Human insulin — is there still a place for it in everyday practice?

Abstract

Type 2 diabetes is a progressive disease where in case of unsuccessful behavioral modifications and metformin monotherapy treatment needs to be intensified by adding some other oral agents and/or GLP-1 agonists and/ /or basal insulin. After some years of treatment with increasing defect of beta cells, there is a necessity to start or intensify insulin therapy with prandial insulin, premixed insulin, basal-bolus regimen or multiple injections of insulin. Patient’s treatment should be individualized but there are no direct recommendations which type of insulin to choose — human or analogue one. This article summarizes clinical situations in which one could consider using human insulin. When selecting a suitable insulin, the type of dietary habits, especially eating snacks, the presence of gastroparesis and economic issues should be taken into account. It turnes out that for patients with type 2 diabetes both human and analogue insulins are equally safe and efficient in terms of risk of severe hypoglycaemia. Undoubtedly, analogue insulin has uncontestable advantages, but in some clinical cases human insulin seems to be a better option.