Intermediate and long-acting insulin: Insulin isophane (Protophane and
Humulin NPH) is a recombinant form, classed as an intermediate-duration
insulin. Onset of action is about 90 minutes following injection, with peak
concentration between four and 12 hours and duration of action up to
24 hours. Newer analogue insulins are marketed as being more effective
for basal administration, with fewer hypoglycaemic episodes. Analogue,
long-acting insulin includes insulin glargine (Lantus) and insulin detemir
(not available in New Zealand). Analogue insulin is modifi ed to provide
a slow, steady absorption over 24 hours.
The newer analogue insulin is signifi cantly more expensive than the older
isophane: $94.50 for fi ve vials of 3ml of 100u/ml, compared to $29.86.24
Analogue insulin now comprises 83 per cent of the global market in basal
insulins, up from 60 per cent in 2005.25 Data does not, however, support
benefi ts of newer analogue basal insulins over isophane. A Cochrane review
in 2006 found little support for the more expensive insulin, showing
both to be equally effective at controlling HbA1c. While there were fewer
hypoglycaemic episodes when using the glargine or detemir, the incidence
of severe hypoglycaemic episodes was similar to those for isophane
Intermediate and long-acting insulin: Insulin isophane (Protophane and
Humulin NPH) is a recombinant form, classed as an intermediate-duration
insulin. Onset of action is about 90 minutes following injection, with peak
concentration between four and 12 hours and duration of action up to
24 hours. Newer analogue insulins are marketed as being more effective
for basal administration, with fewer hypoglycaemic episodes. Analogue,
long-acting insulin includes insulin glargine (Lantus) and insulin detemir
(not available in New Zealand). Analogue insulin is modifi ed to provide
a slow, steady absorption over 24 hours.
The newer analogue insulin is signifi cantly more expensive than the older
isophane: $94.50 for fi ve vials of 3ml of 100u/ml, compared to $29.86.24
Analogue insulin now comprises 83 per cent of the global market in basal
insulins, up from 60 per cent in 2005.25 Data does not, however, support
benefi ts of newer analogue basal insulins over isophane. A Cochrane review
in 2006 found little support for the more expensive insulin, showing
both to be equally effective at controlling HbA1c. While there were fewer
hypoglycaemic episodes when using the glargine or detemir, the incidence
of severe hypoglycaemic episodes was similar to those for isophane
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