Login Register Cart 0
Generic placeholder image

Current Diabetes Reviews

Editor-in-Chief

ISSN (Print): 1573-3998
ISSN (Online): 1875-6417

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Review Article

Centenary of Insulin Therapy: A Review

Author(s): Abrar Ahmad Zargar, Ranjeet Kumar*, Arvind Kumar, Ruby Gangwar and Amit Sharma

Volume 20, Issue 1, 2024

Published on: 14 April, 2023

Article ID: e200323214785 Pages: 13

DOI: 10.2174/1573399819666230320162745

Price: $65

conference banner
Abstract

Insulin is an endocrine hormone produced by the beta cells of islets of Langerhans in the pancreas. It regulates blood sugar levels and various anabolic activities such as glycogenesis and lipid synthesis. Despite the fact that insulin therapy has been around for 100 years, insulin formulations are continually being improved to lower the risk of hypoglycaemia and other adverse effects, including weight gain. The development of insulin pens has significantly reduced the consequences of hypoglycaemia instead of vials and syringes. Both injectable devices were well-received by the patients. In the population under study, the efficacy and safety profiles of the pen appeared to be comparable to those of the vial/syringe. However, more patients reported that they would like to keep using pen devices. This article aimed to summarize the background of insulin, its mechanism, types, needle size, injection technique, adverse drug reactions and various studies related to insulin. It has been recommended intensive treatment of type-1 and type-2 diabetes patients to achieve good metabolic control and avoid chronic complications caused by poor glycaemic control. Healthcare professionals should address concerns about safe and effective implementation of inpatient hypoglycaemic control and insulin usage and they should empower patients to self-manage their diabetes, so they may improve their quality of life as well as avoid potential complications. Much more progress is expected in the future, at a faster pace, based on the implementation of well-organized recovery efforts, advancing technologies, and scientific collaboration.

Keywords: Centenary, insulin therapy, hypoglycaemia, pen devices, biosynthesis, pharmacokinetics.

