Abstract
The epoch-making discovery of insulin heralded a new dawn in the management of diabetes. However, the earliest, unmodified soluble insulin preparations were limited by their short duration of action, necessitating multiple daily injections. Initial attempts to protract the duration of action of insulin involved the use of various additives, including vasoconstrictor substances, which met with limited success. The subsequent elucidation of the chemical and three-dimensional structure of insulin and its chemical synthesis and biosynthesis allowed modification of the insulin molecule itself, resulting in insulin analogs that are designed to mimic normal endogenous insulin secretion during both fasting and prandial conditions. Insulin glargine was the first once-daily, long-acting insulin analog to be introduced into clinical practice more than 10 years ago and is specifically designed to provide basal insulin requirements. It has a prolonged duration of action and no distinct insulin peak, making it suitable for once-daily administration and reducing the risk of nocturnal hypoglycemia that is seen with intermediate-acting insulins. Insulin glargine can be used in combination with prandial insulin preparations and non-insulin anti-diabetic agents according to individual requirements.
| Original language | English |
|---|---|
| Journal | Drugs |
| Volume | 74 |
| Issue number | 8 |
| Pages (from-to) | 911-927 |
| Number of pages | 17 |
| ISSN | 0012-6667 |
| DOIs | |
| Publication status | Published - 01.01.2014 |
Funding
Acknowledgments The authors are grateful to all members of the ‘‘New Insulins’’ team of former Hoechst AG. They thank Dr. Naoki Sakai (University of Lübeck) for help with Fig. 3. RH acknowledges support by the Chinese Academy of Sciences through a Visiting Professorship for Senior International Scientists (Grant no. 2010T1S6). Editorial support for this article was provided by Alexander Jones, Ph.D., from Medicus International, London, and funded by Sanofi.
