Several insulin formulations are currently available for clinical use, including human regular and protaminated insulins, rapid- and long- acting analogs and premixed combinations, which can be used in different regimens. However, there is no consensus on which are the insulin formulation and the insulin regimen of choice, especially in type 2 diabetes. Overall, insulin analogs are preferred for their better pharmacological properties with a minor hypoglycaemic risk, whereas their superiority in reducing HbA1c levels is still debated. Despite the impressive steps undertaken so far, insulin therapy is still too complex and burdensome, and even with an intensified regimen, only a modest percentage of subjects reaches HbA1c goals. New insulin formulations and devices are currently awaited to better fulfill the still unmet needs of insulin therapy.
Published in | Science Journal of Clinical Medicine (Volume 1, Issue 1) |
DOI | 10.11648/j.sjcm.20120101.12 |
Page(s) | 4-9 |
Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
Copyright |
Copyright © The Author(s), 2012. Published by Science Publishing Group |
Insulin Analogs, Type 2 Diabetes, Hypoglycaemia, Hba1c
[1] | DeWitt DE, Hirsch IB. Outpatient insulin therapy in type 1 and type 2 diabetes mellitus: scientific review. JAMA. 2003;289:2254-64. |
[2] | Gerich JE. Novel insulins: expanding options in diabetes management. Am J Med 2002;113:308–316. |
[3] | Bode BW. Comparison of pharmacokinetic properties, phy-sicochemical stability, and pump compatibility of 3 rapid-acting insulin analogues - aspart, lispro, and glulisine. Endocr Pract. 2011;17:271-80. |
[4] | Howey DC, Bowsher RR, Brunelle RL, et al. [Lys(B28),Pro(B29)]- human insulin. A rapidly absorbed analogue of human insulin. Diabetes 1994;43:396–402. |
[5] | Vajo Z, Fawcett J, Duckworth WC. Recombinant DNA technology in the treatment of diabetes: insulin analogs. Endocr Rev. 2001;22:706-17. |
[6] | Ulrich H, Snyde B, Satish KG. Combining insulins for optimal blood glucose control in type 1 and 2 diabetes: Focus on insulin glulisine.Vascul Health And Risk Management 2007;3:245-254. |
[7] | Plank J, Siebenhofer A, Berghold A, et al. Systematic review and meta-analysis of short-acting insulin analogues in patients with diabetes mellitus. Arch Intern Med 2005;165:1337-44. |
[8] | Mannucci E, Monami M, Marchionni N. Short-acting insulin analogues vs. regular human insulin in type 2 diabetes: a meta-analysis. Diabetes Obes Metab 2009;11:53-9. |
[9] | Perriello G, Pampanelli S, Porcellati F, et al. Insulin aspart improves meal time glycaemic control in patients with Type 2diabetes: a randomized, stratified, double-blind and cross-over trial. Diabet Med 2005;22:606-11. |
[10] | Rys P, Pankiewicz O, Łach K, et al.Efficacy and safety comparison of rapid-acting insulin aspart and regular human insulin in the treatment of type 1 and type 2 diabetes mellitus: a systematic review. Diabetes Metab 2011;37:190-200. |
[11] | Blaak EE, Antoine JM, Benton D, et al. Impact of postprandial glycaemia on health and prevention of disease. Obes Rev 2012. doi: 10.1111/j.1467-789X.2012.01011.x. |
[12] | Home PD. The pharmacokinetics and pharmacodynamics of rapid-acting insulin analogues and their clinical consequences. Diabetes Obes Metab 2012;14:780-8. |
[13] | Torlone E, Di Cianni G, Mannino D, et al. Insulin analogs and pregnancy: an update. Acta Diabetol 2009;46:163-72. |
[14] | Durnwald CP, Landon MB. Insulin analogues in the man-agement of the pregnancy complicated by diabetes mellitus. Curr Diab Rep 2011;11:28-34. |
