• MeSH
• Glucagon-Like Peptide-1 Receptor Agonists administration & dosage   pharmacology   therapeutic use   MeSH
• Diabetes Mellitus drug therapy   MeSH
• Insulin, Long-Acting administration & dosage   pharmacology   therapeutic use   MeSH
• Insulins * administration & dosage   pharmacology   therapeutic use   MeSH
• Insulin, Short-Acting administration & dosage   pharmacology   therapeutic use   MeSH
• Humans MeSH
• Insulin, Isophane administration & dosage   therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

V prezentované kasuistice poukazujeme na úspěšné využití koncentrovaných inzulinů lispro 200 jednotek/ml a glargin 300 jednotek/ml u obézní pacientky s diabetes mellitus 2. typu a s inzulinovou rezistencí po transplantaci ledviny. Jednou z největších výhod koncentrovaných inzulinů je aplikace menšího množství inzulinu při zachované dávce a tím zmírnění bolesti a diskomfortu v případě podávání větších dávek, což je téměř pravidlem u obézních diabetiků 2. typu s inzulinovou rezistencí. Navíc, dlouhodobě působící inzulinový analog glargin s koncentrací 300 jednotek/ml (Toujeo®) má vyrovnanější a prolongovanější farmakokinetický a farmakodynamický profil ve srovnání s glarginem 100 jednotek/ml. Je srovnatelně účinný s inzulinem glargin 100 jednotek/ml a léčba tímto koncentrovanějším inzulinem je ve srovnání s glarginem 100 jednotek/ml spojena se sníženým či se srovnatelným rizikem hypoglykemie.

We present a case study of an obese female patient with type 2 diabetes mellitus and insulin resistance after renal transplantation in whom concentrated insulins lispro 200 U/ml and glargine 300 U/ml were used successfully. One of the biggest advantages of concentrated insulins consists of the possibility to apply less insulin volume while using the same dose, thus diminishing the pain and discomfort compared to the application of higher insulin volumes (high doses are needed in most obese patients with type 2 diabetes and insulin resistance). Moreover, the long‑acting insulin analog glargine 300 U/ml (Toujeo®) has a more stable and prolonged pharmacokinetic and pharmacodynamical profile than glargine 100 U/ml. At the same time, glargines 300 U/ml and 100 U/ml are equally effective while the risk of hypoglycemia associated with the former is lower than or comparable to that associated with the latter.

• MeSH
• Patient Compliance MeSH
• Diabetes Mellitus, Type 2 * drug therapy   MeSH
• Glycated Hemoglobin metabolism   MeSH
• Insulin Glargine * administration & dosage   MeSH
• Insulin, Regular, Human administration & dosage   MeSH
• Insulin Lispro * administration & dosage   MeSH
• Insulin Resistance MeSH
• Middle Aged MeSH
• Humans MeSH
• Isophane Insulin, Human administration & dosage   MeSH
• Obesity MeSH
• Kidney Transplantation MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

AIM: To evaluate the efficacy and safety of twice-daily insulin degludec/insulin aspart vs. twice-daily biphasic insulin aspart 30 in people with Type 2 diabetes mellitus who were naïve to insulin. METHODS: In this 26-week, multinational, open-label, controlled, two-arm, parallel-group, treat-to-target trial, participants [mean (± sd) age 58.9 (±8.9) years, duration of diabetes 9.5 (±5.9) years, HbA1c 68 (±8.7) mmol/mol or 8.4 (±0.8)% and BMI 31.2 (±4.2) kg/m(2) ) were randomized (1:1) to insulin degludec/insulin aspart (n = 197) or biphasic insulin aspart 30 (n = 197), administered with breakfast and the main evening meal, titrated to a self-monitored plasma glucose target > 3.9 and ≤ 5.0 mmol/l. RESULTS: The mean HbA1c was reduced to 49 mmol/mol (6.6%) with insulin degludec/insulin aspart and 48 mmol/mol (6.5%) with biphasic insulin aspart 30. Insulin degludec/insulin aspart achieved the prespecified non-inferiority margin (estimated treatment difference 0.02%; 95% CI -0.12, 0.17). Insulin degludec/insulin aspart was superior in lowering fasting plasma glucose (estimated treatment difference -1.00 mmol/l; 95% CI -1.4, -0.6; P < 0.001) and reducing overall and nocturnal confirmed hypoglycaemia at a similar overall insulin dose compared with biphasic insulin aspart 30. Similar proportions of participants in each arm experienced severe hypoglycaemia. Adverse events were equally distributed. CONCLUSIONS: Consistent with previous findings, insulin degludec/insulin aspart twice daily effectively improved long-term glycaemic control, with superior reductions in FPG, and significantly less overall and nocturnal confirmed hypoglycaemia compared with biphasic insulin aspart 30 in people with Type 2 diabetes who were insulin-naïve.

