Pediatric diabetes: Potential for insulin degludec

Kalra, Sanjay; Unnikrishnan, Ambika Gopalakrishnan; Sahay, Rakesh

doi:10.4103/2230-8210.145036

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…It can be given either in the morning or the evening and may not need a daily dose because of its long halflife in the circulation but would still require prandial insulins for meal and snack coverage. It is not yet approved for use in those under 18 years of age, but clinical studies are in progress to address safety and efficacy issues [85,86]. Postprandial as well as nocturnal hypoglycemia is the same or less than other products in testing to date [87].…”

Section: Ultra-slow-acting Insulinsmentioning

confidence: 99%

Insulin Past, Present, and Future: 100 Years from Leonard Thompson

Brink

2022

Diabetology

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Before the discovery of insulin and the critical role of the pancreas vis-à-vis diabetes mellitus pathophysiology, childhood diabetes or what we now call type 1 or autoimmune diabetes mellitus was almost universally fatal. In limited-resource countries (LRC) around the world, this remains sadly true because of the expense and unavailability of medical care, medical information, and/or medications. In 1889, Minkowski and Mering identified the pancreas as the likely source of the problem in pancreatectomized dog experiments, and Langerhans, working with Virchow, identified the islands of pancreatic tissue now named after Langerhans as the likely source of the problem. Prior to that, Cawley, Boucherdat, Zuelzer, Gley, de Meyer, Schafer, Scott, Kleiner, and Paulescu all worked on this problem with varying results until Banting, Best, MacLeod, and Collip in Toronto in 1921 successfully treated pancreatectomized dogs with an alcohol-based pancreatic extract and then were the first to do the same with children and adults with diabetes, starting with Leonard Thompson in early 1922. Urinary and blood glucose levels were reduced, and clinical symptoms decreased concurrently. The magnificent medical historical work by Professor Michael Bliss, also from Toronto, as well as an excellent US NPR Television documentary, describes the trials and tribulations of this event that culminated in the “fastest Nobel Prize” awarded. Progressive biopharmaceutical advances have modified insulin from pigs and cows and then genetically engineered insulin to work much faster and also much slower to provide more modernized ways of providing insulin. Insulin pens then replaced vial and syringe administration, and then insulin pumps coupled with continuous blood glucose sensors have made delivery more physiologic in addition to more attention paid to nutrition advice, education, and psychosocial support around the world. Programs to assist delivery of expensive insulin to LRC administered by Insulin for Life, Life for a Child (LFAC), Changing Diabetes in Children (CDIC) coupled with support by ISPAD (International Society for Pediatric and Adolescent Diabetes) have continued to make such advances available thorough wonderful philanthropy in insulin manufacturers and manufacturers of blood glucose monitoring equipment and insulin pump/sensor suppliers.

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Section: Ultra-slow-acting Insulinsmentioning

confidence: 99%

Insulin Past, Present, and Future: 100 Years from Leonard Thompson

Brink

2022

Diabetology

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“…The physician explained to them that there was nothing wrong in administering it and is not contra-indicated in T1DM. [ 2 ] The parents were also explained that insulin degludec may even help the child to convert from four injections to one injection a day, and from very frequent monitoring to once in a day. After reviewing the literature about insulin degludec, the parents were finally convinced about it.…”

Section: Introductionmentioning

confidence: 99%

Type 1 diabetes mellitus-common cases

Kumar

2015

Indian J Endocr Metab

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Tight glycemic control in type 1 diabetes mellitus patients is associated with the risk of hypoglycemia. Diabetic patients are forced to change their lifestyle to adjust to the disease condition and survive it. The best way to manage diabetes would be to develop a therapy, which could adjust to the patient's conditions. Here, I present few cases wherein switching to a long-acting basal insulin analog helped combat recurrent hypoglycemic episodes experienced by the patients.

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“…Therapy change always needs to take into consideration both the clinical situation and the patient's preference. There are clinical situations when analogue insulins have important advantages, in paediatrics, 14 in pregnancy 15 and in Ramadan. 16 Many people with diabetes unfortunately remain in poor glycaemic control 17 , 18 due to barriers such as compliance to therapy, patient and healthcare professional preferences, and resource allocation, all of which must be addressed.…”

mentioning

confidence: 99%

Recombinant Human Insulin in Global Diabetes Management – Focus on Clinical Efficacy

Mbanya

Sandow

Landgraf

et al. 2017

European Endocrinology

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Biosynthetic human insulin and insulin analogues are the mainstay of insulin therapy for both type 1 and type 2 diabetes although access to human insulin at affordable prices remains a global issue. The world is experiencing an exponential rise in the prevalence of diabetes presenting an urgent need to establish effective diabetes therapy in countries burdened by inadequate health care budgets, malnutrition and infectious diseases. Recombinant human insulin has replaced animal insulins and animal-based semisynthetic human insulin thereby available in sufficient quantities and at affordable prices able to provide global access to insulin therapy. In many patients, analog insulins can offer additional clinical benefit, although at a considerably higher price thus severely restricting availability in low income countries. The approval process for recombinant human insulins (i.e. biosimilars) and analogue insulins is highly variable in the developing countries in contrast to Europe and in North America, where it is well established within a strict regulatory framework. This review aims to discuss the future access to human insulin therapy in a global context with an ever increasing burden of diabetes and significant economic implications.

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Pediatric diabetes: Potential for insulin degludec

Cited by 3 publications

References 10 publications

Insulin Past, Present, and Future: 100 Years from Leonard Thompson

Insulin Past, Present, and Future: 100 Years from Leonard Thompson

Type 1 diabetes mellitus-common cases

Recombinant Human Insulin in Global Diabetes Management – Focus on Clinical Efficacy

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