Abstract
Insulin is a lifesaving drug for patients with type 1 diabetes mellitus. Many type 2 diabetes mellitus patients will eventually require insulin. The rapid-acting and long-acting insulin analogues (RAIAs and LAIAs) have a pharmacological profile that closely mimics normal human physiology when compared to Neutral Protamine Hagedorn (NPH) insulin and regular human insulin, respectively. Glucagon-like peptide 1 receptor agonists (GLP-1RAs) were found to have a proven cardiovascular safety. They are preferred over insulin in many recent guidelines. Fixed-ratio combinations of GLP-1RAs and insulin are also recommended when either of these molecules fail to achieve glycaemic control. Despite decades of experience in using insulin, there is a debate among the scientific community over the safety of exogenous insulin, especially regarding their cardiovascular safety and the risk of cancer. There is also an ongoing debate regarding the safety, even though two long-acting insulin analogues (glargine and degludec) have proven their cardiovascular non-inferiority. Drugs with proven safety are often preferred in patients with pre-existing cardiovascular disease or at high risk of cardiovascular disease. In this review we will critically analyse efficacy and safety issues related to insulin molecules to help in clinical decision making.
Keywords: Insulin, insulin analogue, diabetes mellitus, cardiovascular safety, efficacy, cancer.
Current Drug Safety
Title:Efficacy and Cardiovascular Safety of Insulins
Volume: 16 Issue: 2
Author(s): Cornelius James Fernandez and Chandni Radhakrishnan*
Affiliation:
- Professor of Medicine and Head of Department of Emergency Medicine, Govternment Medical College Kozhikode, Kerala,India
Keywords: Insulin, insulin analogue, diabetes mellitus, cardiovascular safety, efficacy, cancer.
Abstract: Insulin is a lifesaving drug for patients with type 1 diabetes mellitus. Many type 2 diabetes mellitus patients will eventually require insulin. The rapid-acting and long-acting insulin analogues (RAIAs and LAIAs) have a pharmacological profile that closely mimics normal human physiology when compared to Neutral Protamine Hagedorn (NPH) insulin and regular human insulin, respectively. Glucagon-like peptide 1 receptor agonists (GLP-1RAs) were found to have a proven cardiovascular safety. They are preferred over insulin in many recent guidelines. Fixed-ratio combinations of GLP-1RAs and insulin are also recommended when either of these molecules fail to achieve glycaemic control. Despite decades of experience in using insulin, there is a debate among the scientific community over the safety of exogenous insulin, especially regarding their cardiovascular safety and the risk of cancer. There is also an ongoing debate regarding the safety, even though two long-acting insulin analogues (glargine and degludec) have proven their cardiovascular non-inferiority. Drugs with proven safety are often preferred in patients with pre-existing cardiovascular disease or at high risk of cardiovascular disease. In this review we will critically analyse efficacy and safety issues related to insulin molecules to help in clinical decision making.
Export Options
About this article
Cite this article as:
Fernandez James Cornelius and Radhakrishnan Chandni *, Efficacy and Cardiovascular Safety of Insulins, Current Drug Safety 2021; 16 (2) . https://dx.doi.org/10.2174/1574886315999201105153458
DOI https://dx.doi.org/10.2174/1574886315999201105153458 |
Print ISSN 1574-8863 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3911 |
![Wayfinder Image](/images/wayfinder.jpg)
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Tumor Growth is Stimulated by Muscarinic Receptor Agonism: Role of Autoantibodies in Breast Cancer Patients
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Intracellular Calcium, Endothelial Cells and Angiogenesis
Recent Patents on Anti-Cancer Drug Discovery Treatment of Hypertensive Complications in Pregnancy
Current Pharmaceutical Design Nano Traditional Chinese Medicine: Current Progresses and Future Challenges
Current Drug Targets Tissue Doppler Imaging in Coronary Artery Diseases and Heart Failure
Current Cardiology Reviews N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP): Potential target molecule in research of heart, kidney and brain
Current Pharmaceutical Design PDE-5 Inhibitors for BPH-Associated LUTS
Current Drug Targets Blind Snipers: Relevant Off Target Effects of Non-chemotherapeutic Agents in Oncology: Review of the Literature
Reviews on Recent Clinical Trials Role of Opioid Antagonists in the Treatment of Women with Glucoregulation Abnormalities
Current Pharmaceutical Design Insulin Resistance in the Early Stages of Renal Failure: Implications for Cardiovascular Risk
Current Diabetes Reviews Combined Effect of Anti-Angiogentic Agents, Angiotensin Type 1 Receptor Antagonists and Radiation Therapy
Current Signal Transduction Therapy Cardiac Amyloidosis: A Contemporary Review of Medical and Surgical Therapy
Current Cardiology Reviews Progress in Therapies for Myocardial Ischemia Reperfusion Injury
Current Drug Targets Cancer Gene Therapy Utilizing Interleukin-13 Receptor α2 Chain
Current Gene Therapy The Roles of MicroRNAs in Heart Diseases: A Novel Important Regulator
Current Medicinal Chemistry Heme Oxygenase Overexpression Attenuates Glucose-Mediated Oxidative Stress in Quiescent Cell Phase: Linking Heme to Hyperglycemia Complications
Current Neurovascular Research The Role of Tumor Suppressor DLC-1: Far From Clear
Anti-Cancer Agents in Medicinal Chemistry Ammonium Activates Ouabain-Activated Signalling Pathway in Astrocytes: Therapeutic Potential of Ouabain Antagonist
Current Neuropharmacology Uric Acid in Metabolic and Cerebrovascular Disorders: A Review
Current Vascular Pharmacology Pharmacotherapy of Mixed Dyslipidemia in the Metabolic Syndrome
Current Clinical Pharmacology