By Prof (Dr) L Sreenivasa Murthy
According to International Diabetes Federation (IDF), it has been estimated that there are now approximately 425 million adults (1 in 11) living with diabetes worldwide, 90% of whom have type 2 diabetes mellitus.
Diabetes is a global public health concern and multiple stakeholders have been working tirelessly to find suitable innovations to improve outcomes and quality of life of people with diabetes. Insulin which was discovered 100 years ago has played a critical role in diabetes care.
With constant research and innovation, various new forms of insulin have been introduced and it has become the most effective way of managing diabetes.
The types of insulin depend upon factors such as – how long the effect lasts, how quickly they work, how they are taken and how effective they are in reducing blood sugar level.
In the past 100 years, insulin has undergone a series of innovative changes that has helped people with diabetes get closer to the goal of optimal glycemic control along with decreased diabetes-related complications. Each generation of insulin introduced new flexibilities and increased the adherence leading to improved quality of life.
Advantages of Modern Insulin / New Generation Insulins
According to the landmark trials in diabetes, every 1% reduction in HbA1c leads to significant reduction in microvascular complications that affect kidneys, eyes and nerves as well as macrovascular complications such as heart attack, stroke and peripheral vascular diseases and also death. Modern insulin/new generation insulins (MI/NGI) solves most of the complications of diabetes. Insulin is the drug that has the maximum glycemic efficacy among all anti-diabetic medications. If used appropriately, insulin helps in keeping blood glucose level within a healthy range and help people with diabetes to achieve their blood glucose targets.
MI/NGI can help manage diabetes better as it provides effective glycemic control, reduces risk of hypoglycemia, more flexibility in dose timings and hence convenience and improves quality of life. MI/NGI has also some additional benefits such as reduced number of injections, with better safety profile.
Modern insulins have a predictable action profile with more flexibility when planning insulin doses. Additionally, they offer the benefit of less weight gain compared to conventional human insulins. Newer Generation insulins in case of ultra-long acting basal insulins have the ability to reduce the risk of hypoglycemia as they release the medication very slowly and require only fewer injections.
Modern insulin and new generation insulin should be given based on the need of the patient. If the fasting plasma glucose is on the higher side, basal insulin should be chosen. The frequency of insulin depends on the duration of action of insulin, typically once or twice daily. If the postprandial glucose is on the higher side, then a rapid acting insulin can be given, the frequency depends on the number of meals to be covered. If both the fasting and postprandial glucose is elevated, then the individual may need either a premix insulin or a basal bolus insulin.
Future with early adoption of Insulin Therapy
We are fortunate today, to be living with better medication, healthcare system than ever. However, still the incidence of diabetes continues to grow at an alarming rate.
Decades of research and innovation has helped improve outcomes for people with diabetes on insulin. Therefore, it is important that people with diabetes, start adopting insulin at an early stage. Insulin therapy is the most effective way to lower blood sugar levels and manage diabetes more effectively.
The greatest challenges faced by Treating Physicians (in spite of availability of modern Insulins) is the Inertia exhibited by treating doctors to initiate Insulins at the right time to needy patients and to overcome the resistance exhibited by patients for Insulin initiation with proper counselling.
(The author is Senior Consultant Physician and Diabetologist, Life Care Hospital and Research Centre, Bangalore. The article is for informational purposes only. Please consult health experts and medical professionals before starting any therapy or medication. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)