Talk:Insulin analog

Vegetable insulins
It is the most important not-commertial variant, and it is scienticlly tested, see authoritative references on the article.
 * I am not sure the compounds you are discussing are true "insulin analogues". They would fall, more likely, in the category of Anti-diabetic drug.
 * Can we decide without a molecular structure?


 * The clue is that it is only effective for type II diabetes, as are the sulfonylureas. They potentiate the effect of insulin, but do not replace insulin. I would think that if plants were a source of the insulin proteins they would have been exploited as a source of insulin, as were the plant based steroids that became the source of birth control pills at Syntex.


 * Yes, good clues... The usual and "effective treatment" is with concentrated extract, commercialized in a 0.5kg (~2 US dollar cheap) packed rocks, named "Pedra hume de kaá". The infusion is for "more homeopatic" treatment. A good reference (start point) may be rain-tree.com/Myrcia. More recent papers are at pharm.or.jp (PDF) and ncbi.nlm.nih.gov (abstract). They cite flavanone glucosides (myrciacitrins) and acetophenone glucosides (myrciaphenones), and report inhibitory activities on aldose reductase and alphaglucosidase.  -- Krauss 16 October 2006


 * "Vegetable Insulin" is an herbal extract - it is not an analog of insulin - while it "may" help in reducing glucose levels, I can find no reliable claim its structure is similiar. For this reason and based on the previous comments it should be removed. If someone can find a "vegetable insulin" that has a structure remotely like insulin then it may qualify - this does not appear to be the case now. Hichris 16:08, 16 October 2006 (UTC)


 * Yes, thank you, it is correct/consistent (except your "may" - the use of herbal extracts is not folklore!). Sorry updated here, if no evidence, the correct place (as you pointed - thanks) is Anti-diabetic drug. -- Krauss 17 October 2006


 * Sounds fine to me to include it with anti-diabetes drugs - (fyi: looking at the literature there are only a few studies done with this extract, and they are conflicting - hence the "may".) Hichris 19:31, 17 October 2006 (UTC)

Lantus availablility
This link (http://www.pslgroup.com/dg/1cdef6.htm) contradicts Lantus's availability as occuring in 2003. Also it might be good to specify that this is US availability -- other countries may adopt earlier or later. 192.75.95.127 22:45, 9 March 2007 (UTC)

NPH?
Is NPH considered an "insulin analog" the way the drugs listed on this page are? I get the impression that the insulin molecule itself isn't modified, it's just mixed with protamine. Guy Harris 23:39, 5 September 2007 (UTC)


 * Thats correct. It just has the best performing formulation, so is the standard all other formulations and analogs are compared to. --Richard Arthur Norton (1958- ) 00:45, 7 September 2007 (UTC)


 * I dispute some of this, in particular the word "best". A routine effect of "human" NPH on many diabetics is a massive peak in action around 5 hours after injection, leading to regular hypoglycaemia.  Furthermore, these hypoglycaemiae are notorious amongst hypoglycaemiae for being devoid of symptoms.  I don't know any academic sources for this, but a meticulous search through the archives of the newsgroup misc.health.diabetes will confirm it.  Although "human" NPH supposedly lasts ~24 hours, for some users the residual activity after the first 7 or 8 hours can be vestigial indeed.  Zinc insulin (Semilente, Lente and Ultralente) don't suffer these problems.  "Human" NPH is thus a very useful drug for comparison with new analogs, since it is easy to show that the analogs perform better.  AMackenzie (talk) 19:01, 20 April 2008 (UTC)


 * NPH insulin is NOT an analog. Moreover, it cannot be considered as the "best" because as a basal insulin it is arguably flawed by its peak at 4-8 hours, which can predispose to hypoglycemia. This makes it less ideal than detemir or glargine (which are peakless) for basal-bolus regimens, i.e. insulin regimens consisting of a separate long-acting (basal) and short-acting (prandial) doses of insulin. Moreover, among the long-acting insulins NPH as the greatest variability in terms of absorption, followed by glargine, then detemir. Therefore it's clear than NPH cannot be regarded as "best" and in fact analogs as a whole are considered superior to conventional insulins (NPH and regular insulin and their premix formulations) for, among other things, less hypoglycemia. Hwi Noree (talk) 18:40, 12 February 2015 (UTC)

Criticism
There is much waffle in the second paragraph, it could be reduced to the first couple of sentences, or lost entirely Andywhatever (talk) 20:19, 29 March 2014 (UTC)

Corrections to the section about insulin degludec
I would like to suggest two corrections in the section about Insulin_analogue on the Insulin_analogue page.

The article currently states that insulin degludec is being developed. It is already approved and marketed in Europe and other countries, so I suggest to delete 'being' in that sentence.

The article also states that insulin degludec may be injected thrice per week instead of once per day. It is currently approved for once per day, and the reference to the suggestion, that it may be injected thrice per week, is an old article from October 2010.

Can anyone help me correct this:

delete the first part about thrice per week to keep it aligned with the description approved by The European Medicines Agency.

The EMA page about insulin degludec as external 3rd party source for both corrections.

Will anyone be able to review this and make the appropriate corrections?


 * Kofod (talk) Kasper Kofod 13:06, 14 April 2014 (UTC)
 * , I've removed the  tag you've placed, as it is mainly to be used when someone is unsure of how to edit wikipedia. It is not to be used to create discussion on article editing. Cheers, Primefac (talk) 16:06, 26 September 2014 (UTC)

Errors
First off, I'm an endocrinologist by profession so this field is my expertise. There are major errors in this Wikipedia entry because it includes insulins that are NOT analogs being listed as analogs. To be an insulin analog, the fundamental molecular structure of the insulin must have been deliberately altered to modify the insulin's dynamics (absorption, duration of action, etc.). In particular this involves modifying the amino acid sequence of the insulin (e.g. lispro) or adding something to the amino acid chain (e.g. myristic acid in detemir).

In this regard:

1. Animal insulins -- are NOT analogs. They are simply insulins of non-human origin and therefore differ from human insulin by one or a few amino acids. 2. NPH (neutral protamine Hagedorn) insulin -- is NOT an analog. It's human insulin that's mixed with protamine to decrease its solubility and therefore prolong the action. The fundamental structure of the insulin is unaltered.

When "insulin analog" is used in medical literature it only refers to the short-acting analogs lispro, aspart and glulisine, the older long-acting analogs detemir and glargine, and the newest long-acting analog degludec. Therefore the entries for "fast acting" should only have lispro, aspart and glulisine while "long acting" should have glargine, detemir, and degludec. If the purpose of putting NPH and animal insulins in the article is for comparison purposes then they can be kept BUT they should moved to a separate section. The current categorization is highly misleading and implies that NPH and animal insulins are analogs when in fact they aren't.

Hwi Noree (talk) 18:51, 12 February 2015 (UTC)

I've edited the article accordingly, with NPH and animal insulin moved to a separate section

Hwi Noree (talk) 03:15, 3 April 2015 (UTC)