Basal Insulin Therapy
Basal Insulin Therapy
Farzad Hadaegh MD
Prevention of metabolic disorders research center
AGENDA
- Overview On Insulin
- Long-acting Insulin Analogues
- Clinical Studies on Glargine and Detemir
- Insulins and Cancer
- Cost effectiveness
The Basal/Bolus Insulin Concept
- Basal Insulin
- Suppresses glucose production between meals
and overnight - Nearly constant levels
- 50% of daily needs
- Suppresses glucose production between meals
- Bolus Insulin (mealtime or prandial)
- Limits hyperglycemia after meals
- Immediate rise and sharp peak at 1 hour
- 10% to 20% of daily requirement at each meal
The Ideal Basal Insulin Should Have…
- Square-wave action profile, ie, no peak, long-lasting
- Reproducible effects (after several injections)
- Pharmacodynamic effects similar to pump insulin
