safety follow-up. The primary endpoint was the incidence of total hypoglycemic events [blood glucose (BG) ≤54 mg/dL (≤3.0 mmol/L)] at week 24.

RESULTS:

Of the 259 patients enrolled, 64.1% were males, had mean [standard deviation (SD)] age 52.1 (11.38) years, and had diabetes for mean (SD) 6.75 (5.16) years. The mean HbA1c (SD) levels significantly improved from baseline to week 24 [-1.03 (1.554); p <0.0001] and Basaglar titration doubled from baseline. Total hypoglycemic events were reported in 10 (3.86%), 7 (2.70%), and 4 (1.54%) patients during weeks 0-24, 0-12, and 12-24, respectively. Ten patients (3.90%) reported 12 adverse events (AE; 11 mild and moderate, one severe). One death, unrelated to Basaglar, was reported.

CONCLUSION:

Basaglar was well tolerated with few hypoglycemic events and significantly reduced HbA1c and BG from baseline in Indian insulin-naïve patients with T2DM.

01 Jan 2025·BMJ Open

Role of biosimilar introduction on insulin glargine prices: a retrospective analysis in 28 European countries

Article

Author: Morolla, Davide ; von Schoen-Angerer, Tido ; Ewen, Margaret ; Beran, David ; Raviglione, Mario

Objective:

Quantify insulin glargine prices following the market introduction of biosimilars. Examine price levels and price changes for originator and biosimilars, by country.

Methods:

Retrospective quantitative analysis using insulin glargine pricing data, both of the originator product and its biosimilars. Segmented regression analysis using a dual-model approach: pooled and country-specific.

Setting:

28 European countries using data from the European Medicine Price Database for the period 2013–2023.

Main outcome measures:

Price variations between countries were analysed to assess trends and correlations before and after biosimilar market entry.

Results:

In the 28 countries studied, cost of insulin glargine underwent a median 21.6% decrease overall in the last decade (p<0.001). In 2022, the median price was €9.0 for the originator (first to market) Lantus (IQR €8.1–€10.4), €8.9 for the biosimilar Abasaglar (IQR €7.6–€10.1) and €7.0 for the biosimilar Semglee (median €7.0; IQR €6.8–€7.5). The originator price was higher than biosimilars (p=0.009). Biosimilar market entry was associated with an overall significant price reduction of the originator, both immediately after entry (p<0.001) and in the long-term postentry (p<0.001). No significant correlation was observed between the price of insulin and the countries’ economic indicators.

Conclusion:

This is the first study to show the price trend of insulin glargine and its correlation with the introduction of biosimilars, in Europe. A significant price reduction of the originator was observed after biosimilars entered the market. The median cost of biosimilars was lower than the originator, although with substantial differences between individual countries and producers.

News (Medical) associated with Insulin Glargine(Boehringer Ingelheim)

16 Oct 2025

·endpoints.news

California to offer its own, cheaper version of insulin pens

California Gov. Gavin Newsom on Thursday unveiled a deal to keep insulin glargine pen prices down for diabetics in the state, offering Biocon’s interchangeable biosimilar for a suggested retail price of about half of what pharmacies currently pay for competitors offered by Eli Lilly and Sanofi. Beginning Jan. 1, 2026, the cheaper insulin for Californians, offered under the CalRx brand, will cost no more than $55 per five-pack of pens, Newsom said. The price was forged via a deal between Virginia-based nonprofit generic drugmaker Civica Rx and India-based Biocon Biologics. Biocon and Civica on Thursday announced a “multiyear” private label agreement where Biocon will manufacture and supply insulin glargine to Civica, and Civica will commercialize it under Biocon Biologics’ existing marketing approval. The push from California shows how states may look to take unique approaches to bring down drug prices, particularly for biologics like insulin, where prices remain persistently high despite ongoing competition. Civica expects to launch the same price for its insulin glargine pens in all 50 states on Jan. 1, the company’s chief government affairs officer Allan Coukell told Endpoints News . Biocon said it will continue to directly commercialize its own interchangeable biosimilar insulin glargine, known as Semglee, which launched in the US in November 2021. The current list price of Semglee is almost 10 times higher than what the CalRx biosimilar will retail at for a pack of five pens. In March 2022, Civica laid out plans for its suggested retail price of no more than $55 per pack of five pens, which compared at the time with a list price of $425 for Sanofi’s Lantus, $404 for Semglee, and $148 for unbranded Semglee. Now, Lilly’s insulin glargine, known as Rezvoglar, retails at about $89 per pack, according to the governor’s office, while its Basaglar pens cost more than $310. Lantus retails at $92, while Sanofi’s Toujeo version sells for $411 for a pack of five. “California didn’t wait for the pharmaceutical industry to do the right thing — we took matters into our own hands. By beginning the process to manufacture our own insulin and pricing it at a maximum cost of $11 a pen in a five-pack, California and Civica are showing the nation what it looks like to put people over profits,” Newsom said in a statement . Newsom also signed a bill on Monday that would ensure consumer cost-sharing for insulin at $35 for a month-long supply.

