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    Home > Active Ingredient News > Endocrine System > Advanced insulin, looking at the third-generation insulin to bring balanced benefits to patients with type 2 diabetes

    Advanced insulin, looking at the third-generation insulin to bring balanced benefits to patients with type 2 diabetes

    • Last Update: 2021-11-14
    • Source: Internet
    • Author: User
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    *Only for medical professionals to read for reference.
    To sort out the development history of insulin, and to take stock of the advantages of the third-generation insulin therapy
    .

     2021 is the 100th anniversary of the discovery of insulin.
    From animal insulin to human insulin to insulin analogues, insulin has been innovated continuously over the past century
    .

    What logic does the insulin update iteration follow? Why develop insulin analogues? What benefits can insulin analogs and premixed insulin analogs bring to patients? Reason: Tracing back to the source of insulin renewal iteration.
    In 1921, Banting and his assistant Best successfully extracted insulin from the pancreas of dogs for the first time, and then animal insulin began to be used to treat diabetes and supplement the lack of insulin secretion in the body [1]
    .

    However, animal insulin production and purity are low and cannot meet clinical needs [1]
    .

     In addition, animal insulin is very easy to activate the immune response, leading to allergic reactions, and the action time is short, and it requires multiple injections a day, which brings a lot of inconvenience and pain to the patient
    .

    Fortunately, in the 1980s, researchers used animal insulin as the raw material, through genetic engineering/recombinant DNA technology to make the amino acid arrangement the same as the human body's own insulin, realizing the industrial production of human insulin and ushering in the second era of insulin development.

    .

     Human insulin greatly reduces the occurrence of allergic reactions in patients, and the average daily dosage of insulin is less [1], but it still has shortcomings: insulin has an obvious absorption peak and cannot fully simulate the physiological insulin curve, so it must be injected 30 minutes before a meal , In order to be synchronized with the peak blood sugar time after a meal, this feature can also easily lead to greater blood sugar fluctuations, and even cause hypoglycemia
    .

     Therefore, the development of insulin analogues that mimic the normal physiological insulin release pattern for diabetic patients has become an important goal of insulin evolution
    .

     In the 1990s, with the development and innovation of technology, the third generation of insulin-insulin analogues came into being
    .

    Compared with human insulin, insulin analogues can better simulate physiological insulin secretion [2].
    It does not need to be injected 30 minutes before a meal, and it can be injected at a meal, which is more convenient
    .

    Discrimination: Clarify the difference between human insulin and insulin analogues Nowadays, both human insulin and insulin analogues are widely used in the treatment of diabetes.
    What are the differences between the two? In fact, apart from the difference in source and type, human insulin and insulin analogues are also different in the time of administration
    .

     Ordinary soluble human insulin forms a hexamer after subcutaneous injection, and forms a certain polymerization-dissociation equilibrium with the monomer, and it takes a certain time for it to be released into the blood [3]
    .

    Since this dissociation process prolongs the onset time of insulin subcutaneous injection, this type of insulin needs to be injected 30 minutes before a meal
    .

     Insulin analogs are produced by modifying the amino acid sequence of human insulin, which have different pharmacokinetic properties from ordinary insulin, and change the action time of insulin [3]
    .

    For example, insulin lispro reverses the order of proline and lysine at positions B28 and B29 of human insulin, which can play a quick-acting hypoglycemic effect.
    It is a short-acting insulin and can also be combined with protamine as a medium-acting agent [3]
    .

    In addition, since the insulin analogue can be eaten immediately after injection, it also greatly improves the patient's compliance
    .

     Insulin analogues are absorbed faster and can more mimic the human body's insulin secretion, and have unique advantages.
    Each guide fully affirms its clinical advantages
    .

    The "Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2020 Edition)" pointed out that compared with human insulin, insulin analogues have similar effects in controlling blood sugar, but they are superior to human insulin in terms of simulating physiological insulin secretion and reducing the occurrence of hypoglycemia [4]
    .

     The above different characteristics of human insulin and insulin analogs can be summarized in a table to distinguish them (Table 1)
    .

     Table 1 The difference between human insulin and insulin analogues Seek results: from insulin analogues to premixed insulin analogues, how much benefit does the patient benefit? According to the time characteristics of insulin analogs, insulin analogs can be divided into quick-acting, short-acting, medium-acting, long-acting and premixed insulin analogs
    .

     Among them, the premixed insulin analogue uses the difference in the onset time of different dosage forms of insulin to mix the prandial insulin that lowers postprandial blood sugar and the basal insulin that lowers fasting blood sugar in a certain proportion, so as to produce both lower postprandial blood sugar and lower fasting.
    The dual-phase insulin of blood sugar can achieve the therapeutic effect of "killing two birds with one stone" [5]
    .

     In short, because premixed insulin analogues take into account both fasting and postprandial blood sugar, the risk of hypoglycemia is lower, and the injection time is more flexible, so patients have higher compliance and become the best choice in diabetes management
    .

     Summary After a hundred years of development and innovation, insulin drugs are becoming more and more convenient and user-friendly
    .

    Compared with human insulin, insulin analogues have more clinical advantages in the treatment of diabetes, and premixed insulin analogues can control postprandial blood sugar while taking into account overall blood sugar, further bringing balanced benefits and better Patient compliance and higher treatment satisfaction bring ideal choices to the clinic and benefit more diabetic patients
    .

     
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