New Ultra Long Acting Insulin Could End the Need for Daily Injections

February 18th, 2011

insulin syringe

Danish pharmaceutical giant Novo Nordisk has completed clinical testing of a new generation of ultra long acting insulin, called insulin degludec. More than 10,000 type 1 and type 2 diabetics from 40 different countries participated in 17 different trials.

Trial results consistently showed Degludec to be as effective in lowering blood sugar as the current most widely used long acting insulin, Sanofi-Aventis' Lantus (insulin glargine), with no difference in adverse effects.

More importantly, trial participants given Degludec experienced significantly fewer episodes of hypoglycemia than those given Lantus, especially potentially dangerous night time hypoglycemia. Trials with type 2 diabetics saw a decrease in nighttime hypoglycemia of over 35 percent, and trials with type 1 diabetics of 40 percent.

Degludec is effective for up to 40 hours, roughly twice as long as insulin glargine. Lantus is said to be effective for 18 to 26 hours, although some users report a shorter efficacy. The only other long acting insulin on the market, Novo Nordisk's Levemir (insulin detemir), has a similar action period. Like Lantus and Levemir, Degludic's action is flat, without pronounced peaks in effectiveness.

The new insulin is released so slowly and steadily into the body that it may allow some diabetics to go from daily injections to just three injections a week. Degludic's long and steady action is attributable to the fact it forms a "depot" of soluble multi-hexamers when injected under the skin, from which the insulin is slowly and steadily absorbed into the body.

At the same time, Novo Nordisk is also developing Degludec Plus, the first combination of a long acting insulin (or basal insulin) with a rapid acting (or bolus) insulin, insulin aspart. Until now, it hasn't been possible to combine a basal insulin and a bolus insulin in one single injection.

Lantus (insulin glargine) currently leads the market, generating sales of almost $4 billion a year globally. Levemir (insulin detemir) lags far behind in sales. Now that the phase 3 trials have been completed, Novo Nordisk will be seeking FDA approval for both Degludec and Degludec Plus in 2011, and hopes to begin marketing the new diabetes medications in 2013. Degludec is expected to be marketed at a higher price than Lantus, because of its reduced incidence of hypoglycemia and potential need for less frequent insulin injections.

For more information on Degludec and Degludec Plus, click this Global Medical News video link.

New Disposable Insulin Delivery Device About to Hit the Market

September 14th, 2011

Valeritas, an American medical technology company focused on the development and commercialization of innovative drug delivery solutions, is poised to begin marketing a new disposable insulin delivery device called the V-Go Disposable Insulin Delivery Device.

The V-Go is designed to provide an alternative to multiple daily insulin injections for adult type 2 diabetics using basal-bolus insulin therapy. The V-Go delivers a continuous preset rate of basal insulin (20, 30 or 40 units of insulin per 24 hours) and allows for on demand bolus dosing at mealtimes (in two unit increments up to 36 units).

Users fill the V-Go with their desired insulin dose using an included disposable filling accessory, the V-Go EZ Fill. The small, lightweight (about 1 ounce when full) device delivers insulin subcutaneously for 24 hours, after which it is replaced with a new one. The discreet device is worn under a patient's clothing, and should not be exposed to direct sunlight or high temperatures, although it can be submerged in up to three feet of water.

The non-electronic V-Go was tested using both Humalog insulin lispro and Novolog (insulin aspart), and achieved FDA approval at the end of 2010. The company has been pursuing financing to market it ever since, and has just announced that it has raised $150 million to bring the V-Go Disposable Insulin Delivery Device to market.

"Millions of adult patients suffer from type 2 diabetes and require insulin," says Valeritas CEO Kristine Peterson, "We believe the V-Go will be an important treatment option to assist in the management of their diabetes." To visit the V-Go site and to sign up for email updates on the availability of the innovative insulin delivery device, >Click Here.<

Choosing Between Insulin Injections or Pumps

December 31st, 2013

If you're considering switching from insulin injections to insulin pump therapy, each each method offers pros and cons. Here are some things to consider.

Insulin injections

Interested in simplicity? Injections win hands down. Less education and training is required. Many people do not understand this significant difference. An insulin pump requires professional training.

Injection therapy is also cheaper than using an insulin pump. So, cost-effectiveness and simplicity are two major pros.

On the the flip side, however, injections have a few significant drawbacks. If your treatment plan involves frequent injections, you may develop areas of the body that become resistant to absorbing insulin properly. Also, If you are using different types of insulin, low blood glucose levels can easily occur.

What about an insulin pump?

A pump is designed to deliver insulin throughout the day more consistently which produces fewer highs and lows in blood glucose levels. The secret to these consistent blood glucose levels is the fact that the insulin is being delivered in a more accurate and precise fashion.

Obviously, there will be less needle sticks. Whereas, you may have only one injection every three days with the pump, the same three-day period could require up to 18 needles if your method of choice is insulin shots.

Finally, if a patient is thoroughly trained on how to use an insulin pump and receives proper management, a more flexible lifestyle could be a wonderful side benefit.

A Possible downside to the use of an insulin pump is an increased risk of developing diabetic ketoacidosis or DKA. Diabetic ketoacidosis is a serious complication. When the body produces high levels of blood acids called key tones, a long list of symptoms can occur including excessive thirst, frequent urination, nausea, vomiting abdominal pain, weakness, a fruity scented breath and even a state of confusion. Monitoring blood glucose levels frequently and understanding what to do if this occurs is an important part of the training required before using an insulin pump.

Lastly, pump supplies are more expensive than injections and are not always easy to hide. The pump has to remain attached your body all day which could be an unwelcome reminder to you and others that you are indeed a diabetic.

Unfortunately, there is no clear-cut choice between insulin pumps and insulin injections. Weighing the overall cost, effectiveness and convenience will in the end be a personal choice.