• MeSH
• Biphasic Insulins administration & dosage   adverse effects   therapeutic use   MeSH
• Diabetes Mellitus, Type 2 blood   drug therapy   MeSH
• Insulin, Long-Acting administration & dosage   adverse effects   chemistry   therapeutic use   MeSH
• Drug Combinations MeSH
• Glycated Hemoglobin analysis   MeSH
• Hyperglycemia prevention & control   MeSH
• Hypoglycemia chemically induced   epidemiology   physiopathology   prevention & control   MeSH
• Hypoglycemic Agents administration & dosage   adverse effects   chemistry   therapeutic use   MeSH
• Insulin Aspart administration & dosage   adverse effects   therapeutic use   MeSH
• Meals MeSH
• Blood Glucose analysis   MeSH
• Middle Aged MeSH
• Humans MeSH
• Drug Monitoring MeSH
• Insulin, Isophane administration & dosage   adverse effects   therapeutic use   MeSH
• Risk MeSH
• Solubility MeSH
• Drug Administration Schedule MeSH
• Blood Glucose Self-Monitoring MeSH
• Aged MeSH
• Severity of Illness Index MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Randomized Controlled Trial MeSH
• Comparative Study MeSH

Mnoho překážek brání ve veřejných lékárnách odhalit příčinu lékových problémů, např. nedostatek informací o pacientovi nebo nedostatek času. Prezentován je však případ, kdy se vhodnou komunikací s pacientem během dispenzace léků podařilo odhalit příčinu špatné kompenzace diabetu.

There are many barriers in the community pharmacy that hinder identifying of drug-related problem, e. g. lack of informations about patient or lack of time. In the presented case report it was possible to identify the reason for poor diabetes control through appropriate communication with the patient during dispensing drugs.

• MeSH
• Diabetes Mellitus * MeSH
• Hypoglycemia drug therapy   MeSH
• Insulin, Regular, Pork administration & dosage   MeSH
• Diabetes Complications MeSH
• Prescription Drugs MeSH
• Metformin administration & dosage   MeSH
• Isophane Insulin, Human administration & dosage   MeSH
• Ramipril administration & dosage   MeSH
• Drug Administration Schedule MeSH
• Aged MeSH
• Community Pharmacy Services * MeSH
• Check Tag
• Aged MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Inzulin glargin o koncentraci 100 j./ml (glargin U100) je dnes standardně používán v léčbě diabetu 1. i 2. typu a jeho výhody oproti dlouhodobě působícímu humánnímu NPH inzulinu byly opakovaně prokázány. Nyní je k dispozici také inzulin glargin s koncentrací 300 j./ml (glargin U300), který se od klasického glarginu liší nejen možností aplikace vyšší dávky v nižším objemu, ale také řadou dalších důležitých charakteristik. V důsledku menšího povrchu má glargin U300 pomalejší uvolňování ze subkutánního depa, delší biologický poločas a menší variabilitu účinku než glargin U100, což se projevuje snížením výskytu zejména nočních hypoglykemií. Cílem článku je podat přehled o farmakokinetických a farmakodynamických vlastnostech glarginu U300. Diskutovány budou dále výsledky klinických studií, v nichž byl tento inzulin srovnáván s glarginem U100, a perspektivy jeho použití v léčbě diabetu.

