Skip to main content
Top
Published in: Diabetes Therapy 11/2023

Open Access 22-09-2023 | Insulins | Review

Insulin Therapy for the Management of Diabetes Mellitus: A Narrative Review of Innovative Treatment Strategies

Authors: Ken M. Nkonge, Dennis K. Nkonge, Teresa N. Nkonge

Published in: Diabetes Therapy | Issue 11/2023

Login to get access

Abstract

The discovery of insulin was presented to the international medical community on May 3, 1922. Since then, insulin has become one of the most effective pharmacological agents used to treat type 1 and type 2 diabetes mellitus. However, the initiation and intensification of insulin therapy is often delayed in people living with type 2 diabetes due to numerous challenges associated with daily subcutaneous administration. Reducing the frequency of injections, using insulin pens instead of syringes and vials, simplifying treatment regimens, or administering insulin through alternative routes may help improve adherence to and persistence with insulin therapy among people living with diabetes. As the world commemorates the centennial of the commercialization of insulin, the aims of this article are to provide an overview of insulin therapy and to summarize clinically significant findings from phase 3 clinical trials evaluating less frequent dosing of insulin and the non-injectable administration of insulin.
Literature
1.
go back to reference Hirsch IB, Juneja R, Beals JM, Antalis CJ, Wright EE. The evolution of insulin and how it informs therapy and treatment choices. Endocr Rev. 2020;41:733–55. PubMedPubMedCentralCrossRef Hirsch IB, Juneja R, Beals JM, Antalis CJ, Wright EE. The evolution of insulin and how it informs therapy and treatment choices. Endocr Rev. 2020;41:733–55. PubMedPubMedCentralCrossRef
2.
go back to reference Wellington A. Leonard Thompson ‘ever remembered’: the first person to receive insulin. J Med Biogr. 2022;30:64–6. PubMedCrossRef Wellington A. Leonard Thompson ‘ever remembered’: the first person to receive insulin. J Med Biogr. 2022;30:64–6. PubMedCrossRef
4.
go back to reference de Leiva-Hidalgo A, de Leiva-Pérez A. On the occasion of the centennial of insulin therapy (1922–2022), II-organotherapy of diabetes mellitus (1906–1923): acomatol. Pancreina. Insulin. Acta Diabetol. 2023;60:163–89. PubMedCrossRef de Leiva-Hidalgo A, de Leiva-Pérez A. On the occasion of the centennial of insulin therapy (1922–2022), II-organotherapy of diabetes mellitus (1906–1923): acomatol. Pancreina. Insulin. Acta Diabetol. 2023;60:163–89. PubMedCrossRef
8.
go back to reference Vecchio I, Tornali C, Bragazzi NL, Martini M. The discovery of insulin: an important milestone in the history of medicine. Front Endocrinol (Lausanne). 2018;9:613. PubMedCrossRef Vecchio I, Tornali C, Bragazzi NL, Martini M. The discovery of insulin: an important milestone in the history of medicine. Front Endocrinol (Lausanne). 2018;9:613. PubMedCrossRef
9.
go back to reference Riggs AD. Making, cloning, and the expression of human insulin genes in bacteria: the path to humulin. Endocr Rev. 2021;42:374–80. PubMedCrossRef Riggs AD. Making, cloning, and the expression of human insulin genes in bacteria: the path to humulin. Endocr Rev. 2021;42:374–80. PubMedCrossRef
10.
go back to reference Garg SK, Rewers AH, Akturk HK. Ever-increasing insulin-requiring patients globally. Diabetes Technol Ther. 2018;20:S21-24. PubMedCrossRef Garg SK, Rewers AH, Akturk HK. Ever-increasing insulin-requiring patients globally. Diabetes Technol Ther. 2018;20:S21-24. PubMedCrossRef
12.
go back to reference Rege NK, Liu M, Yang Y, et al. Evolution of insulin at the edge of foldability and its medical implications. Proc Natl Acad Sci USA. 2020;117:29618–28. PubMedPubMedCentralCrossRef Rege NK, Liu M, Yang Y, et al. Evolution of insulin at the edge of foldability and its medical implications. Proc Natl Acad Sci USA. 2020;117:29618–28. PubMedPubMedCentralCrossRef
13.
14.
go back to reference Bolli GB, Cheng AYY, Owens DR. Insulin: evolution of insulin formulations and their application in clinical practice over 100 years. Acta Diabetol. 2022;59:1129–44. PubMedPubMedCentralCrossRef Bolli GB, Cheng AYY, Owens DR. Insulin: evolution of insulin formulations and their application in clinical practice over 100 years. Acta Diabetol. 2022;59:1129–44. PubMedPubMedCentralCrossRef
15.
go back to reference Heise T, Mathieu C. Impact of the mode of protraction of basal insulin therapies on their pharmacokinetic and pharmacodynamic properties and resulting clinical outcomes. Diabetes Obes Metab. 2017;19:3–12. PubMedCrossRef Heise T, Mathieu C. Impact of the mode of protraction of basal insulin therapies on their pharmacokinetic and pharmacodynamic properties and resulting clinical outcomes. Diabetes Obes Metab. 2017;19:3–12. PubMedCrossRef
18.
go back to reference Battelino T, Bosnyak Z, Danne T, et al. InRange: comparison of the second-generation basal insulin analogues glargine 300 U/mL and degludec 100 U/mL in persons with type 1 diabetes using continuous glucose monitoring–study design. Diabetes Ther. 2020;11:1017–27. PubMedPubMedCentralCrossRef Battelino T, Bosnyak Z, Danne T, et al. InRange: comparison of the second-generation basal insulin analogues glargine 300 U/mL and degludec 100 U/mL in persons with type 1 diabetes using continuous glucose monitoring–study design. Diabetes Ther. 2020;11:1017–27. PubMedPubMedCentralCrossRef
19.
go back to reference Mauricio D, Hramiak I. Second-generation insulin analogues—a review of recent real-world data and forthcoming head-to-head comparisons. Eur Endocrinol. 2018;14:2–9. PubMedPubMedCentral Mauricio D, Hramiak I. Second-generation insulin analogues—a review of recent real-world data and forthcoming head-to-head comparisons. Eur Endocrinol. 2018;14:2–9. PubMedPubMedCentral
21.
