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May 8, 2001

Insulin Analogs

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Question from Rancho Cucamonga, California, USA:

I was reading the information your site has on Humalog (lispro insulin) and was curious how current the information was. The part that caught my eye was that it had received FDA approval for children over the age of 12 and that studies were ongoing to obtain approval for younger children. My daughter is six years of age and has been taking Humalog since she was diagnosed with type�1 diabetes about 10 months ago.

Answer:

From: DTeam Staff

Humalog is the lispro synthetic analog produced by Eli Lilly and Company in Indianapolis. Novolog is the aspart synthetic analog produced by Novo-Nordisk. Both are rather similar, work quicker than other rapid acting insulins and thus have a potential benefit to improve immediate postprandial glucose excursions. Both also do not last so long as other fast-acting insulins, and thus decrease the need for mid-morning and mid-afternoon snacks as well as the potential for hypoglycemia 4-12 hours after the analog doses. Because both work so quickly, they can also be used immediately after eating as well as immediately before eating. This is a great benefit for binge eaters who do not always calculate amounts of foods appropriately. Also a great benefit for very young children where exact food intake is not always known ahead of time — so the dose of analog insulin can be provided just after food as well as just before. Since most people do not wait the 30-60 minutes needed for Regular insulins to act and “meet” food excursions, almost all post-prandial doses with Regular insulin do not provide optimum coverage. The analogs, in our team’s opinion at my local program, are significantly better. There is also date about fewer episodes of hypoglycemia and improved hemoglobin A1c — but not in all studies. There is a monograph being prepared by Novo-Nordisk that will discuss these facts — should be available later in 2001.

SB