Articles de revues : « Insulin analogue »

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Balos, Ljiljana, Silvija Sajic et Vera Zdravkovic. « Elements of metabolic control in children with type 1 diabetes before and after introduction to insulin analogues ». Srpski arhiv za celokupno lekarstvo 139, n^o 9-10 (2011) : 605–9. http://dx.doi.org/10.2298/sarh1110605b.

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Introduction. Diabetes mellitus type 1 (T1DM) in children is characterized by unstable course. A significant number of studies shows that introduction to insulin analogues treatment aims towards better control of the disease. Objective. The assessment of metabolic control in children with T1DM that were introduced to insulin analogue treatment after many years of treatment with classic (human) insulin. Methods. The study included 59 patients 2-19 years old (12.9?3.8) with T1DM, transferred from treatment with human insulin to insulin analogues treatment. Data were obtained directly from patients and their parents, as well as from medical records. Results. The introduction to insulin analogues treatment, leads to a decrease in the value of glycolized haemoglobin (HbA1c) after 6 months (9.27?1.68% vs 8.63?1:26%, p=0.06). Average daily dose of insulin expressed per IU/kg of classic and insulin analogue (1.04?0.38 vs 1.03?0.30; p>0.05), remained almost the same. In 39 examinees (66.1%), 6 months before the introduction to insulin analogue treatment, severe hypoglicemia was registered and 6 months after the introduction to insulin analogue treatment it appeared in only two examinees (3.4%) (p<0.001). Ketoacidosis, 6 months before introduction to insulin analogues treatment, appeared in 16 examinees (27.1%), while 6 months after it was not registered (p<0.001). Conclusion. The use of insulin analogue treatment in childhood provides adequate metabolic control and substantially reduces the risk of acute complications (severe hypoglicemia, ketoacidosis).

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Girsh, Ya V., et Z. A. Akhmedova. « Hypersensitivity Reaction to Insulin Detemir in a Paediatric Patient Taking Basal-Bolus Therapy ». Doctor.Ru 19, n^o 10 (2020) : 69–73. http://dx.doi.org/10.31550/1727-2378-2020-19-10-69-73.

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Objective: To present a case study demonstrating an atypic side effect of insulin — hepersensitivity reaction to insulin detemir, a long-term human insulin analogues. Key Points. At the inpatient paediatric unit, we had an 11-year old girl with symptoms and clinical signs of diabetes mellitus (DM). Following physical examination, the patient was diagnosed with type 1 diabetes (manifestation). She was prescribed intensified basal-bolus therapy with insulin analogues: insulin detemir and insulin aspart. On day 5, the patient developed a hypersensitivity reaction in the site of insulin detemir injections. Replacement of insulin detemir with insulin degludec resolved the allergic reaction. Conclusion. We described a case of a hypersensitivity reaction to intensified insulin therapy with basal insulin analogue detemir. Hypersensitivity reactions to insulin analogues are rare; however they can be life-threatening. The primary management is the use of another insulin analogue. Keywords: diabetes mellitus, allergy, insulin detemir, insulin degludec.

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Ewen, Margaret, Huibert-Jan Joosse, David Beran et Richard Laing. « Insulin prices, availability and affordability in 13 low-income and middle-income countries ». BMJ Global Health 4, n^o 3 (juin 2019) : e001410. http://dx.doi.org/10.1136/bmjgh-2019-001410.

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IntroductionGlobally, one in two people needing insulin lack access. High prices and poor availability are thought to be key contributors to poor insulin access. However, few studies have assessed the availability, price and affordability of different insulin types in low-income and middle-income countries in a systematic way.MethodsIn 2016, 15 insulin price and availability surveys were undertaken (using an adaptation of the WHO/Health Action International medicine price and availability measurement methodology) in Brazil, China (Hubei and Shaanxi Provinces), Ethiopia, Ghana, India (Haryana and Madhya Pradesh States), Indonesia, Jordan, Kenya, Kyrgyzstan, Mali, Pakistan, Russia (Kazan Province) and Uganda. Data were collected in three sectors (public, private pharmacies and private hospitals/clinics) in three regions per survey. Insulin prices were standardised to 10 mL 100 IU/mL in US dollars ($). Data were also collected for four comparator medicines.ResultsMean availability was higher for human (55%–80%) versus analogue insulins (55%–63%), but only short-acting human insulin reached 80% availability (public sector). Median government procurement prices were $5 (human insulins) and $33 (long-acting analogues). In all three sectors, median patient prices were $9 for human insulins. Median patient prices for analogues varied between the public sector ($34) and the two private sectors ($44). Vials were cheaper than pens and cartridges. Biosimilars, when available, were mostly cheaper than originators. A low-income person had to work 4 and 7 days to buy 10 mL human and analogue insulin, respectively. For isophane human insulin, only three countries meet the WHO target of 80% availability of affordable essential medicines for non-communicable diseases in any sector.ConclusionImproving insulin availability and affordability needs to be addressed through national and global actions, including prioritising the supply of more affordable human insulin, increasing competition through the use of lower priced quality-assured biosimilars, negotiating lower prices from manufacturers and improving distribution systems.

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Romantsova, Tatiana Ivanovna, T. Sh Dzhavakhishvili et O. V. Roik. « Effects of metformin on body weight in patients with type 2 diabetes mellitus,receiving insulin analogue treatment ». Diabetes mellitus 16, n^o 1 (15 mars 2013) : 48–51. http://dx.doi.org/10.14341/2072-0351-3596.

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Aims. To study the dynamics of body weight, waist circumference, blood lipid and insulin demand in patients with type 2 diabetes mellitus (T2DM) during first year of combined treatment with metformin and insulin analogues, compared with insulin analogue monotherapy. Materials and Methods. We examined 78 patients with T2DM on newly initiated insulin therapy, including 54 females and 24 males. Median age was 56 [51.0; 64.0] years, median disease duration ? 9 [6.8;14.0] years. Participants were subdivided in two groups. First group was comprised of 48 subjects (33 females and 15 males), who received monotherapy with insulin analogues (glargine, de- temir, biphasic Aspart 30 and Humalog Mix 25 or rapid-acting lispro and aspart). Second group included 30 patients (18 females and12 males), who were treated with combined therapy (insulin analogues plus metformin). We measured HbA1c, plasma lipid composition, BMI, waist circumference and insulin demand initially and after one year of follow-up. Results. We showed that combined therapy vs. insulin monotherapy allows better glycemic compensation while reducing insulin demand and lowering risks for weight gain. Conclusions. Combined insulin analogue plus metformin treatment delivers better metabolic control in patients with T2DM and is as- sociated with lower risks for body weight gain and increase in insulin demand against monotherapy with insulin analogues.

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Mbanya, Jean Claude, Juergen Sandow, Wolfgang Landgraf et David R. Owens. « Recombinant Human Insulin in Global Diabetes Management – Focus on Clinical Efficacy ». European Endocrinology 13, n^o 01 (2017) : 21. http://dx.doi.org/10.17925/ee.2017.13.01.21.