[1]
Trehan A, Ali A. Recent approaches in insulin delivery. Drug Dev Ind Pharm 1998; 24(7): 589-97.
[http://dx.doi.org/10.3109/03639049809082359] [PMID: 9876502]
[2]
Wikipedia Insulin.. Available from: https://en.wikipedia.org/wiki/Insulin
[3]
Rostène W, De Meyts P. Insulin: A 100-year-old discovery with a fascinating history. Endocr Rev 2021; 42(5): 503-27.
[http://dx.doi.org/10.1210/endrev/bnab020] [PMID: 34273145]
[4]
Joshi SR, Parikh RM, Das AK. Insulin-history, biochemistry, physiology and pharmacology. JAPI 2007; Jul 1;55(L): 19.
[5]
Vecchio I, Tornali C, Bragazzi NL, Martini M. The discovery of insulin: An important milestone in the history of medicine. Front Endocrinol (Lausanne) 2018; 9: 613.
[http://dx.doi.org/10.3389/fendo.2018.00613] [PMID: 30405529]
[6]
Steiner DF. The biosynthesis of insulin.Pancreatic Beta Cell in Health and Disease. Tokyo: Springer 2008; pp. 31-49.
[http://dx.doi.org/10.1007/978-4-431-75452-7_3]
[7]
Kahn CR. The molecular mechanism of insulin action. Annu Rev Med 1985; 36(1): 429-51.
[http://dx.doi.org/10.1146/annurev.me.36.020185.002241] [PMID: 2986528]
[8]
Scheen André J. Pathophysiology of insulin secretion. Ann Endocrino l65(1): 29-36.2004;
[http://dx.doi.org/10.1016/S0003-4266(04)95627-2]
[9]
Insulin price of 102 brands/Trade names. Medindia. 2004. Available from: https://www.medindia.net/drug-price/insulin.htm Assessed on July 22, 2022
[10]
Donner T, Sarkar S. Insulin – pharmacology, therapeutic regimens, and principles of intensive insulin therapy. EndotextMDTextcom, Inc. South Dartmouth (MA) 2000.
[PMID: 25905175]
[11]
Binder C, Lauritzen T, Faber O, Pramming S. Insulin pharmacokinetics. Diabetes Care 1984; 7(2): 188-99.
[http://dx.doi.org/10.2337/diacare.7.2.188] [PMID: 6376015]
[12]
Turnheim K, Waldhäusl WK. Essentials of insulin pharmacokinetics. Wien Klin Wochenschr 1988; 100(3): 65-72.
[PMID: 3281377]
[13]
Duckworth WC, Hamel FG, Peavy DE. Hepatic metabolism of insulin. Am J Med 1988; 85(5): 71-6.
[http://dx.doi.org/10.1016/0002-9343(88)90399-3] [PMID: 3057896]
[14]
Slabaugh SL, Bouchard JR, Li Y, Baltz JC, Meah YA, Moretz DC. Characteristics relating to adherence and persistence to basal insulin regimens among elderly insulin-naïve patients with type 2 diabetes: Pre-filled pens versus vials/syringes. Adv Ther 2015; 32(12): 1206-21.
[http://dx.doi.org/10.1007/s12325-015-0266-5] [PMID: 26563324]
[15]
Home J, Bond K, Sarangarm P. Comparison of inpatient glycaemic control with insulin vials versus insulin pens in general medicine patients. Hosp Pharm 2015; 50(6): 514-21.
[http://dx.doi.org/10.1310/hpj5006-514] [PMID: 26405343]
[16]
Asakura T, Seino H, Nakano R, et al. A comparison of the handling and accuracy of syringe and vial versus prefilled insulin pen (FlexPen). Diabetes Technol Ther 2009; 11(10): 657-61.
[http://dx.doi.org/10.1089/dia.2009.0006] [PMID: 19821758]
[17]
Ahmann A, Szeinbach SL, Gill J, Traylor L, Garg SK. Comparing patient preferences and healthcare provider recommendations with the pen versus vial-and-syringe insulin delivery in patients with type 2 diabetes. Diabetes Technol Ther 2014; 16(2): 76-83.
[http://dx.doi.org/10.1089/dia.2013.0172] [PMID: 24266497]
[18]
Korytkowski M, Bell D, Jacobsen C, Suwannasari R. A multicenter, randomized, open-label, comparative, two-period crossover trial of preference, efficacy, and safety profiles of a prefilled, disposable pen and conventional vial/syringe for insulin injection in patients with type 1 or 2 diabetes mellitus. Clin Ther 2003; 25(11): 2836-48.
[http://dx.doi.org/10.1016/S0149-2918(03)80337-5] [PMID: 14693308]
[19]
Lee WC, Balu S, Cobden D, Joshi AV, Pashos CL. Medication adherence and the associated health-economic impact among patients with type 2 diabetes mellitus converting to insulin pen therapy: An analysis of third-party managed care claims data. Clin Ther 2006; 28(10): 1712-25.
[http://dx.doi.org/10.1016/j.clinthera.2006.10.004] [PMID: 17157128]