go back to reference Sinding C. Making the unit of insulin: standards, clinical work, and industry, 1920–1925. Bull Hist Med. 2002;76:231–70. PubMedCrossRef Sinding C. Making the unit of insulin: standards, clinical work, and industry, 1920–1925. Bull Hist Med. 2002;76:231–70. PubMedCrossRef
22.
go back to reference Schloot NC, Hood RC, Corrigan SM, Panek RL, Heise T. Concentrated insulins in current clinical practice. Diabetes Res Clin Pract. 2019;148:93–101. PubMedCrossRef Schloot NC, Hood RC, Corrigan SM, Panek RL, Heise T. Concentrated insulins in current clinical practice. Diabetes Res Clin Pract. 2019;148:93–101. PubMedCrossRef
23.
go back to reference Madsbad S. LY2605541—a preferential hepato-specific insulin analogue. Diabetes. 2014;63:390–2. PubMedCrossRef Madsbad S. LY2605541—a preferential hepato-specific insulin analogue. Diabetes. 2014;63:390–2. PubMedCrossRef
24.
go back to reference Matli MC, Wilson AB, Rappsilber LM, Sheffield FP, Farlow ML, Johnson JL. The first interchangeable biosimilar insulin: insulin glargine-yfgn. J Diabetes Sci Technol. 2023;17:490–4. PubMedCrossRef Matli MC, Wilson AB, Rappsilber LM, Sheffield FP, Farlow ML, Johnson JL. The first interchangeable biosimilar insulin: insulin glargine-yfgn. J Diabetes Sci Technol. 2023;17:490–4. PubMedCrossRef
25.
go back to reference Cunningham SM, Tanner DA. A review: the prospect of inhaled insulin therapy via vibrating mesh technology to treat diabetes. Int J Environ Res Public Health. 2020;17:5795. PubMedPubMedCentralCrossRef Cunningham SM, Tanner DA. A review: the prospect of inhaled insulin therapy via vibrating mesh technology to treat diabetes. Int J Environ Res Public Health. 2020;17:5795. PubMedPubMedCentralCrossRef
26.
go back to reference Zizzari AT, Pliatsika D, Gall FM, Fischer T, Riedl R. New perspectives in oral peptide delivery. Drug Discov Today. 2021;26:1097–105. PubMedCrossRef Zizzari AT, Pliatsika D, Gall FM, Fischer T, Riedl R. New perspectives in oral peptide delivery. Drug Discov Today. 2021;26:1097–105. PubMedCrossRef
28.
go back to reference Rosenstock J, Del Prato S. Basal weekly insulins: the way of the future! Metabolism. 2022;126: 154924. PubMedCrossRef Rosenstock J, Del Prato S. Basal weekly insulins: the way of the future! Metabolism. 2022;126: 154924. PubMedCrossRef
29.
go back to reference Mehta R, Chen R, Hirose T, et al. Practical use of insulin degludec/insulin aspart in a multinational setting: beyond the guidelines. Diabetes Obes Metab. 2020;22:1961–75. PubMedPubMedCentralCrossRef Mehta R, Chen R, Hirose T, et al. Practical use of insulin degludec/insulin aspart in a multinational setting: beyond the guidelines. Diabetes Obes Metab. 2020;22:1961–75. PubMedPubMedCentralCrossRef
30.
go back to reference Blumer I, Pettus JH, Cavaiola TS. Fixed-ratio combination therapy for type 2 diabetes: the top ten things you should know about insulin and glucagon-like peptide-1 receptor agonist combinations. Postgrad Med. 2018;130:375–80. PubMedCrossRef Blumer I, Pettus JH, Cavaiola TS. Fixed-ratio combination therapy for type 2 diabetes: the top ten things you should know about insulin and glucagon-like peptide-1 receptor agonist combinations. Postgrad Med. 2018;130:375–80. PubMedCrossRef
31.
go back to reference Guerci B, Chanan N, Kaur S, Jasso-Mosqueda J, Lew E. Lack of treatment persistence and treatment nonadherence as barriers to glycaemic control in patients with type 2 diabetes. Diabetes Ther. 2019;10:437–49. PubMedPubMedCentralCrossRef Guerci B, Chanan N, Kaur S, Jasso-Mosqueda J, Lew E. Lack of treatment persistence and treatment nonadherence as barriers to glycaemic control in patients with type 2 diabetes. Diabetes Ther. 2019;10:437–49. PubMedPubMedCentralCrossRef
32.
go back to reference Matteucci E, Giampietro O, Covolan V, Giustarini D, Fanti P, Rossi R. Insulin administration: present strategies and future directions for a noninvasive (possibly more physiological) delivery. Drug Des Dev Ther. 2015;9:3109–18. CrossRef Matteucci E, Giampietro O, Covolan V, Giustarini D, Fanti P, Rossi R. Insulin administration: present strategies and future directions for a noninvasive (possibly more physiological) delivery. Drug Des Dev Ther. 2015;9:3109–18. CrossRef
33.
go back to reference Munshi M, Neumiller JJ. Liberalisation, deintensification, and simplification in diabetes management: words matter. Lancet Diabetes Endocrinol. 2020;8:95–7. PubMedCrossRef Munshi M, Neumiller JJ. Liberalisation, deintensification, and simplification in diabetes management: words matter. Lancet Diabetes Endocrinol. 2020;8:95–7. PubMedCrossRef
34.
go back to reference Steenkamp D, Eby EL, Gulati N, Liao B. Adherence and persistence to insulin therapy in people with diabetes: impact of connected insulin pen delivery ecosystem. J Diabetes Sci Technol. 2022;16:995–1002. PubMedCrossRef Steenkamp D, Eby EL, Gulati N, Liao B. Adherence and persistence to insulin therapy in people with diabetes: impact of connected insulin pen delivery ecosystem. J Diabetes Sci Technol. 2022;16:995–1002. PubMedCrossRef
35.
