(Ultra-)long-acting insulin analogues for people with type 1 diabetes mellitus

Hemmingsen, Bianca; Richter, Bernd; Metzendorf, Maria‐Inti

doi:10.1002/14651858.cd013498

Cited by 6 publications

(5 citation statements)

References 36 publications

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“…The most recent Cochrane review on the use of basal insulin analogs compared to NPH insulin in patients with type 1 diabetes included 26 randomized controlled trials with 8,784 patients and had shown the following findings: insulin detemir lowered the risk of severe hypoglycemia compared to NPH insulin but this finding was not consistent; there was no difference in the incidence of severe hypoglycemia when comparing insulin glargine to NPH insulin; there was no difference in the occurrence of severe nocturnal hypoglycemia, glucose control, or quality of life when comparing insulin detemir or insulin glargine to NPH insulin; there were no differences in all those outcomes between children and adults. 23 In another systematic review that included 65 randomized and nonrandomized trials with 14,200 patients and was sponsored by the Canadian Health and Canadian Agency for Drugs and Technologies in Health, the authors found benefits of using long-acting basal insulin analogs compared to NPH insulin in patients with type 1 diabetes in terms of reduction of HbA1c, fasting plasma glucose, weight gain, and the incidence of major, serious, or nocturnal hypoglycemia. 24 A more recent systematic review included 28 randomized controlled trials with 7,394 patients and had shown statistically significant improvement of glucose control with the long-acting basal insulins analog glargine but not insulin detemir compared to NPH insulin (mean reduction of HbA1c of 0.31% with insulin glargine and mean reduction of 0.25% with insulin detemir compared to NPH insulin) and lower risk of severe hypoglycemia with basal insulin analogs.…”

Section: Type 1 Diabetesmentioning

confidence: 99%

Comparison of Insulin Analogs and Human Insulins: A Narrative Review

Eledrisi,

Danjuma

2023

Journal of Diabetes and Endocrine Practice

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Introduction Since insulin analogs have pharmacological properties that are similar to the normal physiological action of insulin, it has been suggested that they provide better glucose control and less rates of hypoglycemia compared to human insulins. Methods We performed a narrative, nonsystematic review of the literature including clinical trials, systematic reviews, meta-analyses, and professional guidelines related to the comparison of human insulins and insulin analogs in terms of glucose control, safety profile, and cost. Results Long-acting basal insulins result in mild improvement in glucose control and less rates of nocturnal hypoglycemic compared to neutral protamine Hagedorn insulin, mainly among patients with type 1 diabetes. Rapid-acting insulin analogs provide better glucose control and lower rates of hypoglycemia compared to regular insulin among patients with type 1 diabetes, whereas no advantage has been shown for insulin analogs among patients with type 2 diabetes for glucose control or hypoglycemia. Premixed insulin analogs provided no advantage in glucose control and inconsistent benefit in lowering the rates of hypoglycemia compared to human premixed insulins among patients with type 2 diabetes. The cost of insulin analogs is significantly higher than human insulins, and favorable cost-effectiveness has only been demonstrated for rapid-acting insulin analogs in type 1 diabetes. Conclusion Currently available evidence supports the use of rapid-acting insulin analogs and possibly long-acting basal insulin over human insulins for patients with type 1 diabetes. For patients with type 2 diabetes, the use of long-acting insulin analogs may be recommended for selected patients who are at an increased risk of significant hypoglycemia, while no clear benefits of meal insulin analogs over human insulins have been observed.

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Section: Type 1 Diabetesmentioning

confidence: 99%

Comparison of Insulin Analogs and Human Insulins: A Narrative Review

Eledrisi,

Danjuma

2023

Journal of Diabetes and Endocrine Practice

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“…The World Health Organization has recommended to the globe a “modern comprehensive therapy (quintet)” for diabetes, with diet control ranking first [ 19 ]. Therefore, functional factors that regulate blood sugar have become research hotspots in the field of diabetes prevention and treatment.…”

Section: Introductionmentioning

confidence: 99%

The SWGEDWGEIW from Soybean Peptides Reduces Insulin Resistance in 3T3-L1 Adipocytes by Activating p-Akt/GLUT4 Signaling Pathway

