Addressing Unmet Needs With Injectable Medications in Type 2 Diabetes Treatment: Basal insulins.

In healthy humans, the timing and amount of insulin release are exquisitely tied to the body's metabolic demands. Insulin is released at a relatively constant rate over 24 hours to meet the body's basal metabolic needs. In addition, insulin is released in short bursts in response to nutrient intake, as well as in response to changes in peripheral utilization, sensitivity, and endogenous production.To approximate this physiologic state, 2 general types of insulin formulations have been developed. Basal insulins are intended to address the body's basal metabolic needs over 24 hours, and prandial (or bolus) insulins to address the rapid rise in blood glucose in the postprandial state. The quest for a basal insulin with a constant physiologic effect over 24 hours has been challenging, in part because the subcutaneous route of administration remains the most practical, yet physiologically unnatural route for administering insulin.