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Concentrated insulins: the new basal insulins
Elizabeth M Lamos1, Lisa M Younk2, Stephen N Davis3
1Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA.
Therapeutics and Clinical Risk Management
|March 30, 2016
Summary
New concentrated insulin formulations offer improved 24-hour coverage and reduced hypoglycemia risk for diabetes patients. Understanding their pharmacokinetic and pharmacodynamic properties is crucial for safe and effective high-dose insulin therapy.
Area of Science:
- Endocrinology
- Pharmacology
- Diabetes Mellitus Management
Background:
- Insulin therapy is vital for type 1 and type 2 diabetes.
- A need exists for basal insulins with 24-hour coverage and lower hypoglycemia risk.
- Increasing obesity and insulin resistance necessitate high-dose, low-volume insulin options.
Purpose of the Study:
- To review pharmacokinetic (PK) and glucodynamic properties of concentrated insulins.
- To assess clinical efficacy, hypoglycemia risk, and metabolic changes.
- To discuss challenges in introducing new concentrated insulin generations.
Main Methods:
- Review of published reports on Humulin-R U500, insulin degludec U200, and insulin glargine U300.
- Analysis of PK/glucodynamic data, clinical efficacy, and safety profiles.
- Discussion of market introduction complexities for novel concentrated insulins.
Main Results:
- Humulin-R U500 offers longer duration than U100 regular insulin.
- Insulin glargine U300 shows differential PK/PD effects versus U100.
- Degludec U200 and glargine U300 provide similar glycemic control with reduced nocturnal hypoglycemia compared to glargine U100.
Conclusions:
- Concentrated insulins may act as distinct molecular entities.
- Newer concentrated basal insulins may reduce intra-individual variability and injection burden.
- Understanding PK/PD properties is critical for safe dosing and administration of these insulins.
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