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Biosynthetic human insulin and insulin analogues are the mainstay of insulin therapy for both type 1 and type 2 diabetes although access to human insulin at affordable prices remains a global issue. The world is experiencing an exponential rise in the prevalence of diabetes presenting an urgent need to establish effective diabetes therapy in countries burdened by inadequate health care budgets, malnutrition and infectious diseases. Recombinant human insulin has replaced animal insulins and animal-based semisynthetic human insulin thereby available in sufficient quantities and at affordable prices able to provide global access to insulin therapy. In many patients, analog insulins can offer additional clinical benefit, although at a considerably higher price thus severely restricting availability in low income countries. The approval process for recombinant human insulins (i.e. biosimilars) and analogue insulins is highly variable in the developing countries in contrast to Europe and in North America, where it is well established within a strict regulatory framework. This review aims to discuss the future access to human insulin therapy in a global context with an ever increasing burden of diabetes and significant economic implications.

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Noor Wafaa Hashim, Kadhim Ali Kadhim et Abbas Mahdi Rahmah. « Effect of human insulin and insulin analogue on some inflammatory markers and total antioxidant capacity in a sample of Iraqi type 1 diabetic children and adolescents ». Al Mustansiriyah Journal of Pharmaceutical Sciences 21, n^o 2 (19 avril 2022) : 9–14. http://dx.doi.org/10.32947/ajps.v21i2.804.

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Background: Both human insulin and insulin analogue used in the treatment of type 1 diabetes mellitus. The modification in amino acids sequences of human insulin lead to produce analogue form which have a pharmacokinetic and pharmacodynamics effect near to normal human endogenous insulin release. Aim of study: This study designed to compare between the effect of each type of insulin on high sensitive C-reactive protein and interleukin-6 and total antioxidant capacity in a sample of Iraqi type 1 diabetic children and adolescents. Study design: The study was enrolled on fifty-one Iraqi type 1 diabetic children and adolecence age range (6-18) year. The patients allocated into two groups, Group (1) includes 20 patients assigned to receive conventional human insulin (regular and NPH), and Group (2) includes 20 patients assigned to receive insulin analogue (insulin aspart and glargine) for three months. The inflammatory and antioxidant markers measured at baseline and after three months of intervention. Results: After three months of treatment, both insulin groups did not affect high sensetive C_reactive protein (hs-CRP) significantly from baseline to 3 months. Only insulin analogue reduced Interleukin-6 (IL-6) significantly, while human insulin reduced level of IL-6 but it was not statistically significant. Both therapies reduced total antioxidant capacity (TAOC) significantly; however, insulin analogue had higher reduction percentage (15.1% vs. 5.7%) compared to the conventional insulin. Conclusion: Only insulin analogue reduced IL-6 significantly. Both types of insulins did not effect on hs-CRP. Both therapies reduce TAOC significantly.

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Plavsic, Ljiljana, Katarina Mitrovic, Sladjana Todorovic, Rade Vukovic, Tatjana Milenkovic et Dragan Zdravkovic. « Glycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analogues ». Vojnosanitetski pregled 71, n^o 9 (2014) : 817–20. http://dx.doi.org/10.2298/vsp130422039p.

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Background/Aim. An ideal insulin regimen for children and adolescents with type 1 diabetes mellitus (T1DM) should be physiological, flexibile and predictable, protecting against hypoglycaemia. The aim of this study was to evaluate the influence of insulin analogues on glycaemic control and the occurrence of hypoglycaemic episodes in children and adolescents with T1DM. Methods. The study group consisted of 151 children and adolescents (90 boys, 61 girls) treated with human insulins for at least 12 months before introducing insulin analogues. All the patients were divided into two groups: the group I consisted of 72 (47.7%) patients treated with three injections of regular human insulin before meals and long-acting analogue (RHI/LA), and the group II of 79 (52.3%) patients treated with a combination of rapid-acting and long-acting analogue (RA/LA). The levels of glycated hemoglobin (HbA1c) and the number of hypoglycaemic episodes were assessed at the beginning of therapy with insulin analogues, and after 6 and 12 months. Results. The mean HbA1c was significantly lower in the group I (RHI/LA) after 6 months (9.15% vs 8.20%, p < 0.001) and after 12 months (9.15% vs 8.13%, p < 0.001) as well as in the group II (RA/LA) after 6 months (9.40% vs 8.24%, p < 0.001) and after 12 months of insulin analogues treatment (9.40% vs 8.38%, p < 0.001). The frequency of severe hypoglycaemia was significantly lower in both groups after 6 months (in the group I from 61.1% to 4.2% and in the group II from 54.4% to 1.3%, p < 0.001), and after 12 months (in the group I from 61.1% to 1.4% and in the group II from 54.4% to 1.3%, p < 0.001). Conclusion. Significantly better HbA1c values and lower risk of severe hypoglycaemia were established in children and adolescents with T1DM treated with insulin analogues.

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Greeff, Oppel B. W., Jacob John Van Tonder, Kershlin Naidu, Alicia McMaster, Alet Van Tonder et Rashem Mothilal. « A practical guide to the interpretation of PK/PD profiles of longer-acting analogue insulins. Part two : Insulin degludec vs. insulin glargine U300 ». South African Family Practice 60, n^o 4 (28 août 2018) : 7–12. http://dx.doi.org/10.4102/safp.v60i4.4903.

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Glucose clamp studies form an integral part of the early development of insulin therapies. Data generated in these studies are used to establish pharmacokinetic (PK) and pharmacodynamic (PD) profiles of the agents, but methodological differences confound comparison of results from different glucose clamp studies. The first part of this series on glucose clamp studies discussed practical tips for the interpretation of glucose clamp studies. The second part of the series compares the PK/PD profiles of longer-acting basal analogue insulins, insulin degludec (IDeg) and insulin glargine U300 (Gla-300). The patient populations for glucose clamp studies with these analogue insulins differ, and therefore direct comparison of the data is not always possible. The maximum duration of action of IDeg is reported as 42 h and that of Gla-300 as 36 h, translating to 24 h coverage. The plasma insulin concentration of IDeg is 56 times that of Gla-300. Results from phase III clinical trials for these analogue insulins confirm the predictability and low within-subject variability observed in glucose clamp studies. Insight into the PK/PD profiles of longer-acting basal analogue insulins allows the treating physician to utilise these characteristics to optimise the treatment of their patients with diabetes.

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Koivisto, Veikko A. « The human insulin analogue insulin lispro ». Annals of Medicine 30, n^o 3 (janvier 1998) : 260–66. http://dx.doi.org/10.3109/07853899809005853.

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Ametov, Alexander Sergeevich, et Natalya Al'bertovna Chernikova. « Individual stepwise intensification of insulin analogue therapy in type 2 diabetes mellitus ». Diabetes mellitus 15, n^o 4 (15 décembre 2012) : 89–94. http://dx.doi.org/10.14341/2072-0351-5544.

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Article reviews basic steps and regimens of insulin analogue therapy intensification in patients with type 2 diabetes mellitus (T2DM). Intensification of insulin therapy is commonly implemented by supplementation of basal insulin with prandial before breakfast, lunch and dinner. Updated EASD/ADA guidelines (August 2012) recommend individual stepwise intensification of T2DM insulin therapy. Application of insulin analogues simplifies diabetes training and patient self-monitoring.

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Deák, László. « Reflections of a clinician on switch from human to analogue insulin treatment ». Orvosi Hetilap 153, n^o 40 (octobre 2012) : 1589–93. http://dx.doi.org/10.1556/oh.2012.29464.

