I have 2 questions:

I have read recently that the FDA has just approved the release of the new insulin analog. What is the difference between the new analog and Humalog?
How does a physician determine which insulins to start a child on? My child is six years old and has had diabetes since she was four. I have met two other families that has been started on different insulins than my daughter.

Good questions.

An insulin analog is an insulin that has been changed from the natural configuration. Insulin consists of two chains with many amino acids in the chains. A simple change of two amino acids made the first insulin analog, lispro or Humalog. So Humalog is the first of many analogs. There will be others soon as you are reading about. They are insulin, and they just work differently than the “basic” insulins. Humalog faster, others slower, in order to give us more options.
Choice of insulin: Doctors have several choices. Some use what they learned in residency. Others use different insulins based on age of patient, lifestyle, and experience. Sometimes we just have to “practice” medicine and try a different insulin plan. I tell patients that people are not car motors, and you can’t guarantee that if you use a specific octane gas that they will run just fine. Insulin is like that along with other medicines. Treat each patient as an individual.

LD
Additional comments from Stephanie Schwartz, diabetes nurse specialist:

The new rapid-acting insulin analog that was recently approved by the FDA, insulin aspart, that will carry the brand name Novolog in the USA, NovoRapid in Europe, and should be available in the autumn [of 2000] in the USA.

SS

[Editor’s comment: And there’s another insulin analog coming soon, this one very long-lasting: Lantus (insulin glargine).

WWQ]