[15] | de Valk HW, Visser GH. Insulin during pregnancy, labour and delivery. Best Pract Res Clin Obstet Gynaecol 2011;25:65-76. |
[16] | G.B. Bolli, R. D. Di Marchi, G. D. Park, et al. Insulin ana-logues and their potential in the management of diabetes mellitus Diabetologia 1999;42:1151-1167. |
[17] | Maka S, Hedrington MD, Lindsay Pulliam BS et al. Basal insulin treatment in type 2 diabetes. Diabetes technology & therapeutics 2011;13:Suppl 1 (S 33-42). |
[18] | Sanofi-Aventis. Lantus. Prescribing Information. Revised 2007 http://products.sanofi-aventis.us/lantus/lantus.pdf. |
[19] | Levemir® (insulin detemir [rDNA origin] injection) [pre-scribing information]. Princeton, NJ: Novo Nordisk Inc 2010. |
[20] | Monami M, Marchionni N, Mannucci E. Long-acting insulin analogues versus NPH human insulin in type 2 diabetes: a meta-analysis. Diabetes Res Clin Pract 2008;81:184-9. |
[21] | Riddle MC, Rosenstock J, Gerich J. Insulin Glargine 4002 Study Investigators. The treat-to-target trial: randomized ad-dition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients. Diabetes Care 2003;26:3080-6. |
[22] | Hermansen K, Davies M, Derezinski T, et al. A 26-week, randomized, parallel, treat-to-target trial comparing insulin detemir with NPH insulin as add-on therapy to oral glu-cose-lowering drugs in insulin-naive people with type 2 di-abetes. Diabetes Care 2006;29:1269-74. |
[23] | Khunti K, Damci T, Meneghini L, et al. SOLVE Study Group. Study of Once Daily Levemir (SOLVE™): insights into the timing of insulin initiation in people with poorly controlled type 2 diabetes in routine clinical practice. Diabetes Obes Metab 2012;14:654-61. |
[24] | Lucidi P, Porcellati F, Rossetti P, et al. Pharmacokinetics and pharmacodynamics of therapeutic doses of basal insulins NPH, glargine, and detemir after 1 week of daily administration at bedtime in type 2 diabetic subjects: a randomized cross-over study. Diabetes Care 2011;34:1312-4. |
[25] | Swinnen SG, Simon AC, Holleman F, et al. Insulin detemir versus insulin glargine for type 2 diabetes mellitus. Cochrane Database of Systematic Reviews 2011;7:CD006383. DOI: 10.1002/14651858. CD006383.pub.2 |
[26] | 26. Raskin P, Gylvin T, Weng W, et al. Comparison of insulin detemir and insulin glargine using a basal-bolus regimen in a randomized, controlled clinical study in patients with type 2 diabetes. Diabetes Metab Res Rev 2009;25:542–548. |
[27] | Hollander P, Cooper J, Bregnhøj J, et al. A 52-week, multi-national, open-label, parallel-group, noninferiority, treat-to-target trial comparing insulin detemir with insulin glargine in a basal-bolus regimen with mealtime insulin aspart in patients with type 2 diabetes. Clin Ther 2008;30:1976–1987. |
[28] | Rosenstock J, Davies M, Home PD, et al. A randomised, 52-week, treat-to-target trial comparing insulin detemir with insulin glargine when administered as add-on to glu-cose-lowering drugs in insulin naive people with type 2 di-abetes. Diabetologia 2008;51: 408–416. |
[29] | Swinnen SG, Dain MP, Aronson R, et al. A 24-week, ran-domized, treat-to-target trial comparing initiation of insulin glargine once-daily with insulin detemir twice-daily in patients with type 2 diabetes inadequately controlled on oral glucose-lowering drugs. Diabetes Care 2010;33:1176–1178. |
[30] | Zachariah S, Sheldon B, Shojaee-Moradie F, et al. Insulin detemir reduces weight gain as a result of reduced food intake in patients with type 1 diabetes. Diabetes care 2011;34:1487-1491. |
