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Current Diabetes Reports
Published in: Current Diabetes Reports 6/2024

03-04-2024 | Insulins | REVIEW

Prandial Insulins: A Person-Centered Choice

Authors: Bhawna Attri, Lakshmi Nagendra, Deep Dutta, Sahana Shetty, Shehla Shaikh, Sanjay Kalra, Saptarshi Bhattacharya

Published in: Current Diabetes Reports | Issue 6/2024

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Abstract

Purpose of Review

Postprandial hyperglycemia, or elevated blood glucose after meals, is associated with the development and progression of various diabetes-related complications. Prandial insulins are designed to replicate the natural insulin release after meals and are highly effective in managing post-meal glucose spikes. Currently, different types of prandial insulins are available such as human regular insulin, rapid-acting analogs, ultra-rapid-acting analogs, and inhaled insulins. Knowledge about diverse landscape of prandial insulin will optimize glycemic management.

Recent Findings

Human regular insulin, identical to insulin produced by the human pancreas, has a slower onset and extended duration, potentially leading to post-meal hyperglycemia and later hypoglycemia. In contrast, rapid-acting analogs, such as lispro, aspart, and glulisine, are new insulin types with amino acid modifications that enhance their subcutaneous absorption, resulting in a faster onset and shorter action duration. Ultra-rapid analogs, like faster aspart and ultra-rapid lispro, offer even shorter onset of action, providing better meal-time flexibility. The Technosphere insulin offers an inhaled route for prandial insulin delivery. The prandial insulins can be incorporated into basal-bolus, basal plus, or prandial-only regimens or delivered through insulin pumps. Human regular insulin, aspart, lispro, and faster aspart are recommended for management of hyperglycemia during pregnancy. Ongoing research is focused on refining prandial insulin replacement and exploring newer delivery methods.

Summary

The article provides a comprehensive overview of various prandial insulin options and their clinical applications in the management of diabetes.
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Metadata
Title
Prandial Insulins: A Person-Centered Choice
Authors
Bhawna Attri
Lakshmi Nagendra
Deep Dutta
Sahana Shetty
Shehla Shaikh
Sanjay Kalra
Saptarshi Bhattacharya
Publication date
03-04-2024
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 6/2024
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-024-01540-8
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