Q J Med 2002; 95: 757-761
© 2002 Association of Physicians
Commentary |
Insulin glargine: a new basal insulin analogue
From the Department of Endocrinology, Arrowe Park Hospital, Wirral, UK
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Introduction |
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Currently, the therapeutic challenges in the treatment of both type 1 and 2 diabetes mellitus (DM) are the maintenance of near-normal glycaemia, to prevent long-term complications,1,2 and the avoidance of episodes of hypoglycaemia. For many people with DM, intensive insulin therapy means multiple insulin injections and frequent blood sampling, at the expense of an increased risk of hypoglycaemia. This article will discuss the potential use of a new long-acting insulin analogue, insulin glargine, already prescribed in the US but expected to be available in the UK later this year.
Normal insulin secretion consists of discrete components: low basal levels secreted between meals, through the night and during fasting; and very high levels secreted post-prandially (Figure 1
). Basal-bolus insulin regimens attempt to reproduce this insulin secretion profile, which consists of one or two injections per day of intermediate or long-acting insulins (basal) and multiple mealtime (bolus) injections of rapid-acting or
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Rapid-acting insulins |
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Conventional basal insulins |
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Insulin glargine |
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Clinical trials using insulin glargine |
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Type 1 diabetes mellitus
Type 2 diabetes mellitus
Adverse effects
Recent studies
Summary of trial results
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Further studies |
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