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The development of insulin therapy has not been stopped since the manufacturing of human insulin, because better mimic of physiological insulin response made it necessary to modify the human insulin molecule in order to create rapidly absorbing insulin analogues and 24-hour acting basal insulin analogues. Clinical observations indicate that the complete switch from human basal-bolus therapy to insulin analogues means not only “unit-for-unit” switch but it represents a transfer to an insulin therapy with different basal/bolus ratio as a result of different pharmacokinetic and pharmacodynamic properties of insulin and the level of insulin resistance of the patient. With reference to a case-history, the author presents his experience on a switch from human insulin to insulin analogue. Furthermore, the author summarizes data obtained from a few cases reported in international literature which draw the attention to the fact that the basal/bolus ratio should be adjusted individually, which may be the key for the success in the therapy in these cases. Orv. Hetil., 2012, 153, 1589–1593.

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Jarosinski, Mark A., Yen-Shan Chen, Nicolás Varas, Balamurugan Dhayalan, Deepak Chatterjee et Michael A. Weiss. « New Horizons : Next-Generation Insulin Analogues : Structural Principles and Clinical Goals ». Journal of Clinical Endocrinology & ; Metabolism 107, n^o 4 (24 novembre 2021) : 909–28. http://dx.doi.org/10.1210/clinem/dgab849.

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Abstract Design of “first-generation” insulin analogues over the past 3 decades has provided pharmaceutical formulations with tailored pharmacokinetic (PK) and pharmacodynamic (PD) properties. Application of a molecular tool kit—integrating protein sequence, chemical modification, and formulation—has thus led to improved prandial and basal formulations for the treatment of diabetes mellitus. Although PK/PD changes were modest in relation to prior formulations of human and animal insulins, significant clinical advantages in efficacy (mean glycemia) and safety (rates of hypoglycemia) were obtained. Continuing innovation is providing further improvements to achieve ultrarapid and ultrabasal analogue formulations in an effort to reduce glycemic variability and optimize time in range. Beyond such PK/PD metrics, next-generation insulin analogues seek to exploit therapeutic mechanisms: glucose-responsive (“smart”) analogues, pathway-specific (“biased”) analogues, and organ-targeted analogues. Smart insulin analogues and delivery systems promise to mitigate hypoglycemic risk, a critical barrier to glycemic control, whereas biased and organ-targeted insulin analogues may better recapitulate physiologic hormonal regulation. In each therapeutic class considerations of cost and stability will affect use and global distribution. This review highlights structural principles underlying next-generation design efforts, their respective biological rationale, and potential clinical applications.

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Chap, Z., T. Ishida, J. Chou, C. J. Hartley, M. L. Entman, D. Brandenburg, R. H. Jones et J. B. Field. « First-pass hepatic extraction and metabolic effects of insulin and insulin analogues ». American Journal of Physiology-Endocrinology and Metabolism 252, n^o 2 (1 février 1987) : E209—E217. http://dx.doi.org/10.1152/ajpendo.1987.252.2.e209.

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First-pass hepatic extraction of insulin and hepatic and peripheral contributions to hypoglycemia were compared in conscious dogs during portal infusion of insulin A1, B29 diacetyl insulin, or A1-B29 dodecoyl insulin at 7 and 14 pmol X kg-1 X min-1. The liver removed 43 +/- 2% of insulin, 12 +/- 1% of dodecoyl, and 8 +/- 1% of diacetyl insulin, in a single transhepatic circulation. The hypoglycemia induced by insulin and diacetyl insulin and the ensuing glucagon response were greater than that produced by the dodecoyl analogue. Diacetyl insulin primarily increased glucose utilization, dodecoyl insulin solely inhibited hepatic production, and insulin affected both. The lack of hepatic effect of diacetyl insulin during hypoglycemia can be ascribed to greater counterregulation, because under euglycemic clamp conditions, this analogue caused suppression of glucose production. The different patterns of hypoglycemia exhibited can be explained by the combined effects of altered distribution between the liver and peripheral tissues caused by differences in hepatic extraction, the effect of this phenomenon on the counterregulatory response, and the intrinsic biological potency of the analogues.

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Dedov, Ivan Ivanovich, et Marina Vladimirovna Shestakova. « Insulin degludec is a new ultra-long-acting insulin analogue ». Diabetes mellitus 17, n^o 2 (3 juin 2014) : 91–104. http://dx.doi.org/10.14341/dm2014291-104.

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Achieving optimal glycemic control is an important aspect of preventing and slowing the progression of diabetes-associated complications, and reducing the cost of their treatment. Long-acting insulin analogues, glargine and detemir, provide better metabolic control with reduced risk of hypoglycaemia as compared to NPH insulin. However, fear of hypoglycaemia and weight gain, as well as the complexity of regimen, are still the most important barriers to well-timed initiation and intensification of insulin therapy. Insulin degludec (Tresiba?) is a new ultra-long-acting insulin analogue. After subcutaneous injection degludec forms repository of soluble multi-hexamers, which are gradually absorbed to the bloodstream, providing a flat, stable antihyperglycemic effect lasting more than 42 h, and low intra-individual variability as opposed to currently used basal insulin analogues, insulin glargine and insulin detemir. In the seven randomized, open label, controlled phase 3 trials lasting 26 or 52 weeks, using treat-to-target (no more) non-inferiority design, insulin degludec provided glycemic control similar to that of insulin glargine with lower risk of nocturnal hypoglycaemia and good safety profile in patients with type 1 or 2 diabetes. Furthermore, trials examining a flexible dosing regimen of insulin degludec in patients with type 1 or 2 diabetes have shown that it is possible to vary the injection time without compromising glycemic control or safety of the therapy.

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Flekač, Milan. « Faster Insulin Aspart - a new prandial insulin analogue ». Vnitřní lékařství 63, n^o 10 (1 octobre 2017) : 697–702. http://dx.doi.org/10.36290/vnl.2017.138.

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Soran, Handrean, et Naveed Younis. « Insulin detemir : a new basal insulin analogue ». Diabetes, Obesity and Metabolism 8, n^o 1 (janvier 2006) : 26–30. http://dx.doi.org/10.1111/j.1463-1326.2005.00487.x.

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Goldman-Levine, Jennifer D., Dhiren K. Patel et David M. Schnee. « Insulin Degludec : A Novel Basal Insulin Analogue ». Annals of Pharmacotherapy 47, n^o 2 (février 2013) : 269–77. http://dx.doi.org/10.1345/aph.1r351.

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Younis, N. « Insulin glargine : a new basal insulin analogue ». QJM 95, n^o 11 (1 novembre 2002) : 757–61. http://dx.doi.org/10.1093/qjmed/95.11.757.

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Gale, Edwin AM. « Insulin lispro:a new quick-acting insulin analogue ». Expert Opinion on Investigational Drugs 6, n^o 9 (septembre 1997) : 1247–56. http://dx.doi.org/10.1517/13543784.6.9.1247.

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AUTHIER, François, Gianni M. Di GUGLIELMO, Gillian M. DANIELSEN et John J. M. BERGERON. « Uptake and metabolic fate of [HisA8,HisB4,GluB10,HisB27]insulin in rat liver in vivo ». Biochemical Journal 332, n^o 2 (1 juin 1998) : 421–30. http://dx.doi.org/10.1042/bj3320421.

