Further technological advances enabled the design and manufacture of
insulin analogs with a protracted and more predictable pharmacodynamic action.
The long-acting
insulin analogs (detemir [Levemir[R]], glargine [Lantus[R]]) are well suited to basal insulin therapy as they have a relatively flat time-action profile (see Figure 1) when compared with NPH insulin, which has a distinct and variable peak; they also confer a substantially lower risk of hypoglycemia than NPH insulin, particularly at night (Home & Kurtzhals, 2006; Peterson, 2006).
The availability of human insulin and subsequently
insulin analogs that more closely mimic the body's physiology have contributed to increased safety in patients with diabetes and a greater role in patients with T2DM.
"The use of basal
insulin analogs in usual practice settings may not be associated with clinical advantages for these outcomes," the authors write.
For example, evidence indicates that hypoglycemia occurs less frequently with comparable glycemic control with the use of basal
insulin analogs than with human NPH insulin, (7-13) while weight gain is usually comparable with the basal
insulin analogs and human NPH insulin.
The large variability in
insulin analog cross-reactivities with different commercial assays is noteworthy.
Now, Novo Nordisk AS, which markets Levemir, asserts that it is the only company which offers a complete portfolio of
insulin analogs with a pregnancy category B classification.
The limitations of human premixed insulins have been addressed by using newer
insulin analog premix preparations.
The effectiveness of adding a long-acting
insulin analog to oral therapy has been demonstrated in a 9month, open-label, multicenter, observational study (28) in which add-on insulin glargine (dosed according to the judgment of the treating physician) was initiated in 12,216 patients with type 2 diabetes inadequately controlled with oral drugs.
Three separate lots totaling approximately 129,000 10-mL vials of the long-acting basal
insulin analog, made by Novo Nordisk, were stolen in North Carolina and are now being sold in the U.S.
In partnership with Biocon Ltd (BSE code:532523)(NSE:BIOCON), Mylan NV has developed insulin glargine, a long-acting
insulin analog used to treat adults with type 2 diabetes and adults and pediatric patients (children 6 years and older) with type 1 diabetes for the control of high blood sugar.
The guide is available as an application on iTunes and is specific to Novo Nordisk's
insulin analog portfolio: Levemir (insulin detemir [rDNA origin] injection), NovoLog (insulin aspart [rDNA origin] injection) and NovoLog Mix 70/30 (70% insulin aspart protamine suspension and 30% insulin aspart injection [rDNA origin]).
