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New Insulin Analog

The first of possibly 2 new insulin analogs to be introduced this year was 
approved by the FDA in late April. Insulin glargine is an insulin analog 
produced by recombinant DNA technology. A glycine substitution on the A-chain 
and the extension on the B-chain of 2 arginine residues creates a shift in 
the isoeletric point, reducing the aqueous solubility of this insulin at 
physiologic pH. Furthermore, the hexomeric structure of this molecule is 
stabilized which causes a delay in the dissociation into monomers. 
Consequently, insulin glargine has a delayed and prolonged absorption.The 
absorption of insulin glargine is flat and lasts 24 hours. Perhaps even more 
importantly, the absorption is more consistent, compared with the other 
commonly used basal insulins, NPH and Ultralente. The need to separate basal 
from prandial insulins will continue to become more important as insulin 
therapies for type 1 diabetes continues to evolve.Studies for insulin 
glargine show 1 common theme -- a reduction of hypoglycemia when compared 
with NPH insulin. Due to the lack of a "peak" and more consistent absorption, 
these advantages should not be surprising.
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