Insulin glargine with concentration of 100 IU/ml (glargine U100) is at present routinely used in the treatment of type 1 and type 2 diabetes and its advantages over human long-acting NPH insulin had been well described. Recently introduced insulin glargine with a concentration of 300 IU/ml (glargine U300) differs from glargine U100 not only by the possibility of application of higher dose in a lower volume but also by numerous other important characteristics. Owing to a smaller surface size of the subcutaneous depot, glargine U300 has a slower release into circulation, longer half-life and lower variability of action compared to glargine U100. These features result in a lower rate of especially nocturnal hypoglycaemias. The aim of this paper is to review pharmacokinetic and pharmacodynamic characteristics of glargine U300. We will also describe the results of clinical trials that compared insulin glargine U300 with glargine U100 and discuss the perspectives of its use in the treatment of diabetes.

• MeSH
• Diabetes Mellitus * drug therapy   MeSH
• Glycated Hemoglobin analysis   MeSH
• Drug Evaluation MeSH
• Hypoglycemia MeSH
• Insulin Detemir pharmacokinetics   adverse effects   therapeutic use   MeSH
• Insulin Glargine * administration & dosage   pharmacokinetics   adverse effects   therapeutic use   MeSH
• Clinical Trials, Phase III as Topic MeSH
• Humans MeSH
• Meta-Analysis as Topic MeSH
• Isophane Insulin, Human pharmacokinetics   adverse effects   therapeutic use   MeSH
• Half-Life MeSH
• Dose-Response Relationship, Drug * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, U.S. Government MeSH

Úvod: Náklady na léčbu diabetu 2. typu (DM2T) se zvyšují s nedostatečnou kompenzací a rozvojem komplikací. Nelze-li u pacientů dosáhnout kompenzace DM2T pomocí režimových opatření a podáváním perorálních antidiabetik (PAD), je doporučeno zahájení léčby inzulinem. Efektivita léčby DM2T bazálními inzuliny typu NPH nebo glargin v kombinaci s PAD byla zhodnocena řadou farmakoekonomických studií. Žádná z nich však nebyla provedena v České republice. Cílem projektu POET2 proto bylo porovnat přímé roční náklady na léčbu DM2T v podmínkách běžné klinické praxe v České republice, které vznikly v souvislosti se zahájením léčby bazálním inzulinem NPH nebo glargin v kombinaci s PAD. Metodika: Analyzována byla data od 1 967 pacientů, kteří splnili kritéria pro zařazení do neintervenčního prospektivního registru (DM2T, dosavadní léčba PAD, glykovaný hemoglobin HbA1c > 6 % IFCC) a kteří byli sledováni po dobu 12 měsíců od zahájení terapie inzulinem (glargin: n = 1 061 vs NPH: n = 906). Cena léčby byla hodnocena z pohledu zdravotních pojišťoven a zahrnovala úhrady léčiv, zdravotnických prostředků a pomůcek a zdravotnických výkonů. Výsledky: U obou léčebných skupin došlo k snížení HbA1c (skupina pacientů léčená inzulinem glargin: o 1,77 % IFCC vs skupina pacientů léčená inzulinem NPH: o 1,73 % IFCC) a glykemie nalačno (FPG) (glargin: o 3,67 mmol/l vs NPH: o 3,63 mmol/l). Léčba inzulinem glargin byla spojena s významně nižším výskytem dokumentovaných symptomatických hypoglykemií (glargin: 0,840 příhod na pacienta a rok léčby vs NPH: 1,053 příhod na pacienta a rok léčby; p < 0,05). Celkové přímé roční zdravotnické náklady vzniklé v souvislosti se zahájením léčby bazálním inzulinem byly v průměru o 2 547,07 Kč vyšší při léčbě inzulinem glargin (glargin: 12 173,09 ? 4 169,44 Kč vs NPH: 9 626,02 ? 3 432,79 Kč; p < 0,001) v důsledku vyšší ceny farmakoterapie (glargin: 7 992,97 ? 4 001,81 Kč vs NPH: 3 784,2 ? 3 181,48 Kč; p < 0,001). Při léčbě inzulinem glargin však byly významně nižší náklady spojené s poskytováním zdravotnických prostředků a pomůcek (glargin: 2 332,08 ? 917,84 Kč vs NPH: 3 893,95 ? 989,79 Kč; p < 0,001) a náklady na zdravotnické výkony (glargin: 1 848,04 ? 684,89 Kč vs NPH: 1 947,87 ? 685,43 Kč; p < 0,001). Závěr: Léčba DM2T bazálním inzulinem v kombinaci s PAD byla v podmínkách běžné klinické praxe v České republice efektivní terapeutickou intervencí. Celkové přímé roční zdravotnické náklady byly vyšší při léčbě inzulinem glargin než při léčbě inzulinem NPH. Náklady spojené s poskytováním zdravotnických prostředků a pomůcek a náklady na zdravotnické výkony však byly při léčbě inzulinem glargin nižší. Také výskyt hypoglykemií byl významně nižší u pacientů léčených inzulinem glargin.