License out/inDrug Approval

15 Oct 2025

·www.fiercebiotech.com

Eli Lilly\'s orforglipron bests Farxiga, padding oral GLP-1 case with pair of phase 3 diabetes wins

If everything goes to plan, Eli Lilly will file for approval of orforglipron in Type 2 diabetes in 2026.\n Eli Lilly has guided its oral GLP-1 drug candidate orforglipron through two more late-phase tests in Type 2 diabetes, racking up wins against placebo and AstraZeneca’s Farxiga to stay on track to seek approval in the indication next year.Lilly has run two sets of phase 3 trials for orforglipron, one to support approval in obesity and another to unlock the diabetes market. The company previously posted diabetes victories over placebo and oral semaglutide, Novo Nordisk’s GLP-1 drug. Wednesday, Lilly shared data from two of the remaining three trials in its diabetes program.One trial compared three doses (3 mg, 12 mg and 36 mg) of orforglipron to dapagliflozin, an SGLT-2 inhibitor that AstraZeneca sells as Farxiga. The trial enrolled adults with Type 2 diabetes inadequately controlled on metformin. At Week 40, patients\' A1C, a measure of blood glucose, fell up to 1.7% on orforglipron and 0.8% on dapagliflozin.The other trial compared the same three doses of orforglipron to placebo in adults with Type 2 diabetes and inadequate glycemic control with titrated insulin glargine. After 40 weeks of treatment, Lilly saw A1C reductions of up to 2.1% in the orforglipron arms, versus a 0.8% decline in the placebo cohort.The A1C reductions were big enough for both trials to hit their primary endpoints. Lilly said the studies also met all key secondary endpoints at 40 weeks. Patients taking orforglipron lost weight and showed improvements in multiple cardiovascular risk factors, although Lilly is yet to share the data for these endpoints. Similarly, Lilly said the safety and tolerability profile was consistent with prior studies without sharing any numbers. Lilly’s A1C data raise questions about the need for the high dose. A1C decreased 1.7% in patients taking 12 mg and 36 mg of orforglipron in the dapagliflozin comparison study. Lilly saw a larger drop in A1C on the middle, 12-mg dose than the top dose in the placebo-controlled trial. A1C fell 2.1% on the middle dose, compared to 1.9% on the top dose. Lilly plans to share more data at a future medical meeting. The topline readout means Lilly\'s drug has now delivered wins in four of the five trials in its phase 3 diabetes program. Data from the final global registration trial are due in the first quarter of next year. If everything goes to plan, Lilly will file for approval of orforglipron in Type 2 diabetes in 2026, adding to an obesity submission that is scheduled for this year.Obesity has dominated the thoughts of investors, who sent Lilly’s share price down when weight loss data fell short of expectations earlier this year. But the company sees diabetes as a big opportunity too. Patrik Jonsson, president of Lilly International, told attendees at a Wells Fargo event last month that “the oral Type 2 market in the U.S. is huge” and orforglipron could be a really good medicine in the indication.

$Eli Lilly\'s orforglipron bests Farxiga, padding oral GLP-1 case with pair of phase 3 diabetes wins$

