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Published in: Current Diabetes Reports 10/2017

01-10-2017 | Pharmacologic Treatment of Type 2 Diabetes (HE Lebovitz and G Bahtiyar, Section Editors)

New Basal Insulins: a Clinical Perspective of Their Use in the Treatment of Type 2 Diabetes and Novel Treatment Options Beyond Basal Insulin

Authors: Patrick F. Frias, Juan Pablo Frias

Published in: Current Diabetes Reports | Issue 10/2017

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Abstract

Purpose of Review

The purpose of this review was to review advances in basal insulin formulations and new treatment options for patients with type 2 diabetes not achieving glycemic targets despite optimized basal insulin therapy.

Recent Findings

Advances in basal insulin formulations have resulted in products with increasingly favorable pharmacokinetic and pharmacodynamic properties, including flatter, peakless action profiles, less inter- and intra-patient variability, and longer duration of activity. These properties have translated to significantly reduced risk of hypoglycemia (particularly during the night) compared with previous generation basal insulins. When optimized basal insulin therapy is not sufficient to obtain or maintain glycemic goals, various options exist to improve glycemic control, including intensification of insulin therapy with the addition of prandial insulin or changing to pre-mixed insulin and, more recently, the addition of a GLP-1 receptor agonist, either as a separate injection or as a component of one of the new fixed-ratio combinations of a basal insulin and GLP-1 RA.

Summary

New safer and often more convenient basal insulins and fixed ratio combinations containing basal insulin (and GLP-1 receptor agonist) are available today for patients with type 2 diabetes not achieving glycemic goals. Head-to-head studies comparing the latest generation basal insulins are underway, and future studies assessing the fixed-ratio combinations will be important to better understand their differentiating features.
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Metadata
Title
New Basal Insulins: a Clinical Perspective of Their Use in the Treatment of Type 2 Diabetes and Novel Treatment Options Beyond Basal Insulin
Authors
Patrick F. Frias
Juan Pablo Frias
Publication date
01-10-2017
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 10/2017
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-017-0926-8

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Management of Type 1 Diabetes in the Hospital Setting

Pathogenesis of Type 1 Diabetes (A Pugliese, Section Editor)

Tolerogenic Nanoparticles to Treat Islet Autoimmunity

Microvascular Complications—Retinopathy (JK Sun and PS Silva, Section Editors)

Diabetic Eye Screening: Knowledge and Perspectives from Providers and Patients

Microvascular Complications—Retinopathy (JK Sun and PS Silva, Section Editors)

Diameter Changes of Retinal Vessels in Diabetic Retinopathy

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