Introduction: Poor glycemic control and the resulting development of complications of type 2 diabetes (DM2T) increase treatment costs. If adequate glycemic control cannot be achieved by lifestyle modifications and oral antidia­betic (OAD) therapy, initiation of insulin therapy is recommended. Cost effectiveness of basal insulins of the type NPH or glargine in combination with OAD for the treatment of DM2T was examined in a number of pharmacoeconomic studies. However, none of these studies were conducted in the Czech Republic. Therefore, the aim of the pro­ject POET2 was to compare annual direct medical costs of treating DM2T after addition of insulin NPH or glargine to OAD therapy in a clinical practice setting in the Czech Republic. Methodology: Data collected from 1 967 patients who met the criteria for inclusion into the non-interventional prospective registry POET2 (DM2T, ongoing OAD the­rapy, glycated hemoglobin HbA1c > 6 % IFCC) and who were observed for 12 months following the start of insulin the­rapy (glargine: n = 1 061 vs NPH: n = 906) were analysed. Costs of treatment were analysed from the perspective of health insurance companies and included costs of medication, medical devices and medical procedures. Results: In both treatment groups a reduction of HbA1c (glargine group: by 1.77 % IFCC vs NPH group: by 1.73 % IFCC) and fasting plasma glucose (glargine group: by 3.67 mmol/l vs NPH group: by 3.63 mmol/l) was observed. Insulin glargine the­rapy was associated with the incidence of a significantly lower number of documented symptomatic hypoglycemic events (glargine group: 0.840 events per patient and year of treatment vs. NPH group: 1.053 events per patient and year of treatment; p < 0.05). Overall annual direct medical costs associated with the initiation of basal insulin treatment were higher on average by 2547.07 CZK among patients treated with insulin glargine (glargine group: 12 173.09 ? 4 169.44 CZK vs NPH group: 9 626.02 ? 3 432.79 CZK; p < 0.001) due to higher costs of medication (glargine group: 7 992.97 ? 4 001.81 CZK vs NPH group: 3 784.2 ? 3 181.48 CZK; p < 0.001). By contrast, costs of medical devices (glargine group: 2 332.08 ? 917.84 CZK vs NPH group: 3 893.95 ? 989.79 CZK; p < 0.001) and medical procedures (glargine group: 1 848.04 ? 684.89 CZK vs NPH group: 1 947.87 ? 685.43 CZK; p < 0.001) were lower among patients treated with insulin glargine. Conclusion: Addition of basal insulin to OAD therapy was an efficacious therapeutic intervention for the treatment of DM2T in a clinical practice setting in the Czech Republic. Overall annual direct medical costs were higher among patients treated with insulin glargine than among patients treated with insulin NPH. However, costs of medical devices and medical procedures were lower in the insulin glargine group. In addition, incidence of hypoglycemia was significantly lower among patients treated with insulin glargine.