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Receptor-mediated endocytosis and subsequent endosomal proteolysis of [125I]TyrA14-[HisA8,HisB4,GluB10,HisB27]insulin ([125I]TyrA14-H2 analogue), an insulin analogue exhibiting a high affinity for the insulin receptor, has been studied in liver parenchymal cells by quantitative subcellular fractionation and compared with that of wild-type [125I]TyrA14-insulin. Whereas the kinetics of uptake of the H2 analogue by liver was not different from that of insulin, the H2 analogue radioactivity after the 2 min peak declined significantly more slowly. A significant retention of the H2 analogue compared with insulin in both plasma membrane and endosomal fractions was observed and corresponded to decreased processing and dissociation of the H2 analogue. Cell-free endosomes preloaded in vivo with radiolabelled ligands and incubated in vitro processed insulin and extraluminally released insulin intermediates at a 2–3-fold higher rate than the H2 analogue. In vitro proteolysis of both non-radiolabelled and monoiodinated molecules by endosomal lysates showed a decreased response to the endosomal proteolytic machinery for the H2 analogue. However, in cross-linking and competition studies the H2 analogue exhibited an affinity for insulin-degrading enzyme identical with that of wild-type insulin. Brij-35-permeabilized endosomes revealed a 2-fold higher rate of dissociation of insulin from internalized receptors compared with the H2 analogue. After the administration of a saturating dose of both ligands, a rapid and reversible ligand-induced translocation of insulin receptor was observed, but without receptor loss. The H2 analogue induced a higher receptor concentration and tyrosine autophosphorylation of the receptor β subunit in endosomes. Moreover, a prolonged temporal interaction of the in vivo injected H2 analogue with receptor was observed by direct binding assays performed on freshly prepared subcellular fractions. These results indicate that endosomal proteolysis for the H2 analogue is slowed as a result of an increased residence time of the analogue on the insulin receptor and a low affinity of endosomal acidic insulinase for the dissociated H2 molecule.

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Rodrigues, Prudence Attilade, Anu Balan et Charumathi Purushothaman. « A PROSPECTIVE COMPARATIVE OBSERVATIONAL STUDY ON SAFETY, EFFICACY AND COST EFFECTIVENESS OF INSULIN AND THEIR ANALOGUES ». International Journal of Pharmacy and Pharmaceutical Sciences 10, n^o 7 (1 juillet 2018) : 62. http://dx.doi.org/10.22159/ijpps.2018v10i7.21464.

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Objective: The objective of this study was to compare safety, efficacy and cost effectiveness of insulin and their analogues when compared with human insulin in patients with type-2 diabetes mellitus.Methods: A prospective observational study was carried out in a multispecialty hospital. The inpatients and outpatients from general medicine and endocrinology departments were included in our study for a period of 6 mo. The diabetic profile such as FBS, PPBS, HbA1c and body weight of the diabetic patients at the initial visit and follow up visit was documented.Results: This study showed a statistically significant reduction in HbA1c, PPBS, and FBS levels from the baseline in insulin analogue users. It was found that, insulin analogue with metformin showed statistical improvement (P<0.05) in FBS, PPBS, HbA1c as well as body weight and also found to be a cost-effective treatment according to Incremental cost-effectiveness ratio (ICER) decision matrix.Conclusion: This study concluded that type 2 diabetes patients underlined with the treatment using insulin analogue showed a better glycemic control when compared to human insulin. Metformin was the better OHA option in type-2 diabetes mellitus when compared with sulphonylureas and also metformin showed less weight gain than sulphonylureas.

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Zac-Varghese, Sagen, Bev Summerhayes et Peter Winocour. « Managing type 1 diabetes in frailty ». BMJ Case Reports 15, n^o 12 (décembre 2022) : e253779. http://dx.doi.org/10.1136/bcr-2022-253779.

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Managing type 1 diabetes in frail elderly people can be logistically challenging, particularly for those living alone. District nurse visits are unpredictable and coincide poorly with meal time insulin regimes. Elderly people, particularly those with dementia, have variable oral intake and activity. For some, poor glycaemic control leads to frequent and prolonged inpatient admissions. The use of technology, such as flash glucose monitoring, and the use of analogue insulins can be helpful in this setting. Increased monitoring enables more accurate titration of insulin doses and the information can be accessed by healthcare professionals and carers remotely. Longer lasting analogue insulins allow for a greater margin of error in the timing of insulin administration.

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Ks, Gireesha, et Sumithra M. « PROSPECTIVE STUDY TO COMPARE INSULIN AND INSULIN ANALOGS IN TYPE II DIABETIC PATIENTS ». Asian Journal of Pharmaceutical and Clinical Research 10, n^o 7 (1 juillet 2017) : 356. http://dx.doi.org/10.22159/ajpcr.2017.v10i7.18479.

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Objective: To compare the safety and quality of life of insulin and insulin analogues in Type II Diabetic patients.Methods: 100 patients who are diagnosed with type – II diabetes milletus are taken.In these 50 patients are of insulin analogues and 50 patients are of conventional insulin The safety was based on number of hypoglycemic events.Data was collected by using the EQ-5D questionnaire and EQ Visual Analogue scale (EQ-VAS) to assess the quality of life from the patient.Result:The percentage of the patients who had hypoglycemic events in conventional insulin group is 54% (n=27) and insulin analogues group is 20% (n=10). Mean score points of QOL obtained by conventional insulin patients is 75.9 and by insulin analogues patients is 93.75Conclusion: Insulin analogues group has low risk of hypoglycaemia when compared with the conventional insulin.The patient group who are in No problem category are found to have better QOL. The safety and QOL statistical differences constitute less likely among insulin and insulin analogues. The use of insulin analogues will continue to advance our efforts at improving diabetes care and treated related adverse outcomes can be reduced.

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Ruyatkina, Lyudmila Alexandrovna, et Maxim Sorokin. « Combined insulin detemir and liraglutide therapy in type 2 diabetic patients : a base for an alliance ». Diabetes mellitus 20, n^o 2 (20 juin 2017) : 142–50. http://dx.doi.org/10.14341/7875.

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Combined glucose-lowering therapy, comprising of basal insulin with glucagon-like peptide-1 (GLP-1) analogues, has become central to the treatment of type 2 diabetes both at the start of insulin therapy, and as an alternative to basal-bolus insulin. The combination of insulin detemir (insulin analogue) with liraglutide (GLP-1 analogue) reduces fasting and postprandial glycaemia, lowers the risk of hypoglycaemia and does not have a negative impact on body weight. In this literature review, the pharmacodynamic and pharmacokinetic profiles, as well as the potential benefits of combined insulin detemir and liraglutide therapy on diabetic nephropathy and high cardiovascular disease risk were determined. Data from randomised clinical trials and the National Registry were used to assess the clinical efficacy of combined insulin detemir and liraglutide therapy. The different mechanistic actions of insulin detemir and liraglutide resulted in an additive glucose-lowering effect, which did not affect the pharmacodynamic and pharmacokinetic profiles of each therapeutic agent.

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Greeff, Oppel B. W., Jacob John Van Tonder, Kershlin Naidu, Alicia McMaster, Alet Van Tonder et Rashem Mothilal. « A practical guide to the interpretation of PK/PD profiles of longer-acting analogue insulins. Part one : The principles of glucose clamp studies ». South African Family Practice 60, n^o 3 (12 juillet 2018) : 8–12. http://dx.doi.org/10.4102/safp.v60i3.4874.

