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Endocrine Disorders, Contraception, and Hormone Therapy during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Oral hypoglycemics are not recommended for use in pregnancy because they are known to cross the placenta and can stimulate fetal insulin secretion. These drugs have a very long half-life, and administration near term can result in a severely hypoglycemic neonate (Friend, 1981). ACOG recommends use of human insulin for management of pregnancy in pregnant patients with diabetes (types 1 and 2).
Immunosuppressants, rheumatic and gastrointestinal topics
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Insulin was first isolated from the dog’s pancreata by Banting and Macleod. The first patient to receive the extract, in January 1922 at the Toronto General Hospital, with immediate success, was Leonard Thomson; a 14-year-old boy with diabetes. Early insulins were derived from pig and cow pancreata; modified by the addition of protamine to delay absorption and prolong the action of insulin preparations. Subsequently, recombinant DNA technology has allowed the production of insulin identical to human insulin from recombinant strains of Escherichia coli and yeast, and animal insulins are now rarely used.
Pathophysiology and Clinical Management of Diabetes and Prediabetes
Published in Jeffrey I. Mechanick, Elise M. Brett, Nutritional Strategies for the Diabetic & Prediabetic Patient, 2006
Elliot J. Rayfield, Marilyn V. Valentine
Insulin was discovered in 1921 by Banting and Best and is used for the treatment of T1DM or T2DM as monotherapy or in combination with oral agents. Currently available insulins are synthetic human insulins or analogs of human insulin, which vary in their rate of absorption and duration of action (see Table 2.2). There are also products that are mixtures of rapid/short-acting and intermediate-acting insulins. Purified animal insulins are no longer used.
Comparative efficacy and safety of two insulin aspart formulations (Rapilin and NovoRapid) when combined with metformin, for patients with diabetes mellitus: a multicenter, randomized, open-label, controlled clinical trial
Published in Current Medical Research and Opinion, 2022
Jun Yao, Xiaohui Guo, Li Sun, Ping Han, Xiaofeng Lv, Xiuzhen Zhang, Zhaohui Mo, Wenying Yang, Lihui Zhang, Zhanjian Wang, Lvyun Zhu, Quanmin Li, Tao Yang, Wenbo Wang, Yaoming Xue, Yongquan Shi, Juming Lu, Yongde Peng, Fan Zhang, Dewen Yan, Damei Wang, Xuefeng Yu
Biosimilars or domestic insulins have the potential to reduce treatment costs by 20%, which have been rising steadily for patients with diabetes mellitus over the last decades3,29. This reduction in costs is anticipated to improve patient access to insulin analogs in particular, as these are still prohibitively expensive compared to recombinant human insulin for many patients, despite documented clinical benefits30. The first biosimilar insulin analog approved in Europe was a biosimilar of long-acting insulin glargine Abasaglariv in 201429. Since then, fast-acting insulin biosimilars SAR342434 (insulin lispro, Sanofi-Aventis) and SAR341402 (insulin aspart, Sanofi-Aventis) have also gained regulatory approval in Europe and the USA (SAR342434 only)31–33. In countries outside of the EU and USA, such as India and China, some biosimilar and domestic insulin analogs were approved for use before 2014. Additionally, there is some evidence that biosimilar insulin products are associated with reduced drug acquisition costs, particularly for fast-acting insulins30.
Recent strategies driving oral biologic administration
Published in Expert Review of Vaccines, 2021
Badriyah Shadid Alotaibi, Manal Buabeid, Nihal Abdalla Ibrahim, Zelal Jaber Kharaba, Munazza Ijaz, Ghulam Murtaza
for human insulin (H.I.) were recorded in swine after manual subcutaneous millipost injection (S.C.) (n = 5), intragastric (I.G.) surgical millipost placement (n = 5), or I.G. millipost placement via a SOMA (n = 3). These swine are compared with animals dosed with SOMAs designed to localize the millipost to the tissue wall without injection (I.G. no inj.) (n = 5). 300 mg of human insulin was submerged underneath the tissue for each injection trial. Manually placed milliposts contain 80% human insulin and 20% PEO 200k. (C and D) All swine administered with an insulin injection demonstrated hypoglycemia, and many were rescued with dextrose. The SOMA datasets only include swine with successful fasting without residual food or measurable gastric fluid. Error bars indicate SD. N.D., no statistically significant difference. Adapted from reference [21].
Novel approaches to pharmacological management of type 2 diabetes in Japan
Published in Expert Opinion on Pharmacotherapy, 2021
Basal insulin therapy is now applied extensively, primarily by making use of long-acting insulin analogues (e.g. 72-h insulin) and manifest sustained activity similar to physiologically secreted basal insulin. Weekly long-acting basal insulin analogues are currently undergoing clinical trials [91,92]. In these analogues, three amino acids were replaced to modify the molecule in order to extend the half-life of insulin [93,94]. This modification prevents enzymatic degradation of the peptide and ensures its stability and solubility. In addition, C20 icosane fatty acid has been added to the molecule to enable strong but reversible binding to albumin [93,94] (Figure 5). Each of these modifications slowed the clearance of insulin via its receptor. Its interaction with the insulin receptor prompts signal transduction, leading to a metabolic effect equivalent to that of human insulin. It showed no increase in binding to the IGF receptor, and the effect on mitosis was minimal [94].