Pharmacokinetic and Pharmacodynamic Advantages of Insulin Analogues and Premixed Insulin Analogues Over Human Insulins: Impact on Efficacy and Safety

Rolla, Arturo R.

doi:10.1016/j.amjmed.2008.03.022

Cited by 66 publications

(44 citation statements)

References 66 publications

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“…For example, soluble human insulin preparations aggregate upon injection and are thus absorbed too slowly to protect adequately against postprandial glucose excursions. 7 Intermediateacting preparations, or neutral protamine Hagedorn (NPH) insulin, are associated with unpredictable peaks. In addition, conventional insulin treatment regimens can pose considerable barriers to adherence.…”

Section: Pharmacokinetic Characteristics Of Selected Insulin Therapiesmentioning

confidence: 99%

“…Thus, these formulations may offer advantages to patients who are unwilling to self-administer multiple daily injections or who are at risk of nonadherence due to demands on coordinating treatments with meals. 7,9 Three premixed insulin analogues are approved for use in the United States: insulin aspart 70/30, insulin lispro 75/25, and insulin lispro 50/50. For each preparation, the first number represents the constituent percentage of protaminated analogue, which acts over 8−12 hours to control basal glucose levels.…”

Section: Ahrq's Comparative Effectiveness Research On Premixed Insulinmentioning

confidence: 99%

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AHRQ's Comparative Effectiveness Research on Premixed Insulin Analogues for Adults with Type 2 Diabetes: Understanding and Applying the Systematic Review Findings

Qayyum¹,

Greene²

2011

JMCP

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experience includes numerous meta-analytic studies on treatments for conditions such as type 2 diabetes, hypertension, acute coronary syndromes, and the effectiveness of continuing medical education. His research has been supported by the Agency for Healthcare Research and Quality and the National Institutes of Health. He serves as Associate Editor of the Journal of Hospital Medicine and is a member of the Society of Hospital Medicine, the American Heart Association, and the American College of Physicians. ) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. PRIME ® designates this Journal-Based CME activity for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Pharmacist Accreditation StatementThis curriculum has been approved for 2.5 contact hours by PRIME ® . PRIME ® is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. The universal program number for this activity is 0255-0000-11-004-HO1-P. This learning activity is Knowledge-based. Nurse Accreditation Statement PRIME Education, Inc. (PRIME ® ) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. PRIME ® designates this activity for 2.5 contact hours. Case Manager Accreditation StatementThe Commission for Case Manager Certification designates this educational activity for 2.0 contact hours for certified case managers. AHRQ's Comparative Effectiveness Research on Premixed Insulin Analogues for Adults with Type 2 Diabetes: Understanding and Applying the Systematic Review Findings Credit Instructions:In order to receive CME/CE credit for this program, you must: 1. Review this program in its entirety 2. Access www.ce.effectivehealthcare.ahrq.gov/credit and enter program code CER1 3. Complete the post-test (70% passing score) and evaluation online 4. Print your CME/CE statement immediately following the evaluation DISCLOSURESQayyum produced this program under contract with PRIME Education, Inc. (PRIME ® ). Greene is an employee of PRIME ® . The authors report no financial or other conflicts of interest related to the subjects in this report. Mooradian, Jarvis, Gunning, and Valdez report no financial or other conflicts of interest related to the subjects in this report.Brixner reports consultant relationships with Novo Nordisk, Novartis, and Abbott Laboratories, and grant funds paid to her institution from Bristol-Myers Squibb and Novo Nordisk. Campbell reports participation in the speakers bureau for Eli Lilly. Neumiller reports grant funds paid to his institution from Amylin, Johnson & Johnson, Merck, and Novo Nordisk. Quilliam reports grant funds paid to his institution from Takeda and Ortho-McNeil Janssen. ACKNOWLEDGEMENTSThe authors acknowledge Diana I. Brixner, RPh, PhD, and Karen M. Gunning, PharmD, of the University of Utah Departme...

