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

  • Pharmacologic Treatment of Type 2 Diabetes (HE Lebovitz and G Bahtiyar, Section Editors)
  • Published:
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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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Authors and Affiliations

  1. Emory University School of Medicine, Atlanta, GA, USA

    Patrick F. Frias

  2. National Research Institute, 2010 Wilshire Boulevard, Suite 302, Los Angeles, CA, 90057, USA

    Juan Pablo Frias

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Correspondence to Juan Pablo Frias.

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Patrick F. Frias declares no conflict of interest.

Juan Pablo Frias reports grants and personal fees from Sanofi, grants and personal fees from Novo Nordisk, and grants from Eli Lilly, Merck, and Mylan.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable standards (including the Helsinki declaration and its amendments, instructional/national research committee standards, and international/national/institutional guidelines).

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This article is part of the Topical Collection on Pharmacologic Treatment of Type 2 Diabetes

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Frias, P.F., Frias, J.P. New Basal Insulins: a Clinical Perspective of Their Use in the Treatment of Type 2 Diabetes and Novel Treatment Options Beyond Basal Insulin. Curr Diab Rep 17, 91 (2017). https://doi.org/10.1007/s11892-017-0926-8

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