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Glucose clamp studies are used to determine pharmacokinetics (PK) and pharmacodynamics (PD) of analogue insulins. With the development of longer-acting basal analogue insulins, including glargine 300 (Gla-300) and insulin degludec (IDeg), results from numerous glucose clamp studies are readily available. However, interpreting PK/PD profiles in a scientifically sound manner can be a challenging feat. This is the first in a series of publications that will suggest practical tips for interpreting and comparing results from glucose clamp studies. Variations in the glucose clamp methodology, duration of clamp studies and glucose clamp targets influence the study design and results significantly. Selection of study populations, including healthy patients or patients with Type 1 or 2 diabetes mellitus, has important implications. The dose of study insulin should reflect that of the general treatment population, and ideally steady-state conditions should be used. During the study the plasma insulin concentration and glucose infusion rate describe the pharmacokinetics and pharmacodynamics of the study insulin. With these practical tips in mind, results of glucose clamp studies can be interpreted in a scientifically correct manner. The next article in this series will discuss the interpretation of PK/PD profiles using two newly developed longer-acting basal analogue insulins: Gla-300 and IDeg.

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Hashim, Noor Wafaa, Kadhim Ali Ali et Abbas Mahdi Rahmah. « Comparative Study between the Glycemic Control of Human Insulin and Insulin analogue In Sample of Iraqi Type 1 Diabetic Children and Adolescents ». Al Mustansiriyah Journal of Pharmaceutical Sciences 18, n^o 2 (1 décembre 2018) : 100–104. http://dx.doi.org/10.32947/ajps.v18i2.482.

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Insulin analogue introduced to offer insulin replacement therapy mimic to normal human physiology. The aim of this study is to compare between the glycemic control of insulin analogue and conventional human insulin in a sample of type 1 diabetic Iraqi children and adolescents. Forty type 1 diabetic Iraqi children and adolescents age between (6-18) years enrolled in this study and divided into two groups. Group 1 contains 20 patients switched from human insulin to insulin analogue. Group 2 contain 20 patients continued with conventional human insulin. The results showed that both therapies reduced fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c %) but insulin analogue treated group had highly significant reduction. Both therapies did not affect on blood urea nitrogen and serum creatinine. Human insulin reduced triglyceride (TG) and very low-density lipoprotein (VLDL) significantly. The parameters measures at baseline and after three months of treatments. In conclusion insulin analogue is superior over conventional human insulin in reducing glycemic indices in a sample of type 1 diabetic Iraqi children and adolescents.

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Hansen, B. F., P. Kurtzhals, A. B. Jensen, A. Dejgaard et D. Russell-Jones. « Insulin X10 revisited : a super-mitogenic insulin analogue ». Diabetologia 54, n^o 9 (3 juin 2011) : 2226–31. http://dx.doi.org/10.1007/s00125-011-2203-8.

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Narendran, Parth. « Insulin glulisine : a new rapid-acting insulin analogue ». Prescriber 17, n^o 14 (19 juillet 2006) : 23–29. http://dx.doi.org/10.1002/psb.400.

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H Manning, Elizabeth, et Linda Jackson. « An evaluation of the timing between key insulin administration-related processes : the reasons why these processes happen when they do, and how to improve their timing ». Australian Health Review 29, n^o 1 (2005) : 61. http://dx.doi.org/10.1071/ah050061.

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We investigated the incidence of timing problems with insulin-related processes in a subacute inpatient unit in Melbourne and found that nursing staff often conduct blood glucose level (BGL) testing longer than 30 minutes before insulin administration (between 22% and 41%). Nurses are better at administering rapid-acting insulin doses within the recommended time before food intake (94%) than conventional insulin analogue doses (43%). BGL testing is carried out too early due to established ward practices and busy mornings, as well as poor guidance from an outdated policy. The timing of conventional insulin analogue administration is by nature more complex than that of rapidacting analogues. Current timing places inpatients at risk of harm from hypoglycaemia. The high level of care demand in our subacute unit contributed to timing problems, and this is likely to be a problem in other units. Process redesign, policy revision and staff education could be used to reduce the risk of hypoglycaemia in this subacute inpatient unit.

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Redmon, J. B., T. W. Gettys, V. S. Sheorain, J. D. Corbin et I. L. Taylor. « Failure of insulin to antagonize cAMP-mediated glycogenolysis in rat ventricular cardiomyocytes ». American Journal of Physiology-Endocrinology and Metabolism 258, n^o 5 (1 mai 1990) : E871—E877. http://dx.doi.org/10.1152/ajpendo.1990.258.5.e871.

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Isolated rat ventricular cardiomyocytes were used to study the effects of insulin on glycogen metabolism in cells treated with various agents that activate adenosine 3',5'-cyclic monophosphate (cAMP)-dependent protein kinase. Incubation of myocytes with isoproterenol produced a rapid concentration-dependent increase in cAMP concentration, cAMP-dependent protein kinase activity, and phosphorylase activity and a simultaneous decrease in the glycogen synthase activity ratio. Various cAMP analogues also produced a concentration-dependent increase in phosphorylase activity and a decline in the glycogen synthase activity ratio. Incubation of cells with insulin produced no change in basal phosphorylase activity but produced a rapid 40% increase in the glycogen synthase activity ratio. Inclusion of insulin in cell incubations containing increasing concentrations of isoproterenol did not modify the increases in cAMP concentration, protein kinase activity, or phosphorylase activity. Insulin also did not antagonize the ability of any of the cAMP analogues tested to activate phosphorylase, irrespective of the suitability of the particular cAMP analogue as a substrate for cAMP phosphodiesterases. The failure of insulin to antagonize the glycogenolytic effects of isoproterenol or cAMP analogues was paralleled by its failure to activate low-Km phosphodiesterase activity, but the cAMP analogue, 8-parachlorophenylthio-cAMP produced a small reproducible activation of the low-Km enzyme. In contrast to hepatocytes and adipocytes, where some effects of insulin appear to be due to activation of the phosphodiesterase and hydrolysis of cAMP, the effects in cardiomyocytes appear to be independent of an insulin-sensitive phosphodiesterase or of the effects on other components of the cAMP cascade.

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Lehmann, Eldon D., Cristina Tarín, Jorge Bondia, Edgar Teufel et Tibor Deutsch. « Development of AIDA v4.3b Diabetes Simulator : Technical Upgrade to Support Incorporation of Lispro, Aspart, and Glargine Insulin Analogues ». Journal of Electrical and Computer Engineering 2011 (2011) : 1–17. http://dx.doi.org/10.1155/2011/427196.

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Introduction. AIDA is an interactive educational diabetes simulator available on the Internet without charge since 1996 (accessible at: http://www.2aida.org/). Since the program’s original release, users have developed new requirements, with new operating systems coming into use and more complex insulin management regimens being adopted. The current work has aimed to design a comprehensive diabetes simulation system from both a clinical and information technology perspective.Methods. A collaborative development is taking place with a new generic model of subcutaneous insulin absorption, permitting the simulation of rapidly-acting and very long-acting insulin analogues, as well as insulin injections larger than 40 units. This novel, physiological insulin absorption model has been incorporated into AIDA v4. Technical work has also been undertaken to install and operate the AIDA software within a DOSBox emulator, to ensure compatibility with Windows XP, Vista and 7 operating systems as well as Apple Macintosh computers running Parallels PC emulation software.Results. Plasma insulin simulations are demonstrated following subcutaneous injections of a rapidly-acting insulin analogue, a short-acting insulin preparation, intermediate-acting insulin, and a very long-acting insulin analogue for injected insulin doses up to 60 units of insulin.Discussion.The current work extends the useful life of the existing AIDA v4 program.

