Insulin therapy aims to get as close as possible to the natural insulin response (of someone without diabetes) to help maintain target blood glucose levels1.
The closer that insulin therapy can get to the response of someone without diabetes, the better it is able to balance blood glucose levels. Maintaining target blood glucose levels is the best way to avoid damage to health later in life.
Since the discovery in the 1920s that animal-derived insulin could improve blood glucose control in diabetes, insulin treatment has evolved significantly. Each advancement has got closer to a natural insulin response and overcome some of the inconveniences and limitations of previous treatments1,2.
The latest generation of insulins get even closer to the insulin response of someone without diabetes and offer a number of benefits as a result3-5.
Speak to your doctor or nurse to discuss your diabetes treatment, treatment delivery, or if you have questions about diabetes treatment developments.
Meet Nic, who has type 1 diabetes. Hear why it matters that his insulin therapy gets him as close as possible to a life without diabetes.
Mealtime (bolus) insulin therapy aims to bring down spikes in blood glucose that can occur after eating. The closer that mealtime insulin therapy can get to the insulin response in someone without diabetes, the quicker it may be able to bring down these spikes.
Earlier generations of rapid-acting insulins (regular human insulin) are much slower than the natural insulin response, which can lead to large spikes in blood glucose after eating2. Due to their slow action, human insulins may need to be injected far in advance of a meal4,6 and can also create restrictions on food choices and portions.
While rapid-acting insulin analogues act quicker to bring down post-meal spikes and so shorten dosing time before a meal, they still do not match the speed of the natural insulin response. As a result, people with diabetes may still experience large, prolonged spikes in blood glucose, after eating1,3,4.
The latest generation of ultra-fast acting mealtime insulins aim to close the gap between the speed of insulin therapies and the natural insulin response. As a result, they may improve control of mealtime blood glucose1,4, and offer greater flexibility and convenience with insulin dosing, mealtimes and food choices. These benefits may reduce some of the guesswork in pre-meal dosing and provide greater control for people with diabetes.
Basal insulin therapy aims to match the constant, steady release of insulin between meals and overnight, in someone without diabetes. It is important that basal insulin gets close to a natural insulin response, as too much or too little insulin can cause hypoglycaemia (low blood glucose) or hyperglycaemia (high blood glucose), respectively2,7.
Long-acting human insulins (Neutral Protamine Hagedorn or NPH) have an early peak effect and shorter duration unlike the natural insulin response, which can lead to hypoglycaemia1,7.
While long-acting insulin analogues overcome some of these limitations, there is still a difference between their action and the natural insulin response. This can create a need for additional dosing along with other challenges1,5,7.
The latest generation of long-acting insulins, have been developed to get even closer to a natural insulin response, and so may offer better blood glucose control, greater flexibility in dosing and other benefits1,5.
Another innovation in insulin therapy was the development of premixed insulins. Premixed insulins combine two insulins in a single injection8, and aim to replicate the insulin production in the body of someone without diabetes when fasting (between meals and overnight), and after a meal.
However, due to the speed and duration of the insulins in older premixed insulin formulations not being as quick as the natural insulin response, there may still be a need for more than one injection throughout the course of a day8.
Since Novo Nordisk was founded 95 years ago, we have been changing diabetes. Our key contribution is to discover, develop and deliver better treatments, manufacture them to meet increasing global demand and make them accessible wherever they are needed.
Understanding what it is like to live with a serious chronic disease plays a key role in the development of new treatments. We are committed to innovation and getting ever closer to the natural insulin response in diabetes therapy to ensure people with diabetes can live a life with as few limitations as possible. Every change in the right direction counts.
Come back soon to hear from Stephen Gough, Chief Medical Officer at Novo Nordisk. Stephen explains our commitment to innovation and our ambition to develop insulin therapies that are a closer match to the natural insulin response, to improve the lives of people with diabetes.