Long-term intensive treatment of type 1 diabetes with the short-acting insulin analog
lispro in variable combination with NPH insulin at mealtime.
A recent comparison (33-35) of premixed insulin analogs
vs premixed human insulin formulations suggests similar effectiveness in lowering A1C and FPG levels, but superior effectiveness for premixed analogs in lowering PPG levels (TABLE 1).
The total dose of rapid-acting insulin analog
is divided, with 38% delivered at breakfast, 28% at lunch, and 33% at dinner (White RD, et al.
The characteristics of insulin that contribute to variable efficacy, high risk for hypoglycemia, and weight gain can all be reduced by substituting long- and rapid-acting insulin analogs
for NPH and regular human insulin, respectively.
According to the company, the two Phase III clinical trials for insulin analog
programme are already underway.
A third insulin analog
on the market, insulin glulisine (Apidra), approved in 2004, has a pharmacokinetic profile that is similar to insulin aspart and lispro, but Mr.
Within the last decade, newer insulin analogs
have become available to replace standard insulin formulations and novel agents and delivery devices have been developed.
Various insulin analog
formulations allow for improved basal or postprandial coverage, while premixed formulations provide control for both.