go back to reference Jude EB, Malecki MT, Huelgas RG, et al. Expert panel guidance and narrative review of treatment simplification of complex insulin regimens to improve outcomes in type 2 diabetes. Diabetes Ther. 2022;13:619–34. PubMedPubMedCentralCrossRef Jude EB, Malecki MT, Huelgas RG, et al. Expert panel guidance and narrative review of treatment simplification of complex insulin regimens to improve outcomes in type 2 diabetes. Diabetes Ther. 2022;13:619–34. PubMedPubMedCentralCrossRef
36.
go back to reference Masierek M, Nabrdalik K, Janota O, Kwiendacz H, Macherski M, Gumprecht J. The review of insulin pens–past, present, and look to the future. Front Endocrinol (Lausanne). 2022;13: 827484. PubMedCrossRef Masierek M, Nabrdalik K, Janota O, Kwiendacz H, Macherski M, Gumprecht J. The review of insulin pens–past, present, and look to the future. Front Endocrinol (Lausanne). 2022;13: 827484. PubMedCrossRef
37.
go back to reference Mehta R, Goldenberg R, Katselnik D, Kuritzky L. Practical guidance on the initiation, titration, and switching of basal insulins: a narrative review for primary care. Ann Med. 2021;53:998–1009. PubMedPubMedCentralCrossRef Mehta R, Goldenberg R, Katselnik D, Kuritzky L. Practical guidance on the initiation, titration, and switching of basal insulins: a narrative review for primary care. Ann Med. 2021;53:998–1009. PubMedPubMedCentralCrossRef
38.
go back to reference Edgerton DS, Scott M, Farmer B, et al. Targeting insulin to the liver corrects defects in glucose metabolism caused by peripheral insulin delivery. JCI Insight. 2019;5: e126974. PubMedCrossRef Edgerton DS, Scott M, Farmer B, et al. Targeting insulin to the liver corrects defects in glucose metabolism caused by peripheral insulin delivery. JCI Insight. 2019;5: e126974. PubMedCrossRef
39.
go back to reference Edgerton DS, Moore MC, Gregory JM, Kraft G, Cherrington AD. Importance of the route of insulin delivery to its control of glucose metabolism. Am J Physiol Endocrinol Metab. 2021;320:E891–7. PubMedPubMedCentralCrossRef Edgerton DS, Moore MC, Gregory JM, Kraft G, Cherrington AD. Importance of the route of insulin delivery to its control of glucose metabolism. Am J Physiol Endocrinol Metab. 2021;320:E891–7. PubMedPubMedCentralCrossRef
41.
go back to reference Muñoz-Garach A, Molina-Vega M, Tinahones FJ. How can a good idea fail? Basal insulin peglispro [LY2605541] for the treatment of type 2 diabetes. Diabetes Ther. 2017;8:9–22. PubMedCrossRef Muñoz-Garach A, Molina-Vega M, Tinahones FJ. How can a good idea fail? Basal insulin peglispro [LY2605541] for the treatment of type 2 diabetes. Diabetes Ther. 2017;8:9–22. PubMedCrossRef
42.
go back to reference Garg S, Dreyer M, Jinnouchi H, et al. A randomized clinical trial comparing basal insulin peglispro and insulin glargine, in combination with prandial insulin lispro, in patients with type 1 diabetes: IMAGINE 1. Diabetes Obes Metab. 2016;18(Suppl 2):25–33. PubMedCrossRef Garg S, Dreyer M, Jinnouchi H, et al. A randomized clinical trial comparing basal insulin peglispro and insulin glargine, in combination with prandial insulin lispro, in patients with type 1 diabetes: IMAGINE 1. Diabetes Obes Metab. 2016;18(Suppl 2):25–33. PubMedCrossRef
43.
go back to reference Davies MJ, Russell-Jones D, Selam JL, et al. Basal insulin peglispro versus insulin glargine in insulin-naïve type 2 diabetes: IMAGINE 2 randomized trial. Diabetes Obes Metab. 2016;18:1055–64. PubMedPubMedCentralCrossRef Davies MJ, Russell-Jones D, Selam JL, et al. Basal insulin peglispro versus insulin glargine in insulin-naïve type 2 diabetes: IMAGINE 2 randomized trial. Diabetes Obes Metab. 2016;18:1055–64. PubMedPubMedCentralCrossRef
44.
go back to reference Bergenstal RM, Lunt H, Franek E, et al. Randomized, double-blind clinical trial comparing basal insulin peglispro and insulin glargine, in combination with prandial insulin lispro, in patients with type 1 diabetes: IMAGINE 3. Diabetes Obes Metab. 2016;18:1081–8. PubMedPubMedCentralCrossRef Bergenstal RM, Lunt H, Franek E, et al. Randomized, double-blind clinical trial comparing basal insulin peglispro and insulin glargine, in combination with prandial insulin lispro, in patients with type 1 diabetes: IMAGINE 3. Diabetes Obes Metab. 2016;18:1081–8. PubMedPubMedCentralCrossRef
45.
go back to reference Blevins T, Pieber TR, Colón Vega G, et al. Randomized double-blind clinical trial comparing basal insulin peglispro and insulin glargine, in combination with prandial insulin lispro, in patients with type 2 diabetes: IMAGINE 4. Diabetes Obes Metab. 2016;18:1072–80. PubMedPubMedCentralCrossRef Blevins T, Pieber TR, Colón Vega G, et al. Randomized double-blind clinical trial comparing basal insulin peglispro and insulin glargine, in combination with prandial insulin lispro, in patients with type 2 diabetes: IMAGINE 4. Diabetes Obes Metab. 2016;18:1072–80. PubMedPubMedCentralCrossRef
46.
go back to reference Buse JB, Rodbard HW, Trescoli Serrano C, et al. Randomized clinical trial comparing basal insulin peglispro and insulin glargine in patients with type 2 diabetes previously treated with basal insulin: IMAGINE 5. Diabetes Care. 2016;39:92–100. PubMedCrossRef Buse JB, Rodbard HW, Trescoli Serrano C, et al. Randomized clinical trial comparing basal insulin peglispro and insulin glargine in patients with type 2 diabetes previously treated with basal insulin: IMAGINE 5. Diabetes Care. 2016;39:92–100. PubMedCrossRef
47.
