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Cardio Diabetes Medicine 2017 533

Insulin Therapy Should Mimic 15
Endogenous Insulin Secretion

Plasma glucose profiles Endogenous insulin secretion
Glucose homeostasis
0.08

(U/l) 0.04 8
6
Insulin 4

2 Plasma glucose (mmol/L)
0 0

08.00 13.00 16.00 19.00
Time (hours)

Owens DR, et al. Lancet 2001;358:739−46.

THE ADVENT OF THE ANALOGUES

1–3
• Discovery of insulin’s chemical structure, and elucidation of its 3D structure using X-ray crystallography, 4
revealed the relationship between pro-insulin and insulin
• As a result, new forms of protracted insulin therapy based on alterations to the structure of the molecule
(i.e. insulin analogues) were developed
Rapid-acting Insulin Analogues Long-acting Insulin Analogues
Developed for more rapid absorption by engineering Developed to fulfil basal insulin requirements by pro-
insulin variants with amino- acid changes that reduce viding a constant low level of plasma insulin in fast-
the tendency of insulin molecules to self-associate ing and inter- prandial periods either by increasing
the isoelectric point or by covalent acylation
Currently available rapid-acting insulin analogues Currently available long-acting insulin analogues
• LISPRO • GLARGINE
• ASPART • DETEMIR
• GLULISINE • DEGLUDEC

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