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Section: Pharmacokinetic Characteristics Of Selected Insulin Therapiesmentioning

confidence: 99%

Section: Ahrq's Comparative Effectiveness Research On Premixed Insulinmentioning

confidence: 99%

AHRQ's Comparative Effectiveness Research on Premixed Insulin Analogues for Adults with Type 2 Diabetes: Understanding and Applying the Systematic Review Findings

Qayyum¹,

Greene²

2011

JMCP

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“…11 AEs associated with insulin therapy include weight gain and hypoglycemia, 12 though the risks for both of these effects are reduced with the use of newer insulin analogs. 36 Current treatment guidelines for patients with T2DM recommend an individualized treatment approach to balance glycemic efficacy with tolerability and long-term safety. Guidelines also consider that T2DM is a progressive disease characterized by worsening glycemic control, which requires treatment intensification with dose titration and the addition of medications over time to achieve and maintain treatment goals.…”

Section: 27mentioning

confidence: 99%

Saxagliptin: the evidence for its place in the treatment of type 2 diabetes mellitus

Edelman¹

2010

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“…2,23 In contrast, biphasic insulin regimens use a single insulin preparation to deliver prandial and basal insulin requirements. 24 Premixed insulin analogues are derived from rapid-acting insulin analogues and consist of a mixture of rapid-acting insulin analogue and its intermediate-acting protaminated form. 24 Protamination is a process that produces an analogue with an intermediate duration of action.…”

Section: Introductionmentioning

confidence: 99%

“…24 Premixed insulin analogues are derived from rapid-acting insulin analogues and consist of a mixture of rapid-acting insulin analogue and its intermediate-acting protaminated form. 24 Protamination is a process that produces an analogue with an intermediate duration of action. Biphasic insulins are typically administered once, twice, or thrice daily.…”

Section: Introductionmentioning

confidence: 99%

Sex Differences And Relationship Between Blood Pressure And Age Among The Ibos Of Nigeria

Jervas¹,

Barnabas²,

Emeka³

et al. 2009

IJBA

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Background: In type 2 diabetes, simple, convenient and effective regimens should encourage timely insulin initiation and improve outcomes. Long-and rapid-acting insulin analogues more closely mimic endogenous basal/prandial insulin secretion than human equivalents. Premixed insulin analogues deliver prandial and basal insulin in one formulation and can be administered 1-3 times daily. Premixed insulin may, therefore, provide an alternative to basal-bolus regimens for intensification of insulin therapy.Objectives: The aim of this commentary was to show how biphasic insulin therapy may offer a simple and effective intensification option for patients with type 2 diabetes who do not achieve adequate control with existing insulin therapies.Methods: A literature search using the PubMed database (years: January 1997-September 2010) was carried out using the search terms diabetes AND ([(biphasic OR bi-phasic) AND (insulin OR insulins]) OR ([premix OR pre-mix) AND (insulin OR insulins)]). Clinical trials, systematic reviews, case reports or clinical practice guidelines that addressed topics of interest with regard to premixed insulin analogues/analogue regimens and intensification strategies were identified and included.Results: Clinical data show that premixed insulin analogues reduce hemoglobin A1C and fasting plasma glucose to a similar extent as premixed human insulin, but have advantages in terms of postprandial glucose control, incidence of hypoglycemia, and convenience. Premixed insulins may also provide benefits to glycemic control (reduced HbA1c, fasting and postprandial plasma glucose) in patients failing to achieve targets on basal insulin. In addition, premixed insulin analogue regimens generally compare well with basal-bolus regimens. Conclusions: Premixed insulin analogues offer a simple intensification option in patients with type 2 diabetes not achieving adequate control with existing insulin therapy. Premixed insulin analogues may offer a viable alternative to basal-bolus regimens and an improved physiologic profile compared with human equivalents.

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Pharmacokinetic and Pharmacodynamic Advantages of Insulin Analogues and Premixed Insulin Analogues Over Human Insulins: Impact on Efficacy and Safety

Cited by 66 publications

References 66 publications

AHRQ's Comparative Effectiveness Research on Premixed Insulin Analogues for Adults with Type 2 Diabetes: Understanding and Applying the Systematic Review Findings

AHRQ's Comparative Effectiveness Research on Premixed Insulin Analogues for Adults with Type 2 Diabetes: Understanding and Applying the Systematic Review Findings

Saxagliptin: the evidence for its place in the treatment of type 2 diabetes mellitus

Sex Differences And Relationship Between Blood Pressure And Age Among The Ibos Of Nigeria

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