The Food and Drug Administration (FDA) has approved insulin glulisine (rDNA origin) injection (Apidra, sanofi-aventis) for the control of hyperglycemia in adults with type-1 and type-2 diabetes. This insulin analogue can be taken within 15 minutes before or within 20 minutes after starting a meal. It should be used in regimens that include a longer-acting insulin or a basal insulin analogue such as insulin glargine (Lantus, Aventis).
Insulin glulisine has a more rapid onset of action and a more flexible dosing schedule than regular human insulin.
Because of this agent’s short duration of action, patients will also need a longer-acting insulin or insulin infusion pump therapy to maintain adequate glucose control.
Novo Nordisk Inc. has launched insulin detemir (Levemir, rDNA origin), a long-acting basal insulin analogue in the U.S. It is indicated once or twice daily for adults and children with type-1 diabetes and for adults with type-2 diabetes.
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The drug offers up to 24 hours of blood glucose control. In a clinical trial, 70% of treated patients achieved targeted glycosylated hemoglobin levels below 7%. This is the first basal insulin analogue to have a treat-to-target study in its label.
This product is associated with a low rate of hypoglycemia and weight gain.
Levemir is available in vials and in a prefilled disposable pen.