Insulin Analogue Therapy

Medication

In combination with lifestyle measures (weight control, proper nutrition, and adequate exercise), medications, such as insulin, play an important role in managing blood glucose in patients with diabetes mellitus:

  • Insulin is a hormone that regulates the amount of glucose (sugar) found in the blood.
  • Insulin analogues differ slightly in their chemical makeup from human insulins.
  • Both rapid-acting (mealtime or bolus) and long-acting (background or basal) insulin analogues are available. They are used to treat patients with type 1, type 2, and gestational diabetes.

Condition

Diabetes mellitus is a chronic disease characterized by the body’s inability to produce enough insulin or to use it properly. The condition is classified as follows:

  • Type 1 diabetes results when little or no insulin is made by the body.
  • Type 2 diabetes results when the body makes insulin but is unable to use it effectively.
  • Gestational diabetes presents during pregnancy as glucose intolerance and is usually a temporary condition.

An estimated 2.4 million Canadians have diabetes: 90% of patients have type 2 diabetes mellitus and 10% have type 1 diabetes mellitus. For patients with diabetes, health care costs and costs attributable to premature death and lost productivity exceed more than $9 billion per year. Canada’s aging population and rising rates of obesity suggest that the number of Canadians with type 2 diabetes mellitus will continue to increase.

The chronic complications of diabetes mellitus affect many organs and are responsible for the majority of mortality and morbidity associated with the disease.

Health care providers, consumers, and policy makers require timely, evidence-based information they can rely on to help treat this disease.

Scope of Insulin Analogue Therapy Topic

Insulin Analogue Therapy is one of a number of topics that COMPUS has taken on in conjunction with our overall diabetes management priority area.

Topics include:

Two main types of insulin agents are available in Canada — human insulin and insulin analogues. However, because human insulins do not always replicate how our bodies normally secrete insulin, they may not provide optimal glycemic control. Insulin analogues were therefore developed to address the limitations of human insulin.

Since insulin analogues cost more than conventional human insulins, and health care dollars play a significant role in the sustainability of our health care system, COMPUS’s Advisory Committee (representing Canadian health jurisdictions) recommended that we review the clinical and economic evidence regarding the role of rapid-acting and long-acting insulin analogues in the treatment of diabetes mellitus. Key research questions on this topic area include:

  • Are insulin analogues justified for all patients with diabetes?
  • Do insulin analogues improve long-term health outcomes or patient quality of life?

Where possible, COMPUS builds on existing applicable Canadian and international initiatives and research. As such, our current research initiative is built on two reports of systematic reviews that focus on insulin analogues in the management of diabetes mellitus (produced by CADTH's Health Technology Assessment program in 2007).

Refer to our Project Status web page to find out what stage we are at in this project.