Clinical ResultPhase 3Drug Approval

15 Oct 2025

·endpoints.news

Lilly’s oral GLP-1 racks up two more clinical wins in diabetes

Eli Lilly’s GLP-1 pill has succeeded in two more late-stage trials in type 2 diabetes. The company said Wednesday that orforglipron beat AstraZeneca’s Farxiga at lowering patients’ blood sugar levels in one trial, and it topped placebo on the same measure in a different study in patients who were also taking insulin. The data bolster the case for the pill’s approval in diabetes that could come next year. In the trial designated ACHIEVE-2, the highest dose of Lilly’s drug cut A1C, a measure of glucose in a patient’s blood, by 1.6% after 40 weeks of treatment. Patients given Farxiga had an A1C reduction of 0.8%. Farxiga is an oral SGLT2 inhibitor approved to treat heart failure, but also to help type 2 diabetes patients control their blood glucose levels. Subjects in ACHIEVE-2 couldn’t maintain glycemic control despite taking metformin, the generic diabetes medication. Hello Sean Cole , Endpoints is fielding its next Pulse Poll — a one-minute check-in on how artificial intelligence is reshaping biopharma. Results are confidential and will feed into our coverage of AI's real-world impact. Hello Sean Cole , Endpoints is fielding its next Pulse Poll — a one-minute check-in on how artificial intelligence is reshaping biopharma. Results are confidential and will feed into our coverage of AI's real-world impact. Hello Sean Cole , Endpoints is fielding its next Pulse Poll — a one-minute check-in on how artificial intelligence is reshaping biopharma. Results are confidential and will feed into our coverage of AI's real-world impact. Hello Sean Cole , Endpoints is fielding its next Pulse Poll — a one-minute check-in on how artificial intelligence is reshaping biopharma. Results are confidential and will feed into our coverage of AI's real-world impact. Hello Sean Cole , Endpoints is fielding its next Pulse Poll — a one-minute check-in on how artificial intelligence is reshaping biopharma. Results are confidential and will feed into our coverage of AI's real-world impact. Hello Sean Cole , Endpoints is fielding its next Pulse Poll — a one-minute check-in on how artificial intelligence is reshaping biopharma. Results are confidential and will feed into our coverage of AI's real-world impact. Hello Sean Cole , Endpoints is fielding its next Pulse Poll — a one-minute check-in on how artificial intelligence is reshaping biopharma. Results are confidential and will feed into our coverage of AI's real-world impact. Hello Sean Cole , Endpoints is fielding its next Pulse Poll — a one-minute check-in on how artificial intelligence is reshaping biopharma. Results are confidential and will feed into our coverage of AI's real-world impact. The study tested three doses of orforglipron — 3 mg, 12 mg and 36 mg, each taken once per day. All doses of orforglipron hit statistical significance versus AstraZeneca’s drug on the A1C measure. Lilly said that the trial hit “all key secondary endpoints” too, showing “significant” weight loss as well as improvements in certain cardiovascular risk factors. It did not detail the data for the secondary endpoints. In the other study, named ACHIEVE-5, the same three doses of orforglipron were given alongside Lilly’s long-acting insulin Basaglar. The combo reduced blood sugar levels by 1.8% in patients who received the highest dose at 40 weeks. Patients given a placebo on top of Basaglar saw their blood sugar fall by 0.8%. Again, the difference was significant at all doses. The trial’s participants were permitted to take metformin and/or SGLT2 inhibitors as background therapy. Lilly’s pill already demonstrated a benefit in its first Phase 3 test in type 2 diabetes patients in April . Additional data backing this use arrived last month, when orforglipron beat Novo Nordisk’s rival GLP-1 pill Rybelsus in a head-to-head battle. The drug was roughly as safe and tolerable as it has been in prior trials, Lilly said. The new data come as a relief to the company after the pill disappointed in one obesity study earlier this year. In fairness, the product performed better in patients with both obesity and diabetes than in patients with obesity alone. There is one last study in the ACHIEVE suite of diabetes trials still left to read out. ACHIEVE-4 is testing the pill head-to-head against Basaglar, seeing if it can reduce the risk of cardiovascular events, including heart attacks, strokes and death. Data could come in the first half of next year. Lilly plans to seek approval of orforglipron for type 2 diabetes in 2026. First, though, it plans to submit an application for the drug’s use in obesity, with that filing coming this year. The drugmaker is also trialing the pill in obstructive sleep apnea, high blood pressure and osteoarthritis pain in adults with obesity.

Clinical ResultPhase 3Drug Approval

100 Deals associated with Insulin Glargine(Boehringer Ingelheim)

External Link

KEGG	Wiki	ATC	Drug Bank
D03250	Insulin Glargine(Boehringer Ingelheim)	A10AE04	DB00047

R&D Status

10 top approved records.

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Indication	Country/Location	Organization	Date
Diabetes Mellitus, Type 1	United States	Eli Lilly & Co.	16 Dec 2015
Diabetes Mellitus, Type 2	United States	Eli Lilly & Co.	16 Dec 2015
Diabetes Mellitus	European Union	Eli Lilly Nederland BV	09 Sep 2014
Diabetes Mellitus	Iceland	Eli Lilly Nederland BV	09 Sep 2014
Diabetes Mellitus	Liechtenstein	Eli Lilly Nederland BV	09 Sep 2014
Diabetes Mellitus	Norway	Eli Lilly Nederland BV	09 Sep 2014

