Amongst all options available for curing Diabetes, insulin offers maximum efficacy in lowering blood sugar levels, says DR MANGESH TIWASKAR
Diabetes has been treated using insulin for nearly 100 years now. In 1921, a team of Canadian researchers discovered insulin and triggered years of innovations in the care and management of Diabetes, helping innumerable patients. From being an extract obtained from animal pancreas to being developed into a artificially synthesized or also known as recombinant human insulin and now insulin analogs (modified to deliver as per the need i.e. faster or slower, uniformly effective insulin), insulin therapy has undergone a sea of innovative changes over the years. The changes in the insulin formulations are intended to mimic endogenous insulin (made by the pancreas) that has helped people with diabetes get closer to the goal of optimal blood sugar control along with decreased diabetes-related complications. Amongst all options available for the management of Diabetes, insulin offers the maximum efficacy in lowering blood sugar levels for management of Diabetes. The new generation of insulins have further enabled treating physicians to achieve improved control without compromising on safety.
Conventional formulations of insulins have been associated with the challenge of adherence and relatively increased safety risk of hypoglycaemia. Each new generation of insulin introduced brings in flexibility in terms of timing of dose administration and can facilitate increased adherence with much lower risk of hypoglycaemia. Multiple studies have shown that adherence to medication is an important factor in determining its outcomes in patients, especially those who are suffering from chronic diseases. For people with Diabetes, adherence to medication leads to improved control of blood sugar levels that can translate into lower risk of complications, reduced health care costs, lesser chances of hospitalization, and lower mortality.
Benefits of Modern Insulin or New Generation Insulins (MI/NGI)
Today, the various types of insulins available for patient use include ultra-rapid, rapid, regular, intermediate, with slow protracted acting and concentrated, premixed and coformulation insulins, bestowing people with Diabetes several options to suit their needs. MI/NGI is given on the basis of the patient's individual requirements. Due to flexibility in the timings of the insulin dose, MI/NGI are convenient and can help in managing Diabetes better. Additionally, there is a reduction in the number of injections required per day, particularly with the combination MI/NGI. Their action profile is also predictable, which comes handy in planning and optimization of the doses. Unwanted effects like weight gain have been shown to be relatively less in patients on MI/NGI as compared to those on traditional human insulin.
Newer formulae enable a smoother experience of delivery of insulin and help in improving adherence, and glycaemic control, apart from being cost-effective in terms of value they offer. New insulin formulations, like long-acting acting, ultra-rapid acting, and premixed analogue insulins, have been shown to cause lesser risk of hypoglycaemia while providing required glycaemic control in patients who have Diabetes. Moreover, it is not just that these insulins are relatively better, but also the new age pen devices that they come in, are portable, easy to use even by elderly patients, require lesser dose force and can thus lead to better compliance. With improved accuracy and the lower safety risk, they can be the preferred options over the use of vials and syringes.
Early initiation of basal insulin is helpful
The early initiation of the long-acting basal insulin is known to enhance glycaemic control and help people with Diabetes manage their condition better in the long run. This treatment strategy is also backed by international norms. The reasons behind early initiation of insulin are evidence-based. It has many benefits which includes combatting the gluco toxic effects of hyperglycemia, minimization of the complications related to Diabetes like ischaemic heart diseases, kidney failure, loss of vision due to retinopathy, stroke, neuropathy, peripheral vascular disease leading to limb amputation etc.
As is well-known, Type 2 Diabetes is associated with gradual deterioration of ß-cell function and mass. One of the main aims of early insulin therapy is to safeguard and slow down decline in ß-cells. Insulin therapy can help improve ß-cell function and preserve ß-cell mass through better insulin response to glucose.