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Differentiating Basal Insulin Preparations.

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eMediNexus    02 April 2019

A new article published in Advances in Therapy discussed that prandial insulins are designed to have quick time-action profiles that minimize postprandial glucose excursions, whereas basal insulins are designed to have a protracted time-action profile to facilitate basal glucose control over 24 hours. The authors explained that since all insulins have the same mechanism of action at the target tissue level, the differences in time-action profiles are achieved through different mechanisms of protraction, resulting in different behaviors in the subcutaneous space and different rates of absorption into the circulation. This article elaborated on the results of a study that evaluated the differences in basal insulin preparations based on their differential mechanisms of protraction, and the resulting clinical action profiles. From the results, it was stated that multiple randomized control trials and real-world evidence studies have demonstrated that newer second-generation basal insulin analogs—insulin glargine 300 units/mL and insulin degludec 100 or 200 units/mL, provide stable glycemic control with once-daily dosing and are associated with a reduced risk of hypoglycemia compared with previous-generation basal insulin analogs—insulin glargine 100 units/mL and insulin detemir. It was concluded that these advantages can lead to decreased healthcare resource utilization and cost. This knowledge can help clinicians in individualizing treatment regimen for their patients.

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