Authors: Heise, T.; Heinemann, L.

Source: Current Pharmaceutical Design, Volume 7, Number 14, 1 September 2001 , pp. 1303-1325(23)

Publisher: Bentham Science Publishers

Abstract:

This review summarizes the results of clinical trials with the currently available insulin analogues (i.e., insulin lispro, insulin aspart, and insulin glargine) and evaluates their clinical benefit applying the standards of evidence-based medicine. All analogues show a more physiological time-action profile with either a shorter onset and shorter duration of action (insulin lispro and insulin aspart) or a more constant effect lasting at least 24 hours (insulin glargine). These advantages in the time-action profiles have been shown to improve various surrogate parameters (e.g., postprandial blood glucose concentrations) in a number of randomized controlled trials. Only a few studies are available, however, demonstrating a benefit on patient-oriented clinical endpoints as decrease in glycated hemoglobin (HbA 1c ), reduction of hypoglycemic episodes, and improvement in quality-of-life. This review focuses on the impact of the use of insulin analogues on these endpoints. Provided that insulin therapy is optimized as a whole (rather than just switching from human insulin to insulin analogues) all 3 analogues show (modest) beneficial impact on these endpoints. Finally, we review the relevant data concerning the safety aspects of the various analogues, thus allowing the reader to perform an individual risk-benefit-assessment.

Keywords: insulin analogues; insulin lispro; insulin aspart; insulin glargine; glycated hemoglobin; euglycemic glucose; hypoglycemia; insulin glargine

Document Type: Review article

DOI: http://dx.doi.org/10.2174/1381612013397375

Publication date: 2001-09-01

More about this publication?

• Current Pharmaceutical Design publishes timely in-depth reviews covering all aspects of current research in rational drug design. Each issue is devoted to a single major therapeutic area. A Guest Editor who is an acknowledged authority in a therapeutic field has solicits for each issue comprehensive and timely reviews from leading researchers in the pharmaceutical industry and academia.
  
  Each thematic issue of Current Pharmaceutical Design covers all subject areas of major importance to modern drug design, including: medicinal chemistry, pharmacology, drug targets and disease mechanism.

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