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New Insulins (Insulin Analogues)

• What are insulin analogues?
• How do they differ from conventional insulin?
• What are the different analogues available?
• What are the potential benefits?
• Are they more effective than conventional insulin?
• Are they safe?
• Are they safe to use during Pregnancy?

What are insulin analogues?

Analogues are new insulin compounds which are increasingly used. They are manufactured in the laboratory by modifying the chemical structure of human insulin so that the resulting compound has different chemical properties to human insulin. Insulin analogues are therefore manmade or artificial products.

How do they differ from conventional insulin?

The main difference is usually in the ‘time action profile’. This means the new insulin either works faster and for shorter periods or have a more prolonged course of action for twenty four hours.

What are the different analogues available?

Insulin Lyspro (Humalog^R)

Insulin Aspart (Novorapid^R)

Insulin Glargine (Lantos^R)

Insulin Determir (Levemir^R)

Mixtures:

Humalog Mix25 - 25% Humalog, 75% Humulin I

Humalog Mix50 - 50% Humalog, 50% Humulin I

NovoMix30 - 30% Novorapid, 70% Insulatard

Note: further information on the above insulins is to be provided

What are the potential benefits?

• Timing of injections – short acting analogues do not have to be injected up to half hour before meals like conventional insulin
• Risk of hypoglycaemia may be less with both the short acting and long acting analogues particularly nocturnal hypoglycaemia
• Compliance ( the tendency of people to comply with treatment) may be improved with use of once daily long acting analogues
• The need for snacks between meals may be reduced with short acting analogues
• Some advantages in terms of weight gain

Are analogues more effective than conventional insulin?

The advantage in terms of improved glycaemic control is not that great. It is possible to achieve equally good control using conventional insulin.

Are they safe?

Yes. Current practice suggest insulin analogues are indeed safe.  However, as with all new drugs, long term safety can only be concluded by experience of use in patients over many years.

Concerns have been raised as to the potential to cause cancer though these fears are unfounded.

Are they safe to use during Pregnancy?

These drugs have not as yet been licensed for use in pregnancy.

 

Dr Nishan Wijenaike, Consultant Physician
West Suffolk Hospitals Diabetes Service
October 2002
(Revised April 2006)