Clinical Result

Indication

Phase

Evaluation

View All Results

Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT04153981 (CTgov)	Phase 4	Diabetes Mellitus, Type 2	304	Insulin Glargine	iezvnoqcec = xojlsyaepa fbckghiick (xyskdxwgnr, wcrkuavjjb - ctzyeoccam) View more	-	15 Feb 2024
NCT03338023 (Pubmed) Manual	Phase 3	Diabetes Mellitus, Type 1	272	insulin lispro+LY2963016	fdqylvroag(qvctoadybt) = rormedxglf eijgedajtu (grzlxntcdp, 0.07)	Similar	01 Oct 2021
				insulin lispro+insulin glargine	fdqylvroag(qvctoadybt) = wllpsdboah eijgedajtu (grzlxntcdp, 0.07)
NCT03338010 (Pubmed \| Diabetes Obes Metab) Manual	Phase 3	Diabetes Mellitus, Type 2	536	LY2963016	yuopvuvyah(uhnkvyvwdw) = jbajqypioa gdlcattxyw (joxlsyvanp )	Non-inferior	01 Aug 2021
				insulin glargine	yuopvuvyah(uhnkvyvwdw) = mpllnlkzbt gdlcattxyw (joxlsyvanp )
NCT03338010 (CTgov)	Phase 3	Diabetes Mellitus, Type 2	536	LY2963016 (LY2963016)	wfglyhczsh(ozhzysqxmx) = xlxcjrnkyk liexptivzb (pmxxpendgd, 0.043) View more	-	25 May 2021
				Lantus® (Lantus®)	wfglyhczsh(ozhzysqxmx) = egsnsrkazb liexptivzb (pmxxpendgd, 0.062) View more
NCT03338023 (ABES, CTgov)	Phase 3	Diabetes Mellitus, Type 1	272	LY2963016+Insulin Lispro (LY2963016 + Insulin Lispro)	zzgdnhduai(yaykjrtzyv) = chwnnrvony zgeycjhjjv (sugrrfcuyd, 0.071) View more	-	29 Mar 2021
				Lantus®+Insulin Lispro (Lantus® + Insulin Lispro)	zzgdnhduai(yaykjrtzyv) = dpnyyorwyt zgeycjhjjv (sugrrfcuyd, 0.071) View more
NCT03555305 (CTgov)	Phase 1	-	58	Insulin Glargine (0.5 U/kg Insulin Glargine)	pytuazyyni(nzpfazuked) = iqoowduryl mtqbsdmfft (wmzxnofleu, 31) View more	-	24 Nov 2020
				Lantus (0.5 U/kg Lantus)	pytuazyyni(nzpfazuked) = sbitoldbls mtqbsdmfft (wmzxnofleu, 33) View more
NCT02302716 (ELEMENT 5, Pubmed \| Clin Drug Investig)	Phase 3	Diabetes Mellitus, Type 2	493	Lilly insulin glargine (LY IGlar)	prxneehtgp(tlsucovqjq) = tqguxfwfvi saqlfhhdjz (rfrpccafdy )	Positive	01 Aug 2019
				Insulin glargine (IGlar)	prxneehtgp(tlsucovqjq) = tkqpxrxrec saqlfhhdjz (rfrpccafdy )
NCT02302716 (ELEMENT 5, Pubmed) Manual	Phase 3	Diabetes Mellitus, Type 2	493	Insulin Glargine	twcsfkzqat(ibbacdumvy) = nuenweaxbt zwvhyvrhzy (mtqvtktnjk )	Similar	01 Feb 2019
				Lantus	twcsfkzqat(ibbacdumvy) = qpasbaweej zwvhyvrhzy (mtqvtktnjk )
NCT02302716 (ELEMENT 5, CTgov)	Phase 3	Diabetes Mellitus, Type 2	493	LY2963016+Oral Antihyperglycemic Medication (LY2963016)	wsbdaygese(ffloklpazh) = fqbjpnssdt qpjlwzbfjm (fbnbuniwtd, 0.066) View more	-	24 Oct 2017
				Oral Antihyperglycemic Medication+LANTUS® (LANTUS®)	wsbdaygese(ffloklpazh) = lstxqubmas qpjlwzbfjm (fbnbuniwtd, 0.067) View more
NCT01421459 (ELEMENT 2, Pubmed \| Diabetes Obes Metab) Manual	Phase 3	Diabetes Mellitus, Type 2	756	LY2963016	ykymopnoko(xbnagvqcni) = bztyobzlxh azmpgixgyb (zncjkicztq )	Positive	01 Aug 2015
				insulin glargine	ykymopnoko(xbnagvqcni) = fmxmqncusv azmpgixgyb (zncjkicztq )

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