go back to reference Grunberger G, Chen L, Rodriguez A, et al. A randomized clinical trial of basal insulin peglispro vs NPH in insulin-naïve patients with type 2 diabetes: the IMAGINE 6 trial. Diabetes Obes Metab. 2016;18(Suppl 2):34–42. PubMedCrossRef Grunberger G, Chen L, Rodriguez A, et al. A randomized clinical trial of basal insulin peglispro vs NPH in insulin-naïve patients with type 2 diabetes: the IMAGINE 6 trial. Diabetes Obes Metab. 2016;18(Suppl 2):34–42. PubMedCrossRef
48.
go back to reference Garg S, Selam JL, Bhargava A, et al. Similar HbA1c reduction and hypoglycaemia with variable- vs fixed-time dosing of basal insulin peglispro in type 1 diabetes: IMAGINE 7 study. Diabetes Obes Metab. 2016;18(Suppl 2):43–9. PubMedCrossRef Garg S, Selam JL, Bhargava A, et al. Similar HbA1c reduction and hypoglycaemia with variable- vs fixed-time dosing of basal insulin peglispro in type 1 diabetes: IMAGINE 7 study. Diabetes Obes Metab. 2016;18(Suppl 2):43–9. PubMedCrossRef
49.
go back to reference Harris C, Forst T, Heise T, et al. Hypoglycemia risk related to double dose is markedly reduced with type 2 diabetes mellitus in a randomized trial: IMAGINE 8. Diabetes Technol Ther. 2017;19:463–70. PubMedPubMedCentralCrossRef Harris C, Forst T, Heise T, et al. Hypoglycemia risk related to double dose is markedly reduced with type 2 diabetes mellitus in a randomized trial: IMAGINE 8. Diabetes Technol Ther. 2017;19:463–70. PubMedPubMedCentralCrossRef
51.
go back to reference Rosenstock J, Bain SC, Gowda A, et al. Weekly icodec versus daily glargine U100 in type 2 diabetes without previous insulin. N Eng J Med. 2023;389:297–308. CrossRef Rosenstock J, Bain SC, Gowda A, et al. Weekly icodec versus daily glargine U100 in type 2 diabetes without previous insulin. N Eng J Med. 2023;389:297–308. CrossRef
52.
go back to reference Philis-Tsimikas A, Asong M, Franek E, et al. Switching to once-weekly insulin icodec versus once-daily insulin degludec in individuals with basal insulin-treated type 2 diabetes (ONWARDS 2): a phase 3a, randomised, open-label, multicentre, treat-to-target trial. Lancet Diabetes Endocrinol. 2023;11:414–25. PubMedCrossRef Philis-Tsimikas A, Asong M, Franek E, et al. Switching to once-weekly insulin icodec versus once-daily insulin degludec in individuals with basal insulin-treated type 2 diabetes (ONWARDS 2): a phase 3a, randomised, open-label, multicentre, treat-to-target trial. Lancet Diabetes Endocrinol. 2023;11:414–25. PubMedCrossRef
53.
go back to reference Lingvay I, Asong M, Desouza C, et al. Once-weekly insulin icodec vs once-daily insulin degludec in adults with insulin-naïve type 2 diabetes: the ONWARDS 3 randomized clinical trial. JAMA. 2023;330:228–37. PubMedCrossRef Lingvay I, Asong M, Desouza C, et al. Once-weekly insulin icodec vs once-daily insulin degludec in adults with insulin-naïve type 2 diabetes: the ONWARDS 3 randomized clinical trial. JAMA. 2023;330:228–37. PubMedCrossRef
54.
go back to reference Mathieu C, Ásbjörnsdóttir B, Bajaj HS, et al. Switching to once-weekly insulin icodec versus once-daily glargine U100 in individuals with basal-bolus insulin-treated type 2 diabetes (ONWARDS 4): a phase 3a, randomised, open-label, multicentre, treat-to-target, non-inferiority trial. Lancet. 2023;401:1929–40. PubMedCrossRef Mathieu C, Ásbjörnsdóttir B, Bajaj HS, et al. Switching to once-weekly insulin icodec versus once-daily glargine U100 in individuals with basal-bolus insulin-treated type 2 diabetes (ONWARDS 4): a phase 3a, randomised, open-label, multicentre, treat-to-target, non-inferiority trial. Lancet. 2023;401:1929–40. PubMedCrossRef
56.
57.
go back to reference ClinicalTrials.gov. A research study to see how well the new weekly medicine icosema, which is a combination of insulin icodec and semaglutide, controls blood sugar level in people with type 2 diabetes compared to weekly insulin icodec (COMBINE 1). 2022. https://​clinicaltrials.​gov/​study/​NCT05352815. Accessed 10 Mar 2023. ClinicalTrials.gov. A research study to see how well the new weekly medicine icosema, which is a combination of insulin icodec and semaglutide, controls blood sugar level in people with type 2 diabetes compared to weekly insulin icodec (COMBINE 1). 2022. https://​clinicaltrials.​gov/​study/​NCT05352815. Accessed 10 Mar 2023.
58.
go back to reference ClinicalTrials.gov. A research study to see how well the new weekly medicine icosema, which is a combination of insulin icodec and semaglutide, controls blood sugar level in people with type 2 diabetes compared to weekly semaglutide (COMBINE 2) (COMBINE 2). 2022. https://​clinicaltrials.​gov/​study/​NCT05259033. Accessed 10 Mar 2023. ClinicalTrials.gov. A research study to see how well the new weekly medicine icosema, which is a combination of insulin icodec and semaglutide, controls blood sugar level in people with type 2 diabetes compared to weekly semaglutide (COMBINE 2) (COMBINE 2). 2022. https://​clinicaltrials.​gov/​study/​NCT05259033. Accessed 10 Mar 2023.
59.
go back to reference ClinicalTrials.gov. A research study to see how well the new weekly medicine icosema, which is a combination of insulin icodec and semaglutide, controls blood sugar level in people with type 2 diabetes compared to insulin glargine taken daily with insulin aspart (COMBINE 3). 2022. https://​clinicaltrials.​gov/​study/​NCT05013229. Accessed 10 Mar 2023. ClinicalTrials.gov. A research study to see how well the new weekly medicine icosema, which is a combination of insulin icodec and semaglutide, controls blood sugar level in people with type 2 diabetes compared to insulin glargine taken daily with insulin aspart (COMBINE 3). 2022. https://​clinicaltrials.​gov/​study/​NCT05013229. Accessed 10 Mar 2023.