[31] | Call R, Grimsley M, Cadwallader L, et al. Insulin--carcinogen or mitogen? Preclinical and clinical evidence from prostate, breast, pancreatic, and colorectal cancer research. Postgrad Med 2010;122:158-65. |
[32] | Home PD, Lagarenne P. Combined randomised controlled trial experience of malignancies in studies using insulin glargine. Diabetologia 2009;52:2499-506. |
[33] | Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: a consensus report. CA Cancer J Clin 2010;60:207-21. |
[34] | Giugliano D, Maiorino MI, Bellastella G, et al. Multiple HbA1c targets and insulin analogues in type 2 diabetes: a systematic review. J Diabetes Complications 2011;25:275-81. |
[35] | Cucinotta D, Russo G. Biphasic insulin aspart in the treatment of type 2 diabetes mellitus. Expert Opin Pharmacother 2009;10:2905-11. |
[36] | Davidson J, Vexiau P, Cucinotta D, et al. R. Biphasic insulin aspart 30: literature review of adverse events associated with treatment. Clin Ther. 2005;27 Suppl B:S75-88. |
[37] | Danne T, Bolinder J. New insulins and insulin therapy. Int J Clin Pract Suppl 2011;170:26-30. |
[38] | Steiner S, Hompesch M, Pohl R, et al. A novel insulin for-mulation with a more rapid onset of action. Diabetologia. 2008;51:1602-6. |
[39] | Simon AC, DeVries JH. The future of basal insulin supple-mentation. Diabetes Technol Ther 2011;13 Suppl 1:S103-8. |
[40] | Kalra S, Unnikrishnan AG, Baruah M, et al. Degludec insulin: A novel basal insulin. J Endocrinol Metab 2011;15:S12-6. |
[41] | Garber AJ, King AB, Del Prato S, et al. NN1250-3582 (BE-GIN BB T2D) Trial Investigators. Insulin degludec, an ul-tra-long-acting basal insulin, versus insulin glargine in bas-al-bolus treatment with mealtime insulin aspart in type 2 diabetes (BEGIN Basal-Bolus Type 2): a phase 3, randomised, open-label, treat-to-target non-inferiority trial. Lancet 2012;379: 1498-507. |
[42] | Lasserson DS, Glasziou P, Perera R, et al. Optimal insulin regimens in type 2 diabetes mellitus: systematic review and meta-analyses. Diabetologia 2009;52:1990-2000. |
[43] | Nicolucci A, Del Prato S, Vespasiani G; ELEONOR Study Group. Optimizing insulin glargine plus one injection of insulin glulisine in type 2 diabetes in the ELEONOR study: similar effects of telecare and conventional self-monitoring of blood glucose on patient functional health status and treatment satisfaction. Diabetes Care 2011;34:2524-6. |
[44] | Management of Hyperglycemia in Type 2 Diabetes: A Pa-tient-Centered Approach. Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care, published online April 19, 2012. |
[45] | Pontiroli AE, Miele L, Morabito A. Metabolic control and risk of hypoglycaemia during the first year of intensive insulin treatment in type 2 diabetes: systematic review and meta-analysis. Diabetes Obes Metab 2012;14:433-46. |
[46] | Currie CJ, Peters JR, Tynan A, Evans M, et al. Survival as a function of HbA(1c) in people with type 2 diabetes: a re-trospective cohort study. Lancet 2010;375:481-9. |
[47] | Yudkin JS, Richter B, Gale EA. Intensified glucose lowering in type 2 diabetes: time for a reappraisal. Diabetologia 2010;53:2079-85. |
[48] | Buse JB, Wolffenbuttel BH, Herman WH, et al. The DU-RAbility of Basal versus Lispro mix 75/25 insulin Efficacy (DURABLE) trial:comparing the durability of lispro mix 75/25 and glargine. Diabetes Care 2011;34:249-55. |
[49] | Holman RR, Farmer AJ, Davies MJ, et al. 4-T Study Group. Three-year efficacy of complex insulin regimens in type 2 diabetes. N Engl J Med 2009;361:1736-47. |
APA Style