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Abdel-Wahab, Yasser H. A., Gavin J. Power, Ming T. Ng, Peter R. Flatt et J. Michael Conlon. « Insulin-releasing properties of the frog skin peptide pseudin-2 and its [Lys18]-substituted analogue ». Biological Chemistry 389, n^o 2 (1 février 2008) : 143–48. http://dx.doi.org/10.1515/bc.2008.018.

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Abstract Pseudin-2 is a cationic α-helical peptide that was first isolated from the skin of the paradoxical frog Pseudis paradoxa on the basis of its antimicrobial activity. We have investigated the insulin-releasing properties and cytotoxicity of the peptide, together with selected analogues with increased cationicity and hydrophobicity. At concentrations in the range 10-9–10-6 m, pseudin-2, and its [Lys18], [Phe8], and [d-Lys3,d-Lys10,d-Lys14] derivatives, stimulated insulin release from the BRIN-BD11 clonal β-cell line without increasing release of lactate dehydrogenase. The [Lys18] analogue was the most potent (46% increase in insulin release at 10-9 m) and the most effective (215% increase in insulin release at 10-6 m). The more cationic [Lys3,Lys10,Lys14] and [Lys3,Lys10,Lys14,Lys21] analogues lacked insulinotropic action and the more hydrophobic [Phe16] analogue was cytotoxic at concentrations ≥10-7 m. Pseudin-2 and [Lys18]-pseudin-2 had no effect on intracellular calcium concentrations and stimulated insulin release in the absence of external calcium. [Lys18]-pseudin-2 (10-8 m) stimulated insulin release in the presence of diazoxide and verapamil. Our results demonstrate that pseudin-2 stimulates insulin secretion from BRIN-BD11 cells by a mechanism involving Ca2+-independent pathways and identify [Lys18]-pseudin-2 as a peptide that may have potential for development as a therapeutically valuable insulinotropic agent for the treatment of type 2 diabetes.

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SHOJAEE-MORADIE, Fariba, Michelle P. Y. CHAN, Micayla A. TELFER, Dietrich BRANDENBURG, Erik SUNDERMANN, Heike ECKEY, Jens KLEINJUNG, Achim SCHÜTTLER et Richard H. JONES. « Effect of thyroid hormone binding proteins on insulin receptor binding of B1-thyronine-insulin analogues ». Biochemical Journal 381, n^o 1 (22 juin 2004) : 51–57. http://dx.doi.org/10.1042/bj20040177.

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Certain thyronine-insulin analogues, which form non-covalent complexes with plasma proteins, have been shown to act preferentially in the liver. We hypothesized that this property may be dependant on the ability of the analogue to bind to the insulin receptor without prior dissociation from the binding protein. NαB1-L-thyroxyl-insulin, NαB1-3,3′,5′-triiodothyronine-insulin, NαB1-D-thyroxyl-insulin and NαB1-L-thyroxyl-aminolauroyl-insulin were compared with insulin for their capacity to inhibit the binding of [125I]TyrA14-insulin to rat liver plasma membrane in albumin-free buffer. Effective doses at 50% maximum inhibition of binding (ED50) were calculated with and without addition of the thyroid hormone binding proteins transthyretin, thyroxine binding globulin and human serum albumin. The binding of thyronine-insulin analogues to insulin receptors was inhibited in a dose-dependant manner by the addition of thyroid hormone binding proteins at concentrations in the physiological range. Complexes of thyronine-insulin analogues with thyroid hormone binding proteins exhibit impaired insulin receptor binding affinities compared with those of the analogues in their free form. Hepatoselectivity in vivo may not depend on binding of the intact complexes to hepatocytes. These results have implications for the physiological role of hormone binding proteins and the in vivo properties of other insulin analogues which bind to plasma proteins.

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Vienberg, Sara G., Stephan D. Bouman, Heidi Sørensen, Carsten E. Stidsen, Thomas Kjeldsen, Tine Glendorf, Anders R. Sørensen, Grith S. Olsen, Birgitte Andersen et Erica Nishimura. « Receptor-isoform-selective insulin analogues give tissue-preferential effects ». Biochemical Journal 440, n^o 3 (28 novembre 2011) : 301–8. http://dx.doi.org/10.1042/bj20110880.

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The relative expression patterns of the two IR (insulin receptor) isoforms, +/− exon 11 (IR-B/IR-A respectively), are tissue-dependent. Therefore we have developed insulin analogues with different binding affinities for the two isoforms to test whether tissue-preferential biological effects can be attained. In rats and mice, IR-B is the most prominent isoform in the liver (>95%) and fat (>90%), whereas in muscles IR-A is the dominant isoform (>95%). As a consequence, the insulin analogue INS-A, which has a higher relative affinity for human IR-A, had a higher relative potency [compared with HI (human insulin)] for glycogen synthesis in rat muscle strips (26%) than for glycogen accumulation in rat hepatocytes (5%) and for lipogenesis in rat adipocytes (4%). In contrast, the INS-B analogue, which has an increased affinity for human IR-B, had higher relative potencies (compared with HI) for inducing glycogen accumulation (75%) and lipogenesis (130%) than for affecting muscle (45%). For the same blood-glucose-lowering effect upon acute intravenous dosing of mice, INS-B gave a significantly higher degree of IR phosphorylation in liver than HI. These in vitro and in vivo results indicate that insulin analogues with IR-isoform-preferential binding affinity are able to elicit tissue-selective biological responses, depending on IR-A/IR-B expression.

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Caparrotta, T. M., et M. Evans. « PEGylated insulin Lispro, (LY2605541)-a new basal insulin analogue ». Diabetes, Obesity and Metabolism 16, n^o 5 (12 septembre 2013) : 388–95. http://dx.doi.org/10.1111/dom.12196.

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Gammeltoft, Steen, Bo Falck Hansen, Lars Dideriksen, Anders Lindholm, Lauge Schäffer, Thomas Trüb, Anthony Dayan et Peter Kurtzhals. « Insulin aspart : a novel rapid-acting human insulin analogue ». Expert Opinion on Investigational Drugs 8, n^o 9 (septembre 1999) : 1431–42. http://dx.doi.org/10.1517/13543784.8.9.1431.

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Jochen, A. L., et P. Berhanu. « Chymotrypsin substrate analogues inhibit endocytosis of insulin and insulin receptors in adipocytes. » Journal of Cell Biology 103, n^o 5 (1 novembre 1986) : 1807–16. http://dx.doi.org/10.1083/jcb.103.5.1807.