65.
go back to reference Barnett A, Begg A, Dyson P, Feher M, Hamilton S, Munro N. Insulin for type 2 diabetes: choosing a second-line insulin regimen. Int J Clin Pract. 2008;62:1647–53. PubMedCrossRef Barnett A, Begg A, Dyson P, Feher M, Hamilton S, Munro N. Insulin for type 2 diabetes: choosing a second-line insulin regimen. Int J Clin Pract. 2008;62:1647–53. PubMedCrossRef
66.
go back to reference Pozzilli P, Battelino T, Danne T, Hovorka R, Jarosz-Chobot P, Renard E. Continuous subcutaneous insulin infusion in diabetes: patient populations, safety, efficacy, and pharmacoeconomics. Diabetes Metab Res Rev. 2016;32:21–39. PubMedCrossRef Pozzilli P, Battelino T, Danne T, Hovorka R, Jarosz-Chobot P, Renard E. Continuous subcutaneous insulin infusion in diabetes: patient populations, safety, efficacy, and pharmacoeconomics. Diabetes Metab Res Rev. 2016;32:21–39. PubMedCrossRef
67.
go back to reference Pfützner A, Sachsenheimer D, Grenningloh M, et al. Using insulin infusion sets in CSII for longer than the recommended usage time leads to a high risk for adverse events: results from a prospective randomized crossover study. J Diabetes Sci Technol. 2015;9:1292–8. PubMedPubMedCentralCrossRef Pfützner A, Sachsenheimer D, Grenningloh M, et al. Using insulin infusion sets in CSII for longer than the recommended usage time leads to a high risk for adverse events: results from a prospective randomized crossover study. J Diabetes Sci Technol. 2015;9:1292–8. PubMedPubMedCentralCrossRef
68.
go back to reference Thethi TK, Rao A, Kawji H, et al. Consequences of delayed pump infusion line change in patients with type 1 diabetes mellitus treated with continuous subcutaneous insulin infusion. J Diabetes Complications. 2010;24:73–8. PubMedCrossRef Thethi TK, Rao A, Kawji H, et al. Consequences of delayed pump infusion line change in patients with type 1 diabetes mellitus treated with continuous subcutaneous insulin infusion. J Diabetes Complications. 2010;24:73–8. PubMedCrossRef
70.
go back to reference Russell-Jones D, Pouwer F, Khunti K. Identification of barriers to insulin therapy and approaches to overcoming them. Diabetes Obes Metab. 2018;20:488–96. PubMedCrossRef Russell-Jones D, Pouwer F, Khunti K. Identification of barriers to insulin therapy and approaches to overcoming them. Diabetes Obes Metab. 2018;20:488–96. PubMedCrossRef
71.
go back to reference Edelman S, Cassarino D, Kayne D, Dex T, Li X, Pasquel FJ. Treatment persistence and adherence in people with type 2 diabetes switching to iGlarLixi vs free-dose combinations of basal insulin and glucagon-like peptide 1 receptor agonist. J Manag Care Spec Pharm. 2022;28:958–68. PubMed Edelman S, Cassarino D, Kayne D, Dex T, Li X, Pasquel FJ. Treatment persistence and adherence in people with type 2 diabetes switching to iGlarLixi vs free-dose combinations of basal insulin and glucagon-like peptide 1 receptor agonist. J Manag Care Spec Pharm. 2022;28:958–68. PubMed
72.
go back to reference Spain CV, Wright JJ, Hahn RM, Wivel A, Martin AA. Self-reported barriers to adherence and persistence to treatment with injectable medications for type 2 diabetes. Clin Ther. 2016;38:1653–64. PubMedCrossRef Spain CV, Wright JJ, Hahn RM, Wivel A, Martin AA. Self-reported barriers to adherence and persistence to treatment with injectable medications for type 2 diabetes. Clin Ther. 2016;38:1653–64. PubMedCrossRef
73.
go back to reference Polonsky WH, Arora R, Faurby M, Fernandes J, Liebl A. Higher rates of persistence and adherence in patients with type 2 diabetes initiating once-weekly vs daily injectable glucagon-like peptide-1 receptor agonists in US clinical practice (STAY Study). Diabetes Ther. 2022;13:175–87. PubMedCrossRef Polonsky WH, Arora R, Faurby M, Fernandes J, Liebl A. Higher rates of persistence and adherence in patients with type 2 diabetes initiating once-weekly vs daily injectable glucagon-like peptide-1 receptor agonists in US clinical practice (STAY Study). Diabetes Ther. 2022;13:175–87. PubMedCrossRef
75.
go back to reference Capoccia K, Odegard PS, Letassy N. Medication adherence with diabetes medication: a systematic review of the literature. Diabetes Educ. 2016;42:34–71. PubMedCrossRef Capoccia K, Odegard PS, Letassy N. Medication adherence with diabetes medication: a systematic review of the literature. Diabetes Educ. 2016;42:34–71. PubMedCrossRef
76.
go back to reference Alsaidan AA, Alsaidan OA, Mallhi TH, Khan YH, Alzarea AI, Alanazi AS. Assessment of adherence to insulin injections among diabetic patients on basal-bolus regimen in primary and secondary healthcare centers in Al-Jouf region of Saudi Arabia; a descriptive analysis. J Clin Med. 2023;12:3474. PubMedPubMedCentralCrossRef Alsaidan AA, Alsaidan OA, Mallhi TH, Khan YH, Alzarea AI, Alanazi AS. Assessment of adherence to insulin injections among diabetic patients on basal-bolus regimen in primary and secondary healthcare centers in Al-Jouf region of Saudi Arabia; a descriptive analysis. J Clin Med. 2023;12:3474. PubMedPubMedCentralCrossRef
77.
