Worldwide, diabetes is a leading cause of cardiovascular disease, blindness, kidney failure and lower limb amputation.1. p8a; 11a; 28a In Sub-Saharan Africa, the majority of people with diabetes will be dead before the age of 60. Furthermore, diabetes accounts for almost one out of every three deaths among the economically active age group of 30 to 40 years.1 p71a,73
Type 2 diabetes is the most common form of the disease. It occurs when the body does not produce enough insulin, or when it cannot respond adequately to the insulin that it does produce. Insulin is a hormone produced by the pancreas that enables absorbed glucose from food to pass from the blood stream into cells where it provides energy. In the absence of insulin or its effects, glucose accumulates in the blood, starving the cells of energy, and also causing damage to blood vessels and nerves.1 p22
Careful control of blood glucose can help prevent or delay the potentially devastating consequences of untreated diabetes. Initially this may be adequately achieved with lifestyle change (healthy diet and exercise) and oral medication, but because of the progressive nature of the disease, most people with type 2 diabetes will eventually require insulin.2,3 2. p72a,b; 3. p2c
Insulin is the most effective treatment for diabetes
With appropriate doses, insulin is able to achieve any level of glucose control depending on the target set for each individual.4 p197a
The goal of insulin therapy is to mimic the body’s natural insulin secretion, but this has proved to be challenging. In a healthy individual, the pancreas produces a small, but variable amount of insulin throughout the day, referred to as ‘basal’ insulin secretion. After meals, when glucose levels are very high, there is a short-acting surge of insulin production, which peaks at around 45-60 minutes, followed by a return to baseline within 2 to 3 hours. In people with type 2 diabetes, low levels of insulin mean that not only will blood glucose increase dramatically after meals, it also remains high in between meals.3 p1a, 2b
Until recently, conventional insulin formulations have been unable to accurately replicate normal insulin secretion. The duration of action may be unpredictable and variable from dose to dose and in different people, meaning that glucose control is inconsistent and there is a risk of glucose levels falling dangerously too low (hypoglycaemia).3 p3d Over the past decade, long-acting insulin analogues with improved time-action profiles that reduce this variability have been developed to mimic basal insulin secretion more closely.3 p4a,5b However, to provide effective glucose control, they need to be combined with a short-acting insulin to control glucose after meals, which must be administered separately, requiring multiple daily injections. Together with the fear of hypoglycaemia, this adds to perceived treatment burden and reduces the likelihood that people with diabetes will persevere with their treatment.5 p15a,b
Novo Nordisk, the world’s largest diabetes company and leaders in diabetes research, is proud to introduce, the first co-formulation of a short-acting and a true long-acting insulin analogue.
Because of its unique formulation, it provides an even profile of basal insulin over 24 hours and mealtime insulin in a single injection delivered from one pen device.5 p16b, p17c, p18a
In contrast to currently available premixed insulins, which are a combination of a short-acting insulin and the same insulin modified to provide an intermediate-acting component, this new co-formulation improves fasting and mealtime glucose control and reduces the risk of hypoglycaemia.5 p19a Dosing is highly flexible to allow for different individual insulin requirements.
The co-formulation represents new hope for people with type 2 diabetes. It may help them and healthcare professionals overcome the barriers to intensifying treatment, potentially enabling more people to achieve their glucose targets with a lower risk of hypoglycaemia, flexible dose times and fewer injections.5 p19b
- International Diabetes Federation. IDF Diabetes Atlas, 7th edn.Brussels, Belgium: International Diabetes Federation, 2015. http://www.idf.org/diabetesatlas. Accessed 11 August 2016.
- Henske JA, Griffith ML, Fowler MJ. Initiating and titrating insulin in patients with type 2 diabetes. Clin Diab 2009; 27(2): 72-76.
- Pettus J, Santos Cavaiola T, Tamborlane WV, Edelman S. The past, present, and future of basal insulins. Diab Metab Res Rev 2015. Published online. DOI: 10.1002/dmrr
- Nathan DM, Buse JB, Davidson MB, et al. Medical management of hyperglycaemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy. A consensus statement of the American Diabetes Association and the European Association for the study of Diabetes. Diabetes Care 2009; 32(1): 1-11.
- Unnikrishnan AG, Singh AK, Modi KD, et al. Review of clinical profile of IDegAsp. J Assoc Phys India 2015; 63(Suppl): 15-20.
By: Novo Nordisk