Download Comparison of Different Insulin Preparations: Detemir, Glargine, and Rapid-Acting Insulins and more Assignments Science education in PDF only on Docsity! been developed that maintain a monomeric or dimeric configuration, increasing their speed of absorption and reducing time to onset to 5 to 15 minutes. They are identical to human insulin except for substitutions of amino acids at one or two positions. Such rapidly acting insulin preparations include insulin lispro, insulin aspart, and insulin glulisine. The use of insulin lispro rather than regular insulin can decrease the incidence of hypoglycemia and improve glycemic control. Intravenous insulin infusions can control hyperglycemia more efficiently than intermittent subcutaneous insulin therapy and may be the preferred approach in certain settings, such as post cardiac surgery. - Research on the different Antidiabetic Drugs (focus on Detemir, Glargine, and the different Insulins). How is using Detemir (Levemir) or Glargine (Lantus) insulin better than using Neutral Protamine Hagedorn (NPH) insulin? Both Levemir and Lantus are preferred over NPH insulin because they have a longer duration of action, a less pronounced peak, and are more consistent in their effects with less risk of hypoglycemia. Both Levemir and Lantus are clear solutions, unlike NPH which requires resuspension prior to injection. However, neither Levemir or Lantus perfectly mimic normal basal insulin release. Studies that have compared Levemir and Lantus to NPH have reported almost identical effectiveness in long-term HbA1C control. The rates of symptomatic hypoglycemia were lower with glargine; however, overall hypoglycemia was lower with detemir. Both glargine and detemir reported lower night-time hypoglycemia compared with NPH. Levemir (insulin detemir) is a man-made form of insulin, a hormone that is produced in the body. Insulin works by lowering levels of glucose (sugar) in the blood. Levemir is a long-acting insulin that starts to work several hours after injection and keeps working evenly for up to 24 hours. Insulin glargine (Lantus) tends to be absorbed more slowly and for longer than detemir ( Levemir) because it is not as soluble once injected just under the skin. This means it has a longer duration of action and an insignificant peak effect - instead, it delivers consistent blood levels of insulin. - Some doctors order Basal Glargine (Lantus) insulin in the morning rather than in the evening. What is the rationale for this? The pharmacokinetics of Lantus allows insulin to be released at steady concentrations throughout the day for up to 24 hours. This “peakless” effect suggests that Lantus may not only be given daily at bedtime as indicated by the FDA, but alternatively, once daily in the morning or afternoon. The duration of effect of Lantus is prolonged compared to NPH human insulin. The median time between injection and the end of the pharmacological effect for NPH human insulin is 14.5 hours (range: 9.5 to 19.3) and 24 hours for Lantus (range: 10.8 to >24 hours). This wide range with Lantus suggests that the duration of action in some patients may not last as long as 24 hours. Therefore, some patients may require twice-daily dosing of Lantus in order to control the early elevations in blood sugar prior to the next dose. Physicians are pursuing several different possibilities of dosing that deviate from the FDA-approved instructions for Lantus dosing.