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To explore the possible role of proteolytic step(s) in receptor-mediated endocytosis of insulin, the effects of inhibitors of various classes of proteases on the internalization process were studied in isolated rat adipocytes. Intracellular accumulation of receptor-bound 125I-insulin at 37 degrees C was quantitated after rapidly dissociating surface-bound insulin with an acidic buffer (pH 3.0). Of the 23 protease inhibitors tested, only chymotrypsin substrate analogues inhibited insulin internalization. Internalization was decreased 62-90% by five different chymotrypsin substrate analogues: N-acetyl-Tyr ethyl ester, N-acetyl-Phe ethyl ester, N-acetyl-Trp ethyl ester, benzoyl-Tyr ethyl ester, and benzoyl-Tyr amide. The effect of the substrate analogues in inhibiting insulin internalization was dose-dependent, reversible, and required the full structural complement of a chymotrypsin substrate analogue. Cell surface receptor number was unaltered at 12 degrees C. However, concomitant with their inhibition of insulin internalization at 37 degrees C, the chymotrypsin substrate analogues caused a marked increase (160-380%) in surface-bound insulin, indicating trapping of insulin-receptor complexes on the cell surface. Additionally, 1 mM N-acetyl-Tyr ethyl ester decreased overall insulin degradation by 15-20% and also prevented the chloroquine-mediated increase in intracellular insulin, further indicating that surface-bound insulin was prevented from reaching intracellular chloroquine-sensitive degradation sites. The internalization of insulin receptors that were photoaffinity labeled on the cell surface with B2(2-nitro-4-azidophenylacetyl)-des-PheB1-insulin was also inhibited 70-90% by the five chymotrypsin substrate analogues, as determined by the effects of the analogues on the accumulation of trypsin-insensitive (intracellular) 440-kD intact labeled receptors. In summary, these results show that chymotrypsin substrate analogues efficiently inhibit the internalization of insulin and insulin receptors in adipocytes and implicate a possible role for endogenous chymotrypsin-like enzyme(s) or related substances in receptor-mediated endocytosis of insulin.

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Freeman, Jeffrey S. « Are Analogue Insulins Superior to Human Insulin in Clinical Practice ? » Current Diabetes Reports 10, n^o 3 (26 mars 2010) : 176–83. http://dx.doi.org/10.1007/s11892-010-0104-8.

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Sudár, Zsolt, Lajos Muth, Csaba Nyirati, Vince Szí, János Tornóczky et Gabriella Ulrich. « Clinical experiences with basal analogue insulin in routine care. Retrospective follow up analysis of a database from daily routine care ». Orvosi Hetilap 154, n^o 37 (septembre 2013) : 1476–84. http://dx.doi.org/10.1556/oh.2013.29703.

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Introduction: Basal-bolus insulin regime is frequently used in type 2 diabetes in order to improve metabolic control and decrease the risk of complications. A general question is, however, the effect of application of analogue insulin in comparison to human insulin regimes. Aim: The aim of the authors was to perform a retrospective database analysis among patients who were switched from human insulin only based basal-bolus regime to analogue only insulin regime in order to examine changes in metabolic control, body weight, insulin dose and basal:bolus insulin ratio. Method: Type 2 diabetic patients (n = 137) were enrolled who used once daily basal insulin with complementary bolus insulin given at main meals, and human insulin was switched to analogue insulin. Patients were divided into two groups using detemir (n = 103) or glargine (n = 34). Results: During 17 months ofanalogue insulin treatment the HbA1c was decreased by 0.34% (detemir –0.44%; glargine –0.17%). Body weight was increased by 1.11 kg (detemir +1.0 kg; glargine +1.43 kg). The basal:bolus insulin ratio increased in all groups (entire cohort 6.04%, detemir 5.26%, glargine 8.37%). The average insulin dose was 80.76 units at the end of follow up. There was no significant difference in terms of total and basal insulin doses between detemir (27.89 and 79.78 U, respectively) and glargine group (32.85 and 83.74 U, respectively). Conclusions: These results support that switching from human to analogue insulin in basal-bolus regime could improve the metabolic control by increasing dose of basal analogue insulin and basal: bolus ratio. Both detemir and glargine can provide similar improvement in metabolic control with the same insulin dose but with relatively more weight gain with glargine. Orv. Hetil., 2013, 154, 1476–1484.

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Mao, Ruifeng, Yingying Chen, Zhenjing Chi et Yefu Wang. « Insulin and its single-chain analogue ». Applied Microbiology and Biotechnology 103, n^o 21-22 (21 octobre 2019) : 8737–51. http://dx.doi.org/10.1007/s00253-019-10170-0.

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&NA;. « Insulin analogue : achieves more physiological levels of plasma insulin than soluble insulin ». Inpharma Weekly &NA;, n^o 726 (mars 1990) : 6–7. http://dx.doi.org/10.2165/00128413-199007260-00010.

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Petkova, Elina, Valentina Petkova, Guenka Petrova et Maya Konstantinova. « THE EFFECT OF CONTINUOUS SUBCUTANEOUS INSULIN INFUSION TREATMENT, INSULIN ANALOG, AND HUMAN INSULIN OF CHILDREN WITH DIABETES ». CBU International Conference Proceedings 3 (19 septembre 2015) : 432–36. http://dx.doi.org/10.12955/cbup.v3.634.

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The aim of this study is to evaluate the cost-effectiveness of continuous subcutaneous insulin infusion (CSII) to multiple daily insulin injection (MDI) either with analogues or with human insulin, based on the achieved therapeutic results such as changes in glycated hemoglobin level (HbA1c) in the various therapies. The study was performed with children with type-1 diabetes in Bulgaria. The objective of this study was to serve for the Bulgarian National Health Fund (NHIF).Methods: A combined retrospective and prospective study was performed at the Endocrinology diabetes and genetic diseases clinic.51 children with type-1 diabetes were observed for 7 months diveded into three group: Group 1- on continuous subcutaneous insulin infusion (CSII); Group 2- on multiple daily insulin analogues injections (MDI) and Group 3 – on human insulin (HI).Patient demographic data, age, sex, weight, duration of disease, HbA1c – values before the start of the study and after the end of the observation and type of treatment (CSII; MDI or HI) were observed. Cost-effectiveness, sensitivity and statistical analyses are applied to studied long-term therapeutic results.Results: The three groups of observed children do not differ statistically in age and gender. Most of the participants in Group 1 and Group 2 have suffered from diabetes from 5,6 years. The duration of diabetes was lower in the group of human insulin. All studied children are treated. By all of them the results of the treatment improved, but in the Group 1 the improvement of HbA1c is the highest. The average improvement of HbA1c in the Group 1 after the CSII introduction is 1.85, while after the application of analogue insulin is 0,59 and 0,28 respectively in the Group 3 after the treatment on human insulin.The cost of insulin pump, consumables- infusion set and insulin reservoir, blood glucose monitoring system, strips, needles and insulin cost was calculated.The total cost ot the treatment of diabetes with insulin pump for 7 months is 2358,85Euro; 856,98 Euro in the Group 2 on MDI and 744,24 Euro for 7 months in the Group 3 on human insulin.The differences in costs and therapeutic results permit to conduct cost- effectiveness analysis by comparing of the three alternatives.Our study shows that the CSII pumps allows better diabetes control compared to the treatment with analogue insulin and human insulin. Insulin pumps are also cost- effectiveness alternative for children with type 1 diabetes.

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Radenković, Saša, Milena Velojić-Golubović, Danijela Radojković, Vojislav Ćirić et Radivoj Kocić. « Treatment satisfaction in patients with diabetes mellitus type 1 treated with intensified insulin therapy with insulin analogues ». Acta Facultatis Medicae Naissensis 38, n^o 3 (2021) : 240–46. http://dx.doi.org/10.5937/afmnai38-32875.

