Insulin analogues and management of diabetes mellitus

The introduction of insulin analogues, of which insulin lispro is the prototype, marks a very important milestone in the management of patients with diabetes mellitus. It differs from regular human insulin in its quicker onset and shorter duration of action. In various clinical trials, insulin lispro was found to be superior to regular human insulin in controlling postprandial hyperglycemia without increasing the risk of hypoglycemia. It improved the quality of life of diabetic patients by providing more flexibility to meal plans. Recently, another short acting insulin analogue called insulin aspart has been tried in clinical studies with benefits similar to insulin lispro. The turn of the millennium is now witnessing the development of long acting insulin analogues like insulin glargine, which can provide continuous low-level basal insulin concentrations similar to natural settings. In this review, we discuss the potential of insulin analogues in the modern management of diabetes with emphasis on insulin lispro.