Pharmacology - DRUGS FOR DIABETES (MADE EASY)
Newer Forms of Insulin Make for Easier Diabetes Management
Faster and Longer-Acting Types of Insulin
To help resolve these issues, a number of pharmaceutical companies are now working on newer forms of insulin that work more quickly or last much longer. Faster “rapid-acting” forms, which are injected before a meal, keep up with the rise in blood sugar after eating. These newer rapid-acting products begin to act within three to five minutes of injection, peak within 30 to 90 minutes, and stay in the body for about three to five hours. One form contains a recombinant human hyaluronidase, an enzyme that temporarily breaks down hyaluronan, a structural component of the space just beneath the surface of the skin. This temporary breakdown creates a “window” for improved delivery of injectable molecules such as insulin through the skin, allowing the insulin to be absorbed more rapidly. Another agent recently approved by the U.S. Food and Drug Administration (FDA) is a rapid-acting insulin that is inhaled rather than injected.
These fast-acting types of insulin can often be used together with new-generation basal insulins that have an ultra-long duration of action of more than 42 hours. The new long-acting products consistently release insulin very slowly into the body, just as the pancreas normally would, to prevent dangerous peaks and drops in blood glucose levels. In addition, long-acting insulin allows more flexibility in the timing of the injections while still managing blood sugar levels. In fact, some long-acting products would even allow someone to inject a dose up to eight hours late and still maintain control of blood sugar the following day. One agent has already been approved and launched in the European Union, Japan, and Mexico; in the United States, the FDA has required additional data for approval, and this data is being generated.
As with most medications, the right form, dose, and frequency of insulin depends on each person’s unique needs, medical profile, and lifestyle. Changes in weight, exercise, diet, and medical condition can all affect insulin needs. If you need insulin to help manage diabetes, you and your physician can work together to determine the most appropriate insulin regimen for you.
Athena Philis-Tsimikas, M.D., is an endocrinologist and the corporate vice president for the Scripps Whittier Diabetes Institute at Scripps Health in San Diego.
Video: New Insulin Delivery Recommendations
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