Giuseppina T. Russo, Provvidenza Villari, Elisabetta L Romeo, Annalisa Giandalia, Domenico Cucinotta. (2012). Recombinant Insulin in Type 2 Diabetes Treatment: Where Are We Now?. Science Journal of Clinical Medicine, 1(1), 4-9. https://doi.org/10.11648/j.sjcm.20120101.12
ACS Style
Giuseppina T. Russo; Provvidenza Villari; Elisabetta L Romeo; Annalisa Giandalia; Domenico Cucinotta. Recombinant Insulin in Type 2 Diabetes Treatment: Where Are We Now?. Sci. J. Clin. Med. 2012, 1(1), 4-9. doi: 10.11648/j.sjcm.20120101.12
AMA Style
Giuseppina T. Russo, Provvidenza Villari, Elisabetta L Romeo, Annalisa Giandalia, Domenico Cucinotta. Recombinant Insulin in Type 2 Diabetes Treatment: Where Are We Now?. Sci J Clin Med. 2012;1(1):4-9. doi: 10.11648/j.sjcm.20120101.12
@article{10.11648/j.sjcm.20120101.12, author = {Giuseppina T. Russo and Provvidenza Villari and Elisabetta L Romeo and Annalisa Giandalia and Domenico Cucinotta}, title = {Recombinant Insulin in Type 2 Diabetes Treatment: Where Are We Now?}, journal = {Science Journal of Clinical Medicine}, volume = {1}, number = {1}, pages = {4-9}, doi = {10.11648/j.sjcm.20120101.12}, url = {https://doi.org/10.11648/j.sjcm.20120101.12}, eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20120101.12}, abstract = {Several insulin formulations are currently available for clinical use, including human regular and protaminated insulins, rapid- and long- acting analogs and premixed combinations, which can be used in different regimens. However, there is no consensus on which are the insulin formulation and the insulin regimen of choice, especially in type 2 diabetes. Overall, insulin analogs are preferred for their better pharmacological properties with a minor hypoglycaemic risk, whereas their superiority in reducing HbA1c levels is still debated. Despite the impressive steps undertaken so far, insulin therapy is still too complex and burdensome, and even with an intensified regimen, only a modest percentage of subjects reaches HbA1c goals. New insulin formulations and devices are currently awaited to better fulfill the still unmet needs of insulin therapy.}, year = {2012} }
TY - JOUR T1 - Recombinant Insulin in Type 2 Diabetes Treatment: Where Are We Now? AU - Giuseppina T. Russo AU - Provvidenza Villari AU - Elisabetta L Romeo AU - Annalisa Giandalia AU - Domenico Cucinotta Y1 - 2012/12/30 PY - 2012 N1 - https://doi.org/10.11648/j.sjcm.20120101.12 DO - 10.11648/j.sjcm.20120101.12 T2 - Science Journal of Clinical Medicine JF - Science Journal of Clinical Medicine JO - Science Journal of Clinical Medicine SP - 4 EP - 9 PB - Science Publishing Group SN - 2327-2732 UR - https://doi.org/10.11648/j.sjcm.20120101.12 AB - Several insulin formulations are currently available for clinical use, including human regular and protaminated insulins, rapid- and long- acting analogs and premixed combinations, which can be used in different regimens. However, there is no consensus on which are the insulin formulation and the insulin regimen of choice, especially in type 2 diabetes. Overall, insulin analogs are preferred for their better pharmacological properties with a minor hypoglycaemic risk, whereas their superiority in reducing HbA1c levels is still debated. Despite the impressive steps undertaken so far, insulin therapy is still too complex and burdensome, and even with an intensified regimen, only a modest percentage of subjects reaches HbA1c goals. New insulin formulations and devices are currently awaited to better fulfill the still unmet needs of insulin therapy. VL - 1 IS - 1 ER -