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Lookup NU author(s): Emeritus Professor Philip Home
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© The Author(s) 2023.Insulin injections have never been an entirely satisfactory therapy, and as a result a continuing ‘biobetter’ technological cascade has driven changes in purity and manufacture, in structure and excipients, and in administration devices. The resulting deck of insulin preparations has to be matched by health-care teams and users with individual need. This latter is itself a complex ranging from ambulatory care in type 1 and type 2 diabetes, the topic generally addressed by guidelines and funding advice, to in-patient care and the newly diagnosed, plus secondary diabetes with very different effects on insulin need, through to co-morbidities and medications interfering with glucose metabolism. In this article the match of different clinical scenarios to the available insulins is discussed in the context of available evidence, quality guidelines, and diabetes best practice. Additionally the role of biosimilars of the insulin analogues is addressed, their limited but useful price advantage, and the management consequences of substitution for the originator product.
Author(s): Home P
Publication type: Review
Publication status: Published
Journal: Journal of the Royal College of Physicians of Edinburgh
Year: 2023
Volume: 53
Issue: 2
Pages: 147-155
Print publication date: 01/06/2023
Online publication date: 18/05/2023
Acceptance date: 02/04/2023
ISSN (print): 1478-2715
ISSN (electronic): 2042-8189
Publisher: SAGE Publications Inc.
URL: https://doi.org/10.1177/14782715231173770
DOI: 10.1177/14782715231173770
PubMed id: 37198930