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The outcome of diabetes treatments can and should be evaluated through the patients' treatment satisfaction. The aim of this study was to examine the patients' satisfaction with the therapy with human insulin analogues compared with previous treatment with human insulin. We evaluated patient satisfaction in patients with T1DM in our institution who were currently on IIT with human insulins. We performed testing with standard World Health Organization Diabetes Treatment Satisfaction Questionnaire (WHO DTSQ) before and after the therapy with insulin analogs. The overall DTSQ score in forty-nine patients after the third month of therapy and after the sixth month of therapy is higher than before the initiation of therapy (p < 0.001). The results of the responses on the perception of hyperglycaemia were lower after three months of therapy (p < 0.05) and after the six months of treatment than before the onset of therapy (p < 0.01). There were no differences in the perception of hypoglycaemia after three months; however, perception of hypoglycaemia after the sixth month of treatment was lower than before the onset of therapy (p < 0.001) and compared to the score after the third month of therapy (p < 0.01). Therapy of T1DM patients with insulin analogue aspart over three months led to an increase in satisfaction with therapy and a reduction of the perception of hyperglycaemia. Therapy of T1DM patients with insulin analogues (aspart and glargine) over three months led to an increase in satisfaction with therapy and a reduction of the perception of both hyperglycaemia and hypoglycamia.

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HUANG, YuPu, Qin ZHANG, LanXin WANG et Wei CHEN. « A new generation ultra-long-acting insulin analogue-insulin degludec ». Pharmaceutical Care and Research 13, n^o 1 (28 février 2013) : 6–8. http://dx.doi.org/10.5428/pcar20130103.

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Home, Philip D., et Simon G. Ashwell. « Insulin glargine : the first clinically useful extended-action insulin analogue ». Expert Opinion on Pharmacotherapy 2, n^o 11 (novembre 2001) : 1891–902. http://dx.doi.org/10.1517/14656566.2.11.1891.

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Am Gale, Edwin. « Insulin lispro : The first insulin analogue to reach the market ». Practical Diabetes International 13, n^o 4 (juillet 1996) : 122–24. http://dx.doi.org/10.1002/pdi.1960130409.

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Mori, Yusaku, Eunhyoung Ko, Rudolf Furrer, Linda C. Qu, Stuart C. Wiber, I. George Fantus, Mario Thevis, Alan Medline et Adria Giacca. « Effects of insulin and analogues on carcinogen-induced mammary tumours in high-fat-fed rats ». Endocrine Connections 7, n^o 5 (mai 2018) : 739–48. http://dx.doi.org/10.1530/ec-17-0358.

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It is not fully clarified whether insulin glargine, an analogue with a high affinity for insulin-like growth factor-1 receptor (IGF-1R), increases the risk for cancers that abundantly express IGF-1R such as breast cancer or some types of breast cancer. To gain insight into this issue, female Sprague–Dawley rats fed a high-fat diet were given the carcinogen N-methyl-N-nitrosourea and randomly assigned to vehicle (control), NPH (unmodified human insulin), glargine or detemir (n = 30 per treatment). Insulins were given subcutaneously (15 U/kg/day) 5 days a week. Mammary tumours were counted twice weekly, and after 6 weeks of treatment, extracted for analysis. None of the insulin-treated groups had increased mammary tumour incidence at any time compared with control. At 6 weeks, tumour multiplicity was increased with NPH or glargine (P < 0.05) and tended to be increased with detemir (P = 0.2); however, there was no difference among insulins (number of tumours per rat: control = 0.8 ± 0.1, NPH = 1.8 ± 0.3, glargine = 1.5 ± 0.4, detemir = 1.4 ± 0.4; number of tumours per tumour-bearing rat: control = 1.3 ± 0.1, NPH = 2.2 ± 0.4, glargine = 2.7 ± 0.5, detemir = 2.3 ± 0.5). IGF-1R expression in tumours was lower than that in Michigan Cancer Foundation-7 (MCF-7) cells, a cell line that shows greater proliferation with glargine than unmodified insulin. In rats, glargine was rapidly metabolised to M1 that does not have greater affinity for IGF-1R. In conclusion, in this model of oestrogen-dependent breast cancer in insulin-resistant rats, insulin and insulin analogues increased tumour multiplicity with no difference between insulin types.

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Venkatachalam, Hariharan. « Use of Fast-Acting Insulin Analog for Preparing a Pharmaceutical Composition for Preventing, Treating, or Alleviating Diabetes ». Technoarete Transactions on Recent Research in Applied Microbiology and Biotechnology 1, n^o 1 (3 mars 2022) : 21–24. http://dx.doi.org/10.36647/ttrramb/01.01.a005.

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Diabetes is the most common disease in India that mostly affects adult people and reduces physical strength. Diabetes decreases insulin production in the human body that creates various physical disturbances such as damage to the heart, stroke, and others. In the past decades, medical treatments have followed long-acting insulin that reduces life expectancy rate and increases mortality rate in India. Along with that, in the present time, India's medical treatment has adopted the pharmaceutical composition of insulin to prevent diabetes and manage blood sugar in the human body. In this regard, this research study has selected some previous research papers to understand the importance of fast-acting insulin analogue to prevent diabetes. According to the secondary information, most of the medical treatment process in India has adopted fast-acting insulin analogue to prevent diabetes. Moreover, though fast-acting insulin analogue India reduces mortality rate and increases the life expectancy of adult people in India. Keyword : Metabolic disturbances, E-bacteria, amino acids, Regular Human Insulin (RHI).

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Kang, S., D. R. Owens, J. P. Vora et J. Brange. « Comparison of insulin analogue B9AspB27Glu and soluble human insulin in insulin-treated diabetes ». Lancet 335, n^o 8685 (février 1990) : 303–6. http://dx.doi.org/10.1016/0140-6736(90)90602-2.

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Demidova, Tatiana Y., et Olga V. Balutina. « Special aspects of concentrated insulins : basic characteristics and research findings ». Diabetes mellitus 22, n^o 5 (17 janvier 2020) : 481–90. http://dx.doi.org/10.14341/dm10334.

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The appearance of concentrated insulins in clinical practice determines the need to analyze product priorities in appropriate groups of patients with diabetes. The aim of this article is to summarize the literature on concentrated insulins (i.e. insulin lispro 200 units/mL, insulin degludec 200 units/mL, insulin glargine 300 units/mL) from randomized controlled trials, derive guidance on appropriate and safe use of these agents and demonstrate experience in real clinical practice. Severe hypoglycemia in all studies was generally low (though higher with prandial plus concentrated basal analogue therapy), and statistical improvements in other hypoglycemia categories were observed for concentrated basal insulins versus insulin glargine 100 units/mL. In all analyzed data hypoglycemic effect of insulin glargine 300 units/mL was equitable to insulin glargine 100 units/mL. Other important findings demonstrate more constant and prolonged insulin action with low within-subject/ between-day variability for insulin glargine 300 units/mL versus insulin glargine 100 units/mL, therefore, more physiological treatment might prevent from diabetic microvascular complications. The results of randomized trials are comparable with our clinical practice experience and indicate efficacious and safe glucose-lowering properties without risk of severe hypoglycemia.

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