[20]
Davis EM, Christensen CM, Nystrom KK, Foral PA, Destache C. Patient satisfaction and costs associated with insulin administered by pen device or syringe during hospitalization. Am J Health Syst Pharm 2008; 65(14): 1347-57.
[http://dx.doi.org/10.2146/ajhp070636] [PMID: 18593681]
[21]
Baruah MP, Kalra S, Bose S, Deka J. An audit of insulin usage and insulin injection practices in a large indian cohort. Indian J Endocrinol Metab 2017; 21(3): 443-52.
[http://dx.doi.org/10.4103/ijem.IJEM_548_16.] [PMID: 28553603] [PMCID: PMC5434731]
[22]
Lasalvia P, Barahona-Correa JE, Romero-Alvernia DM, et al. Pen devices for insulin self-administration compared with needle and vial: Systematic review of the literature and meta-analysis. J Diabetes Sci Technol 2016; 10(4): 959-66.
[http://dx.doi.org/10.1177/1932296816633721] [PMID: 26920639]
[23]
Xie L, Zhou S, Wei W, Gill J, Pan C, Baser O. Does pen help? A real-world outcomes study of switching from vial to disposable pen among insulin glargine-treated patients with type 2 diabetes mellitus. Diabetes Technol Ther 2013; 15(3): 230-6.
[http://dx.doi.org/10.1089/dia.2012.0253] [PMID: 23336845]
[24]
Berlanda G, Telo GH, Krug BC, et al. Hypoglycemia frequency and treatment satisfaction in patients receiving insulin analogues for treatment of type 1 diabetes mellitus. Arch Endocrinol Metab 2021; 65(2): 164-71.
[http://dx.doi.org/10.20945/2359-3997000000332] [PMID: 33905628]
[25]
Grabner M, Chu J, Raparla S, Quimbo R, Zhou S, Conoshenti J. Clinical and economic outcomes among patients with diabetes mellitus initiating insulin glargine pen versus vial. Postgrad Med 2013; 125(3): 204-13.
[http://dx.doi.org/10.3810/pgm.2013.05.2656] [PMID: 23748521]
[26]
Pfützner A, Bailey T, Campos C, et al. Accuracy and preference assessment of prefilled insulin pen versus vial and syringe with diabetes patients, caregivers, and healthcare professionals. Curr Med Res Opin 2013; 29(5): 475-81.
[http://dx.doi.org/10.1185/03007995.2013.775112] [PMID: 23402225]
[27]
Aazami S, Mozafari M, Abdollah HP. Insulin-related outcomes (satisfaction, pain, and adherence) among type II diabetes patients switched from syringe to insulin pen. Bali Med J 2018; 7(3): 678-81.
[28]
Campos C, Lajara R, Deluzio T. Usability and preference assessment of a new prefilled insulin pen versus vial and syringe in people with diabetes, physicians and nurses. Expert Opin Pharmacother 2012; 13(13): 1837-46.
[http://dx.doi.org/10.1517/14656566.2012.713350] [PMID: 22873943]
[29]
Asakura T, Jensen KH. Comparison of intuitiveness, ease of use, and preference in two insulin pens. J Diabetes Sci Technol 2009; 3(2): 312-9.
[http://dx.doi.org/10.1177/193229680900300212] [PMID: 20144362]
[30]
Shogbon AO, Ngo D, Jacob B, Kimble LP, Ryan G. Nurses’ perceptions and satisfaction with the use of insulin pen devices compared with insulin vial and syringes in an inpatient setting. Diabetes Technol Ther 2014; 16(11): 742-6.
[http://dx.doi.org/10.1089/dia.2014.0072] [PMID: 25198537]
[31]
Gorska-Ciebiada M, Masierek M, Ciebiada M. Improved insulin injection technique, treatment satisfaction and glycemic control: Results from a large cohort education study. J Clin Transl Endocrinol 2020; 19: 100217.
[http://dx.doi.org/10.1016/j.jcte.2020.100217] [PMID: 32071879]
[32]
Diabetes Education Online. Available from: https://dtc.ucsf.edu/types-of-diabetes/type2/treatment-of-type-2-diabetes/medications-and-therapies/type-2-insulin-rx/calculating-insulin-dose/Assessed on July 23, 2022.
[33]
Diabetes Self-Management.. Available from: https://www.diabetesselfmanagement.com/managing-diabetes/treatment-approaches/ready-aim-inject/Assessed on July 25, 2022.
[34]
Corsino L, Dhatariya K, Umpierrez G. Management of diabetes and hyperglycemia in hospitalized patients. Endotext 2000.

Rights & Permissions Print Cite
Article Metrics
40
2
Wayfinder Image
© 2024 Bentham Science Publishers | Privacy Policy