go back to reference Bellary S, Barnett AH. Insulin icodec: evolution or revolution in diabetes therapy? Lancet Diabetes Endocrinol. 2023;11:379–80. PubMedCrossRef Bellary S, Barnett AH. Insulin icodec: evolution or revolution in diabetes therapy? Lancet Diabetes Endocrinol. 2023;11:379–80. PubMedCrossRef
79.
go back to reference Santoleri D, Titchenell PM. Resolving the paradox of hepatic insulin resistance. Cell Mol Gastroenterol Hepatol. 2019;7:447–56. PubMedCrossRef Santoleri D, Titchenell PM. Resolving the paradox of hepatic insulin resistance. Cell Mol Gastroenterol Hepatol. 2019;7:447–56. PubMedCrossRef
80.
go back to reference Kurtzhals P, Nishimura E, Haahr H, et al. Commemorating insulin’s centennial: engineering insulin pharmacology towards physiology. Trends Pharmacol Sci. 2021;42:620–39. PubMedCrossRef Kurtzhals P, Nishimura E, Haahr H, et al. Commemorating insulin’s centennial: engineering insulin pharmacology towards physiology. Trends Pharmacol Sci. 2021;42:620–39. PubMedCrossRef
81.
82.
go back to reference Hvid H, Brand CL, Hummelshøj T, et al. Preclinical exploration of combined glucagon inhibition and liver-preferential insulin for treatment of diabetes using in vitro assays and rat and mouse models. Diabetologia. 2023;66:376–89. PubMedCrossRef Hvid H, Brand CL, Hummelshøj T, et al. Preclinical exploration of combined glucagon inhibition and liver-preferential insulin for treatment of diabetes using in vitro assays and rat and mouse models. Diabetologia. 2023;66:376–89. PubMedCrossRef
83.
go back to reference Battelino T, Danne T, Bergenstal RM, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the International Consensus on Time in Range. Diabetes Care. 2019;42:1593–603. PubMedPubMedCentralCrossRef Battelino T, Danne T, Bergenstal RM, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the International Consensus on Time in Range. Diabetes Care. 2019;42:1593–603. PubMedPubMedCentralCrossRef
88.
go back to reference Lisco G, De Tullio A, Disoteo O, et al. Basal insulin intensification with GLP-1RA and dual GIP and GLP-1RA in patients with uncontrolled type 2 diabetes mellitus: a rapid review of randomized controlled trials and meta-analysis. Front Endocrinol (Lausanne). 2022;13: 920541. PubMedCrossRef Lisco G, De Tullio A, Disoteo O, et al. Basal insulin intensification with GLP-1RA and dual GIP and GLP-1RA in patients with uncontrolled type 2 diabetes mellitus: a rapid review of randomized controlled trials and meta-analysis. Front Endocrinol (Lausanne). 2022;13: 920541. PubMedCrossRef
89.
go back to reference Ruze R, Liu T, Zou X, et al. Obesity and type 2 diabetes mellitus: connections in epidemiology, pathogenesis, and treatments. Front Endocrinol (Lausanne). 2023;14:1161521. PubMedCrossRef Ruze R, Liu T, Zou X, et al. Obesity and type 2 diabetes mellitus: connections in epidemiology, pathogenesis, and treatments. Front Endocrinol (Lausanne). 2023;14:1161521. PubMedCrossRef
90.
go back to reference Robinson S, Newson RS, Liao B, Kennedy-Martin T, Battelino T. Missed and mistimed insulin doses in people with diabetes: a systematic literature review. Diabetes Technol Ther. 2021;23:844–56. PubMedCrossRef Robinson S, Newson RS, Liao B, Kennedy-Martin T, Battelino T. Missed and mistimed insulin doses in people with diabetes: a systematic literature review. Diabetes Technol Ther. 2021;23:844–56. PubMedCrossRef
91.
go back to reference Pandey M, Choudhury H, Yi CX, et al. Recent updates on novel approaches in insulin drug delivery: a review of challenges and pharmaceutical implications. Curr Drug Targets. 2018;19:1782–800. PubMedCrossRef Pandey M, Choudhury H, Yi CX, et al. Recent updates on novel approaches in insulin drug delivery: a review of challenges and pharmaceutical implications. Curr Drug Targets. 2018;19:1782–800. PubMedCrossRef
92.
go back to reference Rosenstock J, Cefalu WT, Hollander PA, et al. Two-year pulmonary safety and efficacy of inhaled human insulin (exubera) in adult patients with type 2 diabetes. Diabetes Care. 2008;31:1723–8. PubMedPubMedCentralCrossRef Rosenstock J, Cefalu WT, Hollander PA, et al. Two-year pulmonary safety and efficacy of inhaled human insulin (exubera) in adult patients with type 2 diabetes. Diabetes Care. 2008;31:1723–8. PubMedPubMedCentralCrossRef
93.
go back to reference Skyler JS, Jovanovic L, Klioze S, Reis J, Duggan W, Inhaled Human Insulin Type 1 Diabetes Study Group. Two-year safety and efficacy of inhaled human insulin (exubera) in adult patients with type 1 diabetes. Diabetes Care. 2007;30:579–85. PubMedCrossRef Skyler JS, Jovanovic L, Klioze S, Reis J, Duggan W, Inhaled Human Insulin Type 1 Diabetes Study Group. Two-year safety and efficacy of inhaled human insulin (exubera) in adult patients with type 1 diabetes. Diabetes Care. 2007;30:579–85. PubMedCrossRef
94.
go back to reference Barnett AH, Dreyer M, Lange P, Serdarevic-Pehar M. An open, randomized, parallel-group study to compare the efficacy and safety profile of inhaled human insulin (exubera) with metformin as adjunctive therapy in patients with type 2 diabetes poorly controlled on a sulfonylurea. Diabetes Care. 2006;29:1282–7. PubMedCrossRef Barnett AH, Dreyer M, Lange P, Serdarevic-Pehar M. An open, randomized, parallel-group study to compare the efficacy and safety profile of inhaled human insulin (exubera) with metformin as adjunctive therapy in patients with type 2 diabetes poorly controlled on a sulfonylurea. Diabetes Care. 2006;29:1282–7. PubMedCrossRef
95.
