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Insulin analogs: Glimpse on contemporary facts and future prospective

Sharma, Arun K., Taneja, Gaurav, Kumar, Ashish, Sahu, Megha, Sharma, Gunjan, Kumar, Asim, Sardana, Satish, Deep, Aakash
Life sciences 2019 v.219 pp. 90-99
absorption, blood glucose, drug toxicity, hyperglycemia, hypoglycemia, insulin, insulin replacement therapy, insulin secretion, noninsulin-dependent diabetes mellitus, pharmacodynamics, pharmacokinetics
Insulin remains a predominant life-saving medication for type 1 and type 2 Diabetes Mellites. Natural insulin secretion limits the fluctuation of the narrow and high surge of blood glucose levels. However, imitating the same by external insulin remains a challenge as a variety of insulin analogs (rapid acting, short acting, intermediate acting and long-acting) have different pharmacokinetic (PK) and pharmacodynamic (PD) properties. Inconsistent reduction in overall hyperglycemia level and nocturnal hypoglycemia due to variable absorption time and time action profile predominantly highlights the need of revisiting the PK/PD of insulin analogs as single analog is not yet sufficed to replace internal insulin exogenously. Combination therapy with basal and prandial insulins or intensification of hypoglycemic therapy with premixed insulins are of prime importance in managing diabetes effectively, imitating the natural insulin secretion. Therefore, the knowledge of PK/PD properties might help a practitioner to design, implement and manage insulin replacement therapy effectively and averting adverse events. Present study reports the comparative analysis of PK/PD profile of various insulin analogs based on the concurrent information about clinical aspects. Moreover, study interlinks the major concerns of therapeutic efficacy of insulin analogs with their respective onset of action and duration of effectiveness and reported adverse drug reaction which explore the scope of improvement.