Challenges and unmet needs in basal insulin therapy: lessons from the Asian experience
| Autor: | Jung Fu Chen, Su-Yen Goh, Maria Aileen Mabunay, Wing Bun Chan, Sony Wibisono Mudjanarko, Pongamorn Bunnag, Shailendra Bajpai, Iris Thiele Isip-Tan, Thi Thanh Huyen Vu |
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| Rok vydání: | 2017 |
| Předmět: |
Insulin degludec
medicine.medical_specialty medicine.medical_treatment 030209 endocrinology & metabolism Review Type 2 diabetes Hypoglycemia patient education insulin detemir insulin titration 03 medical and health sciences 0302 clinical medicine insulin degludec Diabetes mellitus Internal Medicine medicine 030212 general & internal medicine Intensive care medicine Glycemic Insulin detemir Pharmacology business.industry Insulin glargine Insulin insulin glargine medicine.disease business medicine.drug |
| Zdroj: | Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy |
| ISSN: | 1178-7007 |
| Popis: | Basal insulin therapy can improve glycemic control in people with type 2 diabetes. However, timely initiation, optimal titration, and proper adherence to prescribed basal insulin regimens are necessary to achieve optimal glycemic control. Even so, glycemic control may remain suboptimal in a significant proportion of patients. Unique circumstances in Asia (eg, limited resources, management of diabetes primarily in nonspecialist settings, and patient populations that are predominantly less educated) coupled with the limitations of current basal insulin options (eg, risk of hypoglycemia and dosing time inflexibility) amplify the challenge of optimal basal insulin therapy in Asia. Significant progress has been made with long-acting insulin analogs (insulin glargine 100 units/mL and insulin detemir), which provide longer coverage and less risk of hypoglycemia over intermediate-acting insulin (Neutral Protamine Hagedorn insulin). Furthermore, recent clinical evidence suggests that newer long-acting insulin analogs, new insulin glargine 300 units/mL and insulin degludec, may address some of the unmet needs of current basal insulin options in terms of risk of hypoglycemia and dosing time inflexibility. Nevertheless, more can be done to overcome barriers to basal insulin therapy in Asia, through educating both patients and physicians, developing better patient support models, and improving accessibility to long-acting insulin analogs. In this study, we highlight the unique challenges associated with basal insulin therapy in Asia and, where possible, propose strategies to address the unmet needs by drawing on clinical experiences and perspectives in Asia. |
| Databáze: | OpenAIRE |
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