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Type 1 diabetes, insulin types
Thursday, 26 August 2010 21:18 | 
| Healthcare Blogs - Healthcare Reflections Blogs |
Type 1 diabetes is still treated with insulin injections. Insulin is supplied in a variety of long, intermediate and short-acting preparations. The duration of action of insulin preparations required to give optimal control varies from patient to patient. This means that individual patients are established on particular regimens which are not changed unless they are not working.
In the early days of insulin treatment, animal insulin was used—bovine and porcine, of which porcine became the favorite as the molecule differed from human insulin by only a single amino acid. Bovine insulin was phased out as the purification and supply of porcine insulin was scaled up. This helps to explain why the Danish company Novo Nordisk became the leading insulin manufacturer in Europe, given the strength of the Danish pig industry.
Ultimately, it became possible to make "humanized" insulin from pig insulin by replacing the pig-specific amino acid with the human-specific amino acid. Human insulin is now manufactured from cloned human insulin genes. Genentech and Eli Lilly devised a means of achieving this for the U.S. market and Novo Nordisk followed suit in Europe. The bulk of the market is now converted to human insulin.
The second major innovation in insulin has been the development of ultra fast-acting insulin derivatives. The introduction of recombinant production methods of human insulins made it possible to alter the insulin molecule in order to tailor the pharmacokinetics. Thus, insulin analogues such as insulin lispro (Humalog, Eli Lilly) and insulin aspart (NovoRapid, Novo Nordisk) are absorbed very rapidly and the variability of their effect is minimized.
There is a great variety of insulin formulations on the market; as summarized in the following tables.
Rapid acting (onset less than 15 minutes)
| Type | Company | Source |
|---|---|---|
| Humalog, Insulin lispro | Eli Lilly | Analogue |
| Humalog Cartridges | Eli Lilly and Company | Analogue |
| NovoLog, Insulin aspart | Novo Nordisk | Analogue |
| ApidraTM, insulin glulisine | Aventis Pharmaceuticals | Analogue |
Short acting (onset 1⁄2-2 hours)
| Type | Company | Source |
|---|---|---|
| Humulin R (Regular) | Eli Lilly and Company | Human |
| Iletin II RegularTM | Eli Lilly and Company | Porcine |
| Humulin R Cartridges (1.5 ml) | Eli Lilly and Company | Human |
| Novolin R (Regular) | Novo Nordisk | Human |
| Velosulin Human (Regular) (Buffered) | Novo Nordisk | Human |
Intermediate acting (onset 2-4 hours)
| Type | Company | Source |
|---|---|---|
| Humulin L (Lente) | Eli Lilly and Company | Human |
| Humulin N (NPH) | Eli Lilly and Company | Human |
| Iletin II Lente | Eli Lilly and Company | Porcine |
| Iletin II NPHTM | Eli Lilly and Company | Porcine |
| Humulin N Cartridges (1.5 ml) | Eli Lilly and Company | Human |
| Novolin N (NPH) | Novo Nordisk | Human |
Long acting (onset 4-6 hours)
| Type | Company | Source |
|---|---|---|
| Humulin U (Ultralente) | Eli Lilly and Company | Human |
Very long acting (24+ hours)
| Type | Company | Source |
|---|---|---|
| Lantus (formerly HOE901), Insulin glargine | Aventis Pharmaceuticals | Analog |
| Levemir (formerly NN304), insulin detemir | Novo Nordisk | Analog |
Mixtures
| Type | Company | Source |
|---|---|---|
| Humalog, Insulin lispro | Eli Lilly | Analogue |
| Humalog Cartridges | Eli Lilly and Company | Analogue |
| NovoLog, Insulin aspart | Novo Nordisk | Analogue |
| ApidraTM, insulin glulisine | Aventis Pharmaceuticals | Analogue |
Source: MedMarket DIligence, LLC; Report #D510, "Diabetes Management Worldwide, 2009-2018".
Read More: http://feedproxy.google.com/~r/AdvancedMedicalTechnologies/~3/N53LVxT-gMc/
