The Replacement of Human Insulin with Insulin Analogs

Abstract

To determine current and potential patterns of prescription of human insulins and insulin analogs in patients with diabetes mellitus in hospitals and general/specialist practice in France. This was a survey of diabetologists and endocrinologists working in hospital and/or private practice in France. The clinicians answered a six-part questionnaire during a face-to-face interview at the clinician's practice regarding current and potential patterns of use of human insulin and insulin analogs. A total of 80 French clinicians were interviewed. The majority of clinicians prescribed insulin analogs to their diabetic patients, with human insulin being prescribed in a minority of patients. When asked their opinions on switching from a regimen involving human insulin to one involving insulin analogs, clinicians generally recommended a treatment regimen that involved very little change. Most clinicians recommended that basal insulin analogs replace NPH human insulin, rapid-acting insulin analogs replace rapid-acting (regular) human insulin, and premix insulin analogs replace human premix insulins, with little change in the recommended number of injections or the dose of the insulin. Precaution was recommended in the elderly, pregnant patients, those of certain ethnicities, and those at risk of hypoglycemia. Insulin analogs are currently prescribed by the majority of diabetologists and endocrinologists in this survey in France. When switching from a regimen involving human insulin to one involving insulin analogs, clinicians generally recommend a treatment program that involves very little change.