go back to reference Quattrin T, Bélanger A, Bohannon NJV, Schwartz SL, Exubera Phase III Study Group. Efficacy and safety of inhaled insulin (exubera) compared with subcutaneous insulin therapy in patients with type 1 diabetes: results of a 6-month, randomized, comparative trial. Diabetes Care. 2004;27:2622–7. PubMedCrossRef Quattrin T, Bélanger A, Bohannon NJV, Schwartz SL, Exubera Phase III Study Group. Efficacy and safety of inhaled insulin (exubera) compared with subcutaneous insulin therapy in patients with type 1 diabetes: results of a 6-month, randomized, comparative trial. Diabetes Care. 2004;27:2622–7. PubMedCrossRef
96.
go back to reference Skyler JS, Weinstock RS, Raskin P, et al. Use of inhaled insulin in a basal/bolus insulin regimen in type 1 diabetic subjects: a 6-month, randomized, comparative trial. Diabetes Care. 2005;28:1630–5. PubMedCrossRef Skyler JS, Weinstock RS, Raskin P, et al. Use of inhaled insulin in a basal/bolus insulin regimen in type 1 diabetic subjects: a 6-month, randomized, comparative trial. Diabetes Care. 2005;28:1630–5. PubMedCrossRef
97.
go back to reference Rosenstock J, Zinman B, Murphy LJ, et al. Inhaled insulin improves glycemic control when substituted for or added to oral combination therapy in type 2 diabetes: a randomized, controlled trial. Ann Intern Med. 2005;143:549–58. PubMedCrossRef Rosenstock J, Zinman B, Murphy LJ, et al. Inhaled insulin improves glycemic control when substituted for or added to oral combination therapy in type 2 diabetes: a randomized, controlled trial. Ann Intern Med. 2005;143:549–58. PubMedCrossRef
98.
go back to reference Hollander PA, Blonde L, Rowe R, et al. Efficacy and safety of inhaled insulin (exubera) compared with subcutaneous insulin therapy in patients with type 2 diabetes: results of a 6-month, randomized, comparative trial. Diabetes Care. 2004;27:2356–62. PubMedCrossRef Hollander PA, Blonde L, Rowe R, et al. Efficacy and safety of inhaled insulin (exubera) compared with subcutaneous insulin therapy in patients with type 2 diabetes: results of a 6-month, randomized, comparative trial. Diabetes Care. 2004;27:2356–62. PubMedCrossRef
99.
go back to reference Raskin P, Heller S, Honka M, et al. Pulmonary function over 2 years in diabetic patients treated with prandial inhaled technosphere insulin or usual antidiabetes treatment: a randomized trial. Diabetes Obes Metab. 2012;14:163–73. PubMedCrossRef Raskin P, Heller S, Honka M, et al. Pulmonary function over 2 years in diabetic patients treated with prandial inhaled technosphere insulin or usual antidiabetes treatment: a randomized trial. Diabetes Obes Metab. 2012;14:163–73. PubMedCrossRef
100.
go back to reference Rosenstock J, Lorber DL, Gnudi L, et al. Prandial inhaled insulin plus basal insulin glargine versus twice daily biaspart insulin for type 2 diabetes: a multicentre randomised trial. Lancet. 2010;375:2244–53. PubMedCrossRef Rosenstock J, Lorber DL, Gnudi L, et al. Prandial inhaled insulin plus basal insulin glargine versus twice daily biaspart insulin for type 2 diabetes: a multicentre randomised trial. Lancet. 2010;375:2244–53. PubMedCrossRef
101.
go back to reference Bode BW, McGill JB, Lorber DL, et al. Inhaled technosphere insulin compared with injected prandial insulin in type 1 diabetes: a randomized 24-week trial. Diabetes Care. 2015;38:2266–73. PubMedCrossRef Bode BW, McGill JB, Lorber DL, et al. Inhaled technosphere insulin compared with injected prandial insulin in type 1 diabetes: a randomized 24-week trial. Diabetes Care. 2015;38:2266–73. PubMedCrossRef
102.
go back to reference Rosenstock J, Franco D, Korpachev V, et al. Inhaled technosphere insulin versus inhaled technosphere placebo in insulin-naïve subjects with type 2 diabetes inadequately controlled on oral antidiabetes agents. Diabetes Care. 2015;38:2274–81. PubMedCrossRef Rosenstock J, Franco D, Korpachev V, et al. Inhaled technosphere insulin versus inhaled technosphere placebo in insulin-naïve subjects with type 2 diabetes inadequately controlled on oral antidiabetes agents. Diabetes Care. 2015;38:2274–81. PubMedCrossRef
103.
go back to reference Hoogwerf BJ, Pantalone KM, Basina M, Jones MC, Grant M, Kendall DM. Results of a 24-week trial of technosphere insulin versus insulin aspart in type 2 diabetes. Endocr Pract. 2021;27:38–43. PubMedCrossRef Hoogwerf BJ, Pantalone KM, Basina M, Jones MC, Grant M, Kendall DM. Results of a 24-week trial of technosphere insulin versus insulin aspart in type 2 diabetes. Endocr Pract. 2021;27:38–43. PubMedCrossRef
104.
go back to reference McGill JB, Weiss D, Grant M, Jones MC, Kendall DM, Hoogwerf BJ. Understanding inhaled technosphere insulin: results of an early randomized trial in type 1 diabetes mellitus. J Diabetes. 2021;13:164–72. PubMedCrossRef McGill JB, Weiss D, Grant M, Jones MC, Kendall DM, Hoogwerf BJ. Understanding inhaled technosphere insulin: results of an early randomized trial in type 1 diabetes mellitus. J Diabetes. 2021;13:164–72. PubMedCrossRef
110.
go back to reference Chakravarty A, Panchagnula MV, Mohan A, Patankar NA. Pulmonary drug delivery and retention: a computational study to identify plausible parameters based on a coupled airway-mucus flow model. PLoS Comput Biol. 2022;18: e1010143. PubMedPubMedCentralCrossRef Chakravarty A, Panchagnula MV, Mohan A, Patankar NA. Pulmonary drug delivery and retention: a computational study to identify plausible parameters based on a coupled airway-mucus flow model. PLoS Comput Biol. 2022;18: e1010143. PubMedPubMedCentralCrossRef
111.