• Keywords
• přímé roční zdravotnické náklady,
• MeSH
• Analysis of Variance MeSH
• Diabetes Mellitus, Type 2 * economics   drug therapy   MeSH
• Insulin, Long-Acting * economics   adverse effects   therapeutic use   MeSH
• Glycated Hemoglobin drug effects   MeSH
• Hypoglycemia epidemiology   chemically induced   MeSH
• Hypoglycemic Agents economics   adverse effects   therapeutic use   MeSH
• Drug Therapy, Combination MeSH
• Middle Aged MeSH
• Humans MeSH
• Drug Costs statistics & numerical data   MeSH
• Health Care Costs * statistics & numerical data   MeSH
• Statistics, Nonparametric MeSH
• Insulin, Isophane * economics   adverse effects   therapeutic use   MeSH
• Prospective Studies MeSH
• Body Weight MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Multicenter Study MeSH
• Observational Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Comparative Study MeSH
• Geographicals
• Czech Republic MeSH

Inzulinová léčba je základním terapeutickým přístupem u diabetiků 1. typu a také u řady diabetiků 2. typu zejména s delším trváním onemocnění. U pacientů s diabetem 2. typu je však inzulinová terapie často zahajována později, než by bylo optimální, což je mimo jiné dáno také suboptimálními farmakokinetickými vlastnostmi dostupných inzulinů. Stále proto pokračuje vývoj nových inzulinů, jejichž charakteristiky by byly výhodnější než inzulinů v současné době používaných. Cílem tohoto článku je shrnout stávající poznatky týkající se nových inzulinů, které byly nedávno uvedeny na trh nebo se uvedení na trh přibližují. Zaměříme se rovněž na perspektivy inzulinové terapie v dlouhodobém horizontu včetně alternativních možností aplikace inzulinu mimo jeho klasické podávání subkutánní injekcí. Klíčová slova: alternativní možnosti aplikace inzulinu – diabetes mellitus – hypoglykemie – inzulin – inzulinová analoga

Insulin therapy is a therapeutic cornerstone in patients with type 1 diabetes and also in numerous patients with type 2 diabetes especially with longer history of diabetes. The initiation of insulin therapy in type 2 diabetes patients is often delayed which is at least partially due to suboptimal pharmacokinetic characteristics of available insulins. The development of novel insulins with more favorable characteristics than those of current insulins is therefore still ongoing. The aim of this paper is to review current knowledge of novel insulins that have been recently introduced to the market or are getting close to routine clinical use. We will also focus on the perspectives of insulin therapy in the long-term run including the alternative routes of insulin administration beyond its classical subcutaneous injection treatment. Key words: alternative routes of insulin administration – diabetes mellitus – hypoglycemia – insulin – insulin analogues

• Keywords
• inzulinová analoga, detemir, glargin, degludek, glargin U300, inzulin LY2605541, inteligentní inzulin,
• MeSH
• Administration, Inhalation MeSH
• Administration, Oral MeSH
• Diabetes Mellitus, Type 1 * drug therapy   MeSH
• Diabetes Mellitus, Type 2 * drug therapy   MeSH
• Insulin, Long-Acting * pharmacokinetics   pharmacology   therapeutic use   MeSH
• Hypoglycemia prevention & control   MeSH
• Hypoglycemic Agents pharmacokinetics   therapeutic use   MeSH
• Injections, Subcutaneous MeSH
• Insulin Lispro therapeutic use   MeSH
• Insulin, Short-Acting * pharmacokinetics   therapeutic use   MeSH
• Humans MeSH
• Insulin, Isophane pharmacokinetics   therapeutic use   MeSH
• Polyethylene Glycols therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

Kazuistika popisuje rozdíly v terapii ve dvou graviditách u diabetičky 1. typu. Diabe-tes mellitus (DM) 1. typu byl u pacientky spojen s tyreotoxikózou Graves-Basedowova typu v rámci sdružených autoimunitních chorob.

The case study describes differences in therapy in two pregnancies in type 1 diabetic patient. Diabetes mellitus (DM) type 1 in the patient is associated with Graves-Basedow thyreotoxicosis type within the associated autoimmune diseases.

