Little difference between human insulin and faster-acting drugs

Fast-acting artificial insulin drugs work just as well as regular human insulin, but it's unclear how they could affect the health of people with diabetes over the long run, according to a new review of recent studies.

The designer drugs, called insulin analogs, are a lab creation, different from human insulin by only a few protein building blocks. Insulin analogs with brand names like Humalog, Novolog and Apidra are absorbed more quickly than regular insulin, so diabetic patients can inject them right before or after eating to control their mealtime rise in blood sugar.

On average, people with type 1 diabetes who injected an insulin analog had slightly lower--one-tenth of 1 percent --blood sugar levels than those who used regular insulin, according to the review of 49 studies.

For type 2 diabetes patients, there was no real difference in blood sugar levels between those who used analog or regular insulin. There were also a similar number of low blood sugar episodes in both sets of patients, regardless of the type of insulin used, said Dr. Andrea Siebenhofer of the Medical University of Graz and colleagues.

"Our analysis suggests only a minor benefit of short acting insulin analogs in the majority of diabetic patients treated with insulin," Siebenhofer said.

None of the studies in the review examined the possible long-term effects of insulin analogs, including how they may affect the health of people with diabetes-related complications such as heart disease and kidney failure. Until these effects are studied, there should be "a cautious response to the vigorous promotion of insulin analogs," Siebenhofer warned.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medica

Contact: Andrea Siebenhofer
Center for the Advancement of Health

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