Basal insulin peglispro: Overview of a novel long-acting insulin with reduced peripheral effect resulting in a hepato-preferential action

2016 ◽  
Vol 18 ◽  
pp. 3-16 ◽  
Author(s):  
S. J. Jacober ◽  
M. J. Prince ◽  
J. M. Beals ◽  
M. L. Hartman ◽  
Y. Qu ◽  
...  
Keyword(s):  
Basal Insulin ◽  
Acting Insulin ◽  
Peripheral Effect ◽  
Long Acting

scholarly journals Treatment intensification using long-acting insulin –predictors of future basal insulin supported oral therapy in the DIVE registry

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Thomas Danne ◽  
◽  
Tobias Bluhmki ◽  
Jochen Seufert ◽  
Matthias Kaltheuner ◽  
...  
Keyword(s):  
Basal Insulin ◽  
Oral Therapy ◽  
Treatment Intensification ◽  
Acting Insulin ◽  
Long Acting

scholarly journals Comparative vascular safety of basal long-acting insulin analogue versus intermediate-acting human insulin in real-world patients with type 2 diabetes: a nationwide population-based cohort study

2020 ◽  
Author(s):  
Chun-Ting Yang ◽  
Kuan-Ying Li ◽  
Chen-Yi Yang ◽  
Huang-Tz Ou ◽  
Shihchen Kuo
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Real World ◽  
Basal Insulin ◽  
Lower Risk ◽  
Insulin Analogue ◽  
Population Based ◽  
Acting Insulin ◽  
Long Acting

Abstract Background: Little is known about the comparative vascular safety of basal insulin (intermediate-acting human insulin [IAHI] or long-acting insulin analogue [LAIA]) in type 2 diabetes. We sought to examine the vascular and hypoglycemic effects associated with IAHI versus LAIA in real-world patients with type 2 diabetes. Methods: We conducted a nationwide population-based, retrospective cohort study using Taiwan’s National Health Insurance Research Database to include patients with type 2 diabetes who stably used an IAHI (N=11,521) or LAIA (N=37,651) in the period 2004-2012. A rigorous three-step matching algorithm that considered the initiation date of basal insulin, previous exposure of antidiabetic treatments, comorbidities, diabetes severity and complications, and concomitant medications was applied to achieve the between-group comparability. Study outcomes, including composite cardiovascular diseases (CVDs), composite microvascular diseases (MVDs), and hypoglycemia, were assessed up to the end of 2013. Results: Baseline patient characteristics were balanced with the application of the matching scheme. Compared with LAIA, the use of IAHI was associated with greater risks of composite CVDs (adjusted hazard ratio: 1,79; 95% confidence interval: 1.20-2.67) and hospitalized hypoglycemia (1.82; 1.51-2.20), but a lower risk of composite MVDs (0.88; 0.84-0.91). Subgroup and sensitivity analyses showed a consistent trend of results with that in the primary analyses. Conclusions: The use of a basal insulin with IAHI versus LAIA among patients with type 2 diabetes in usual practice may be associated with a lower risk of MVDs, and strategies should be optimized for minimizing the risks of hypoglycemia and CVDs in this population.

Direct healthcare costs of patients with type 2 diabetes using long-acting insulin analogues or NPH insulin in a basal insulin-only regimen

2010 ◽  
Vol 4 (3) ◽  
pp. 165-172 ◽  
Author(s):  
Jens Gundgaard ◽  
Torsten E. Christensen ◽  
Trine Lyager Thomsen
Keyword(s):  
Type 2 Diabetes ◽  
Basal Insulin ◽  
Healthcare Costs ◽  
Insulin Analogues ◽  
Nph Insulin ◽  
Acting Insulin ◽  
Direct Healthcare Costs ◽  
Long Acting

scholarly journals Can simple intensification of therapy with modern two-phase insulin help in type 2 diabetes when target glycemia failed to be achieved withbasal insulin? Results of subanalysis in the PRESENT study

2009 ◽  
Vol 12 (3) ◽  
pp. 79-84
Author(s):  
Ch S Yang ◽  
S Guler ◽  
Marina Vladimirovna Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Basal Insulin ◽  
Two Phase ◽  
Acting Insulin ◽  
Type2 Diabetes ◽  
Previously Treated ◽  
The Difference ◽  
Long Acting ◽  
Type2 Diabetes Mellitus