• Keywords
• inzulinoterapie,
• MeSH
• Medication Adherence MeSH
• Patient Compliance * MeSH
• Diabetes Mellitus, Type 1 * drug therapy   complications   MeSH
• Insulin, Long-Acting * administration & dosage   MeSH
• Adult MeSH
• Glycated Hemoglobin analysis   MeSH
• Hypoglycemic Agents administration & dosage   MeSH
• Insulin Aspart administration & dosage   MeSH
• Insulin, Regular, Human administration & dosage   MeSH
• Diabetes Complications MeSH
• Humans MeSH
• Insulin, Isophane administration & dosage   MeSH
• Drug Administration Schedule MeSH
• Pregnancy in Diabetics * drug therapy   MeSH
• Pregnancy MeSH
• Thyrotoxicosis drug therapy   complications   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

BACKGROUND: Glucose variability combined with glycosylated hemoglobin (HbA1c) assessments more reliably represents the level of glycemic control. The study was aimed to compare blood glucose variability with insulin glargine vs. neutral protamine Hagedorn (NPH) in patients with type 2 diabetes mellitus using a continuous glucose-monitoring system (CGMS), in patients treated with basal insulin using stable dose of oral antidiabetic agents and HbA1c in the range of 4.5-8.0 % International Federation of Clinical Chemistry (IFCC) units. [6.2-9.4 % Diabetes Control and Complications Trial (DCCT) units]. METHODS: This was a multicenter, prospective, open-label, single-arm study in patients (N = 116) treated for ≥ 2 months with NPH and metformin combined with sulfonylurea or glinide. Glucose variability was measured after a 4-week NPH treatment phase and after a subsequent 12-week glargine treatment phase using CGMS. Based on 72-hour CGMS, glucose variability was assessed by area under the curve [AUC (mmol/L · h)]. Differences (glargine-NPH) in AUC within 24 h in the glucose ranges of ≤ 3.3, ≤ 3.9, 7.5-3.9 (margins excluding), ≥ 7.5, ≥ 10, and ≥ 15 mmol/L were evaluated. Circadian fluctuation of glucose was assessed by M-value (log-transformation of the deviation from an arbitrary standard). RESULTS: AUCs of glucose in the lowest ranges (≤ 3.3 and ≤ 3.9 mmol/L) did not change significantly after treatment with glargine. Those in the higher ranges (≥ 7.5, ≥ 10, and ≥ 15 mmol/L) were significantly lower (p < 0.001 for all ranges), whereas AUC of glucose in the normal range (3.9-7.5 mmol/L) was significantly higher (p < 0.001) at the end of glargine treatment phase. Circadian fluctuation of glucose assessed by M-value showed a significant decrease after glargine treatment (p < 0.003). No significant differences in hypoglycemia confirmed by glucose value ≤ 3.3 mmol/L were found between treatment phases. This trial is registered at ClinicalTrials.gov, NCT00659477. CONCLUSIONS: As monitored by CGMS, switching from NPH to glargine with active titration shifted glucose from abnormally high to normal levels with reduced fluctuation and without increased risk of hypoglycemia.

• MeSH
• Diabetes Mellitus, Type 2 blood   diagnosis   drug therapy   MeSH
• Insulin, Long-Acting administration & dosage   MeSH
• Adult MeSH
• Hypoglycemic Agents administration & dosage   MeSH
• Blood Glucose analysis   MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Drug Monitoring methods   MeSH
• Drug Substitution MeSH
• Insulin, Isophane administration & dosage   MeSH
• Reproducibility of Results MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Sensitivity and Specificity MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Controlled Clinical Trial MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

• MeSH
• Diabetes Mellitus, Type 1 MeSH
• Diabetes Mellitus, Type 2 MeSH
• Diabetes Mellitus * drug therapy   metabolism   physiopathology   MeSH
• Insulin, Long-Acting administration & dosage   pharmacokinetics   pharmacology   MeSH
• Insulin * analogs & derivatives   administration & dosage   physiology   classification   secretion   therapeutic use   MeSH
• Drug Therapy, Combination methods   trends   MeSH
• Blood Glucose drug effects   MeSH
• Humans MeSH
• Insulin, Isophane administration & dosage   pharmacokinetics   therapeutic use   MeSH
• Drug Administration Schedule MeSH
• Drug Administration Routes MeSH
• Check Tag
• Humans MeSH