Session One: Basal Insulins: Still Innovating After All These Years

Abstract

Therapeutic basal insulin has evolved considerably over the past 90 years. A series of landmark innovations has led to the availability of therapies that closely mimic the physiological effects of endogenous insulin and serve as an invaluable addition to the treatment armamentarium for diabetes. Advances in basal insulin have led to the development of the newer basal insulin analogues, namely insulin degludec and insulin glargine 300 U/mL (Gla-300). The desirable pharmacokinetic (PK) and pharmacodynamic (PD) properties of these basal insulins, such as a prolonged duration of action (≥24 hours), may translate into a number of clinical benefits for the patient e.g., a simple, once-daily injection schedule and flexible injection timings. The technologies supporting patients with diabetes have also evolved considerably in recent years. Continuous glucose monitoring (CGM) can provide insights into some of the challenges faced by patients with diabetes, e.g., glycaemic excursions and the impact of injection time, and may become an alternative to the current gold standard glycated haemoglobin (HbA1c). Real-world evidence is also providing fresh perspectives on the effectiveness of basal insulins in clinical practice. Today, innovative methods for real-world evidence collection, analysis, and interpretation are helping to generate robust datasets with external validity. Taken together, these innovative approaches are generating an integrated evidence base that is improving our understanding of how basal insulin therapy can be optimised for the benefit of our patients with diabetes.