Question

There are multiple forms of insulins, all of which may be ordered for patients with type I diabetes mellitus or type II diabetes mellitus (T2DM). They are all highly effective at lowering a patient’s serum blood glucose.

· What are the key pharmacokinetic differences between lispro insulin, NPH insulin, regular insulin, insulin glargine?

· Why are oral hypoglycemics such as metformin, glyburide, pioglitazone, and sitagliptin preferred to insulins in patients with Type 2 diabetes mellitus?

Answer 1

INTRO- The key difference between various administered insulins for T2DM patients is that, wether they are short / long acting type of insulins.

Lispro insulin is fast acting type, where its action starts within 15min of administering and its effect can last for upto 5 hrs.

NPH is an intermediate acting variety, where action starts in 2hrs and the effect can last upto 16hrs, which is dose dependantly.

Insulin Glargine is slow acting compared to others and has a prolonged effect of upto one day, after being administered subcutaneously in body.

Oral glycemics are much better preffered, due to the fact that they are,-

: much easier to administer

: give a better effect on metabolism & cardiovascular aspects.

: patients experienced minimal bodyweight gain.

: lipid profile didnt increase too much.