Insulin therapy: unmet needs and new perspectives

Area of Science:

• Endocrinology
• Pharmacology
• Diabetology

Background:

• Insulin therapy is crucial for managing diabetes, with risks escalating with HbA1c levels.
• Intensive glucose control reduces microvascular and cardiovascular risks but increases hypoglycemia.
• Barriers to optimal insulin therapy include hypoglycemia, reduced quality of life, and lack of tailored preparations.

Purpose of the Study:

• To review the burden of disease associated with insulin therapy.
• To analyze critical aspects of acceptance and self-management in insulin therapy.
• To compare the clinical pharmacology of human insulins and available insulin analogues.

Main Methods:

• Literature review of insulin therapy in diabetes management.
• Analysis of patient and physician barriers to insulin therapy.
• Comparison of pharmacological profiles of insulin preparations.

Main Results:

• Current insulin analogues offer partial improvements in flexibility and quality of life.
• Hypoglycemia remains a significant issue, leading to hospitalizations, increased costs, and cardiovascular mortality.
• Suboptimal glycemic control is often linked to poor compliance and missed insulin injections.

Conclusions:

• Despite advancements, current insulin therapies face challenges in patient acceptance and self-management.
• Newer insulin formulations, such as degludec, show promise in addressing existing barriers.
• Overcoming barriers is essential for optimizing insulin therapy and improving patient outcomes in diabetes care.