Differentiating Basal Insulin Preparations: Understanding How They Work Explains Why They Are Different

Abstract Since the introduction of insulin as a life-saving agent for patients with type 1 diabetes, insulin preparations have evolved to approximate physiologic insulin delivery profiles to meet prandial and basal insulin needs. While prandial insulins are designed to have quick time –action profiles that minimize postprandial glucose excursions, basal insulins are designed to have a protracted time–action profile to facilitate basal glucose control over 24 h. Given that all insulins have the same mechanism of action at the target tissue level, the differences in time–act ion profiles are achieved through different mechanisms of protraction, resulting in different behaviors in the subcutaneous space and different rates of absorption into the circulation. Herein, we evaluate the differences in basal insulin preparations based on their differential mechanisms of protra ction, and the resulting clinical action profiles. Multiple randomized control trials and real-world evidence studies have demonstrated that the newer second-generation basal insulin analogs, insulin glargine 300 units/mL and insulin degludec 100 or 200 units/mL, provide stable glycemic control wi th 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. These advantages can lead to decreased healthcare resource utilization and cost. With this collec...
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research

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Congenital malformations and perinatal mortality rates remain severalfold higher in pregnant women with type 1 diabetes than in the background population, and still only a minority of women plan their pregnancy. Optimizing glycemic control is the accepted goal, but remains challenging, and must be constantly balanced against the risks of hypoglycemia. Recent advances including Continuous Glucose Monitoring Systems, Continuous Subcutaneous Insulin Infusion, Closed Loop Devices and very Fast Acting Insulin Aspart analogs offer new possibilities to increase glucose time in target in selected, motivated patients, however their...
Source: Endocrinology and Metabolism Clinics of North America - Category: Endocrinology Authors: Source Type: research
The CEO of Diasome Pharmaceuticals shares his personal type 1 diabetes story, and how their product directs insulin to the right path for best absorption.
Source: Diabetes Mine - Category: Endocrinology Authors: Source Type: blogs
To investigate in a large population the proportion of daily basal insulin dose (BD) to daily total insulin dose (TD) (BD/TD) and its association with glycated hemoglobin A1c (HbA1c),  body mass index (BMI)- SDS, and treatment modality in children with type 1 diabetes.
Source: The Journal of Pediatrics - Category: Pediatrics Authors: Tags: Original Article Source Type: research
Authors: Udler MS, McCarthy MI, Florez JC, Mahajan A Abstract Over the last decade, there have been substantial advances in the identification and characterization of DNA sequence variants associated with individual predisposition to type 1 and type 2 diabetes. As well as providing insights into the molecular, cellular and physiological mechanisms involved in disease pathogenesis, these risk variants, when combined into a polygenic score, capture information on individual patterns of disease predisposition that have the potential to influence clinical management. In this review, we describe the various opportunitie...
Source: Endocrine Reviews - Category: Endocrinology Tags: Endocr Rev Source Type: research
Publication date: September 2019Source: Biomedical Signal Processing and Control, Volume 54Author(s): Shadi Khodakaramzadeh, Yazdan Batmani, Nader MeskinAbstractArtificial pancreas (AP) systems perform automated insulin delivery to subjects with type 1 diabetes mellitus (T1DM). In this paper, a nonlinear suboptimal controller is designed to make a trade-off between the elimination of hypoglycemia events and the limitation of postprandial hyperglycemia. All the in silico simulations are performed using the distribution version of the UVA/Padova type 1 diabetes (T1D) simulator. The proposed nonlinear AP system is based on an...
Source: Biomedical Signal Processing and Control - Category: Biomedical Science Source Type: research
Authors: Hamouda L, Miliani M, Hadjidj Z, Messali R, Aribi M Abstract BACKGROUND: Monocytes are the main blood innate mononuclear phagocyte and one of the most important effector cells expressing Fcγ receptor, which is critical for the interaction with Fc domain of antibodies. OBJECTIVE: To evaluate the effect of Rituximab (RTX, a chimeric human anti-CD20 monoclonal antibody) on the functional activities of Monocytes (MOs) at the onset of human Type 1 Diabetes (T1D). METHODS: MOs were isolated from peripheral blood mononuclear cells (PBMCs) obtained from volunteer patients with recent-onset T1D and he...
Source: Endocrine, Metabolic and Immune Disorders Drug Targets - Category: Drugs & Pharmacology Tags: Endocr Metab Immune Disord Drug Targets Source Type: research
Disturbed eating behaviors (DEB) in adolescents and emerging adults with type 1 diabetes transitioning to adult care are associated with worse diabetes self-management, according to a longitudinal study.Reuters Health Information
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Diabetes & Endocrinology News Source Type: news
Publication date: Available online 19 July 2019Source: Canadian Journal of DiabetesAuthor(s): P. Khanna, L. Chow, E. Brydges, K. Anukum, S. Liu, J.L. Mahon, T. Joy, R. McManusAbstractPregnancies complicated by diabetes are increasingly frequent. The Endocrine and Pregnancy Clinic [EPC] at St Joseph’s Health Care London is the stable, local provider of all outpatient pregnancy diabetes care, thereby providing an opportunity to document patient characteristics with time.MethodsEPC charts were reviewed for: 2000-2002; 2010-2012; 2014-2016 documenting DM type (T1DM, T2DM, GDM); age; weight; year/week of DM diagnosis; med...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
Authors: Kumar S, Gupta A, Sameja P, Patel I, Gupta S Abstract Diabetes mellitus a disease with various macro and micro vascular complications due to its various metabolic dysregulations, is well known to involve lungs in long run in both type 1 and 2 diabetes mellitus, causing tremendous burden on health care system. Common simple lung function tests alone are likely to underestimate the prevalence and degree of lung dysfunction in diabetes, but newer noninvasive tests of lung mechanical function provide a more sensitive assessment of peripheral airway function, hence by establishing a marker and risk factors for ...
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Authors: Nemcansky J, Stepanov A, Koubek M, Veith M, Klimesova YM, Studnicka J Abstract Purpose: To present a cohort of treatment-naive patients with the neovascular form of age-related macular degeneration (nAMD) treated with aflibercept in a fixed regimen and evaluate the treatment response of three types of choroidal neovascular membrane (CNV)-occult (Type 1), classic (Type 2), and minimally classic (Type 4). Methods: This was a multicentre, prospective, observational consecutive case series study. Patients diagnosed with three types of CNV of nAMD were treated in a fixed regimen (3 injections every 4&thinsp...
Source: Journal of Ophthalmology - Category: Opthalmology Tags: J Ophthalmol Source Type: research
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