Sang

Zhu

et al. 2023

Molecules

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Diabetes mellitus, a group of metabolic disorders characterized by persistent hyperglycemia, affects millions of people worldwide and is on the rise. Dietary proteins, from a wide range of food sources, are rich in bioactive peptides with anti-diabetic properties. Notably, the protective mechanism of the single peptide SWGEDWGEIW (TSP) from soybean peptides (SBPs) on insulin resistance of adipocytes in an inflammatory state was investigated by detecting the lipolysis and glucose absorption and utilization of adipocytes. The results showed that different concentrations of TSP (5, 10, 20 µg/mL) intervention can reduce 3T3-L1 adipocytes’ insulin resistance induced by inflammatory factors in a dose-dependent manner and increase glucose utilization by 34.2 ± 4.6%, 74.5 ± 5.2%, and 86.7 ± 6.1%, respectively. Thus, TSP can significantly alleviate the lipolysis of adipocytes caused by inflammatory factors. Further mechanism analysis found that inflammatory factors significantly reduced the phosphorylation (p-Akt) of Akt, two critical proteins of glucose metabolism in adipocytes, and the expression of GLUT4 protein downstream, resulting in impaired glucose utilization, while TSP intervention significantly increased the expression of these two proteins. After pretreatment of adipocytes with PI3K inhibitor (LY294002), TSP failed to reduce the inhibition of p-Akt and GLUT4 expression in adipocytes. Meanwhile, the corresponding significant decrease in glucose absorption and the increase in the fat decomposition of adipocytes indicated that TSP reduced 3T3-L1 adipocytes’ insulin resistance by specifically activating the p-Akt/GLUT4 signal pathway. Therefore, TSP has the potential to prevent obesity-induced adipose inflammation and insulin resistance.

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“…The World Health Organization currently reports that there are 463 million diabetics worldwide and predicts the existence of 700 million diabetics by 2045 [3] . With the advent of insulin and the rational use of antibiotics, complications such as diabetic ketoacidosis, diabetic foot, and severe systemic infection have been greatly reduced [4][5][6] . However, diabetic retinopathy (DR), diabetic nephropathy (DN) and other diseases caused by diabetes have become major complications that seriously affect the quality of life of patients [7,8] .…”

Section: Introductionmentioning

confidence: 99%

Applying a convolutional neural network as a statistical method to evaluate the correlation between diabetic retinopathy and diabetic nephropathy

Li¹,

Tang²,

Gao³

et al. 2023

Preprint

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Objective At present, there is no consensus on the relationship between diabetic nephropathy (DN) and diabetic retinopathy (DR), and there is a lack of imaging data to prove the correlation between them. Therefore, we aimed to investigate the common risk factors for DN and DR in patients with type 2 diabetes and used Emission Computed Tomography(ECT) imaging technology and clinical test criteria to assess the correlation between DR and DN.Purpose The convolutional neural network was employed to observe and detect pathological changes in DR and DN images. And further analyze the correlation between DR and DN through clinical test data.Results In this study, we discovered that with the aggravation of DR, SCR, BUN and ACR gradually increased while GFR decreased. The incidence of DN in the non-DR, mild-NPDR, moderate-NPDR, severe-NPDR and PDR groups was 4.17%, 28.33%, 55%, 75.83% and 91.67%, respectively. Multivariate linear regression analysis showed that duration of T2D, smoking, HbA1c, TC, TG, HDL-c, LDL-c, UAlb, Scr, BUN, UAlb, ACR, GFR, ACR and GFR were independent risk factors for DR. Renal dynamic ECT imaging analysis demonstrated that with the aggravation of DR, renal blood flow perfusion gradually decreased, thus resulting in a decrease in renal filtration function. In T2D patients, DR and DN show a linear aggravation relationship, and hypercholesterolemia and renal dysfunction are common risk factors for DR and DN.Conclusion The convolutional neural network provides a more accurate, efficient and easier way to analyze DR and DN images. Early screening of the renal function index in DR patients using ECT imaging technology will help to identify and prevent DN as early as possible.

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(Ultra-)long-acting insulin analogues for people with type 1 diabetes mellitus

Cited by 6 publications

References 36 publications

Comparison of Insulin Analogs and Human Insulins: A Narrative Review

Comparison of Insulin Analogs and Human Insulins: A Narrative Review

The SWGEDWGEIW from Soybean Peptides Reduces Insulin Resistance in 3T3-L1 Adipocytes by Activating p-Akt/GLUT4 Signaling Pathway

Applying a convolutional neural network as a statistical method to evaluate the correlation between diabetic retinopathy and diabetic nephropathy

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