Aim. To evaluate efficiency and safety of intensification of therapy by substituting two-phase insulin aspart 30 (DiAsp 30) for basal insulin in patients with type2 diabetes mellitus after a failure to achieve target glycemia. Materials and methods. Analysis of the data obtained in a group of patients involved in the PRESENT study (Physicians Routine Evaluation of Safety andEfficacy of NovoMix 30 Therapy), a 6 month-long observational study conducted in 15 countries. The subanalysis included patients previously treated with along-acting insulin analog (AB, n=34) or intermediate and long-acting human basal insulin (HB, n=3414) and transferred thereafter to DiAsp 30 therapy.End-points of efficiency were the difference between blood HbА1c and glucose (fasting and postprandial) levels measured at the onset of the study and upon itscompletion, the number of hypoglycemic episodes and adverse events, physician and patients content with the results of the treatment. End-points were consideredseparately with reference to preceding basal therapy (AB or HB). Results. Treatment with DiAsp 30 for 6 months resulted in a fall of HbА1c levels compared with initial values (-1,60 and -142% in AB and HB patients respectively,p

scholarly journals The Clinical Role of Insulin Degludec/Insulin Aspart in Type 2 Diabetes: An Empirical Perspective from Experience in Australia

2020 ◽  
Vol 9 (4) ◽  
pp. 1091
Author(s):  
Sarah J. Glastras ◽  
Neale Cohen ◽  
Thomas Dover ◽  
Gary Kilov ◽  
Richard J. MacIsaac ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Aspart ◽  
Basal Insulin ◽  
Insulin Degludec ◽  
Dose Titration ◽  
Treatment Intensification ◽  
Clinical Role ◽  
Acting Insulin ◽  
Long Acting

Treatment intensification in people with type 2 diabetes following failure of basal insulin commonly involves the addition of a rapid-acting insulin analogue (basal plus one or more prandial doses; multiple daily injections) or by a switch to premixed insulin. Insulin degludec/insulin aspart (IDegAsp), comprising rapid-acting insulin aspart and ultra-long-acting insulin degludec in solution, enables both fasting and post-prandial glucose control, with some advantages over other treatment intensification options. These include straightforward dose titration, flexibility in dose timing, low injection burden, simplicity of switching and a lower risk of hypoglycaemia. In Australia, where insulin degludec on its own is not available, IDegAsp enables patients to still benefit from its ultra-long-acting properties. This review aims to provide guidance on where and how to use IDegAsp. Specifically, guidance is included on the initiation of IDegAsp in insulin-naïve patients, treatment intensification from basal insulin, switching from premixed or basal-bolus insulin to IDegAsp, up-titration from once- to twice-daily IDegAsp and the use of IDegAsp in special populations or situations.

Insulin Glargine: A New Basal Insulin

2002 ◽  
Vol 36 (6) ◽  
pp. 1019-1027 ◽  
Author(s):  
Terri L Levien ◽  
Danial E Baker ◽  
John R White ◽  
R Keith Campbell
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Glargine ◽  
Basal Insulin ◽  
Nph Insulin ◽  
Once Daily ◽  
Nocturnal Hypoglycemia ◽  
Acting Insulin ◽  
Long Acting

OBJECTIVE: To review the pharmacology, pharmacokinetics, dosing guidelines, adverse effects, drug interactions, and clinical efficacy of insulin glargine. DATA SOURCES: Primary and review articles regarding insulin glargine were identified by MEDLINE search (1966–July 2001); abstracts were identified through Institute for Scientific Information Web of Science (1995–July 2001) and the American Diabetes Association. Additional information was obtained from the insulin glargine product information. STUDY SELECTION AND DATA EXTRACTION: All of the articles and meeting abstracts identified from the data sources were evaluated, and all information deemed relevant was included in this review. Priority was placed on data from the primary medical literature. DATA SYNTHESIS: Insulin glargine is a long-acting, recombinant human insulin analog that is given once daily as a basal source of insulin in patients with type 1 or type 2 diabetes mellitus. Modification of the basic insulin structure has produced a new insulin that is soluble at an acidic pH, but precipitates in the subcutaneous tissue and is slowly released from a depot. Insulin glargine has a slower onset of action than NPH insulin and a longer duration of action with no peak activity. Once-daily administration of insulin glargine has comparable efficacy to that of NPH insulin administered once or twice daily in basal-bolus regimens when used in combination with intermittent doses of regular insulin or insulin lispro in patients with type 1 and type 2 diabetes, and in conjunction with oral antidiabetic agents in patients with type 2 diabetes. Overall, insulin glargine has an incidence of hypoglycemia comparable to or less than that of NPH insulin, with a reduced incidence of nocturnal hypoglycemia compared with NPH insulin seen in some studies. CONCLUSIONS: Insulin glargine is a long-acting insulin analog capable of providing 24-hour basal insulin coverage when administered once daily at bedtime. Its activity profile, which lacks a pronounced peak, more closely resembles that of endogenous basal insulin than that of other intermediate- or long-acting insulins and appears more likely to be associated with a reduced incidence of hypoglycemia, particularly nocturnal hypoglycemia. Insulin glargine physiologically provides basal insulin but, for most patients, the addition of a rapid-acting insulin, like insulin lispro, before or with meals will need to be included in the treatment regimen to achieve optimal management of blood glucose concentrations.

Novel Long-Acting Insulin Effective

2011 ◽  
Vol 6 (4) ◽  
pp. 17
Author(s):  
MIRIAM E. TUCKER
Keyword(s):  
Acting Insulin ◽  
Long Acting
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