go back to reference Angelo R, Rousseau K, Grant M, Leone-Bay A, Richardson P. Technosphere insulin: defining the role of technosphere particles at the cellular level. J Diabetes Sci Technol. 2009;3:545–54. PubMedPubMedCentralCrossRef Angelo R, Rousseau K, Grant M, Leone-Bay A, Richardson P. Technosphere insulin: defining the role of technosphere particles at the cellular level. J Diabetes Sci Technol. 2009;3:545–54. PubMedPubMedCentralCrossRef
112.
go back to reference White S, Bennett DB, Cheu S, et al. EXUBERA: pharmaceutical development of a novel product for pulmonary delivery of insulin. Diabetes Technol Ther. 2005;7:896–906. PubMedCrossRef White S, Bennett DB, Cheu S, et al. EXUBERA: pharmaceutical development of a novel product for pulmonary delivery of insulin. Diabetes Technol Ther. 2005;7:896–906. PubMedCrossRef
114.
115.
go back to reference Klonoff DC. Afrezza inhaled insulin: the fastest-acting FDA-approved insulin on the market has favorable properties. J Diabetes Sci Technol. 2014;8:1071–3. PubMedPubMedCentralCrossRef Klonoff DC. Afrezza inhaled insulin: the fastest-acting FDA-approved insulin on the market has favorable properties. J Diabetes Sci Technol. 2014;8:1071–3. PubMedPubMedCentralCrossRef
116.
go back to reference Bellary S, Barnett AH. Review: inhaled insulin: overcoming barriers to insulin therapy? Br J Diabetes Vasc Dis. 2006;6:103–8. CrossRef Bellary S, Barnett AH. Review: inhaled insulin: overcoming barriers to insulin therapy? Br J Diabetes Vasc Dis. 2006;6:103–8. CrossRef
117.
go back to reference Guntur VP, Dhand R. Inhaled insulin: extending the horizons of inhalation therapy. Respir Care. 2007;52:911–22. PubMed Guntur VP, Dhand R. Inhaled insulin: extending the horizons of inhalation therapy. Respir Care. 2007;52:911–22. PubMed
118.
go back to reference Gerber RA, Cappelleri JC, Kourides IA, Gelfand RA. Treatment satisfaction with inhaled insulin in patients with type 1 diabetes: a randomized controlled trial. Diabetes Care. 2001;24:1556–9. PubMedCrossRef Gerber RA, Cappelleri JC, Kourides IA, Gelfand RA. Treatment satisfaction with inhaled insulin in patients with type 1 diabetes: a randomized controlled trial. Diabetes Care. 2001;24:1556–9. PubMedCrossRef
119.
go back to reference Skyler JS, Cefalu WT, Kourides IA, et al. Efficacy of inhaled human insulin in type 1 diabetes mellitus: a randomised proof-of-concept study. Lancet. 2001;357:331–5. PubMedCrossRef Skyler JS, Cefalu WT, Kourides IA, et al. Efficacy of inhaled human insulin in type 1 diabetes mellitus: a randomised proof-of-concept study. Lancet. 2001;357:331–5. PubMedCrossRef
120.
go back to reference Cappelleri JC, Cefalu WT, Rosenstock J, Kourides IA, Gerber RA. Treatment satisfaction in type 2 diabetes: a comparison between an inhaled insulin regimen and a subcutaneous insulin regimen. Clin Ther. 2002;24:552–64. PubMedCrossRef Cappelleri JC, Cefalu WT, Rosenstock J, Kourides IA, Gerber RA. Treatment satisfaction in type 2 diabetes: a comparison between an inhaled insulin regimen and a subcutaneous insulin regimen. Clin Ther. 2002;24:552–64. PubMedCrossRef
121.
go back to reference Hayes RP, Muchmore D, Schmitke J. Efffect of inhaled insulin on patient-reported outcomes and treatment preference in patients with type 1 diabetes. Curr Med Res Opin. 2007;23:435–42. PubMedCrossRef Hayes RP, Muchmore D, Schmitke J. Efffect of inhaled insulin on patient-reported outcomes and treatment preference in patients with type 1 diabetes. Curr Med Res Opin. 2007;23:435–42. PubMedCrossRef
122.
go back to reference Rosenstock J, Cappelleri JC, Bolinder B, Gerber RA. Patient satisfaction and glycemic control after 1 year with inhaled insulin (exubera) in patients with type 1 or type 2 diabetes. Diabetes Care. 2004;27:1318–23. PubMedCrossRef Rosenstock J, Cappelleri JC, Bolinder B, Gerber RA. Patient satisfaction and glycemic control after 1 year with inhaled insulin (exubera) in patients with type 1 or type 2 diabetes. Diabetes Care. 2004;27:1318–23. PubMedCrossRef
123.
go back to reference Testa MA, Simonson DC. Satisfaction and quality of life with premeal inhaled versus injected insulin in adolescents and adults with type 1 diabetes. Diabetes Care. 2007;30:1399–405. PubMedCrossRef Testa MA, Simonson DC. Satisfaction and quality of life with premeal inhaled versus injected insulin in adolescents and adults with type 1 diabetes. Diabetes Care. 2007;30:1399–405. PubMedCrossRef
125.
go back to reference Gedawy A, Martinez J, Al-Salami H, Dass CR. Oral insulin delivery: existing barriers and current counter-strategies. J Pharm Pharmacol. 2018;70:197–213. PubMedCrossRef Gedawy A, Martinez J, Al-Salami H, Dass CR. Oral insulin delivery: existing barriers and current counter-strategies. J Pharm Pharmacol. 2018;70:197–213. PubMedCrossRef
Metadata
Title
Insulin Therapy for the Management of Diabetes Mellitus: A Narrative Review of Innovative Treatment Strategies
Authors
Ken M. Nkonge
Dennis K. Nkonge
Teresa N. Nkonge
Publication date
22-09-2023
Publisher
Springer Healthcare
Published in
Diabetes Therapy / Issue 11/2023
Print ISSN: 1869-6953
Electronic ISSN: 1869-6961
DOI
https://doi.org/10.1007/s13300-023-01468-4

Other articles of this Issue 11/2023

Diabetes Therapy 11/2023 Go to the issue