Figure 3 Pharmacodynamic action profiles of long-acting insulins

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Figure 3 Pharmacodynamic action profiles of long-acting insulins Figure 3 | Pharmacodynamic action profiles of long-acting insulins. The schematic shows the pharmacodynamic action profiles of long-acting insulins in steady state9,75,78. The pharmacokinetic action profiles of these insulins cannot be compared because the acylated insulins (insulin detemir and insulin degludec) are mostly bound to albumin and total concentrations of insulin do not yield helpful information on action profiles. Therefore, this figure shows the pharmacodynamic action profiles from studies that were carried out in steady state, as these yield the most useful information for the clinician using these insulins on a daily basis in patients with type 1 diabetes mellitus. The difference in action profile between a single injection and steady state is particularly important for those insulins with half-lives above 12 h (insulin glargine U300 and insulin degludec). Care must be taken when interpreting the curves, as experimental settings in which the data were gathered differed between studies. GIR, glucose infusion rate; NPH, neutral protamine Hagedorn. Mathieu, C. et al. (2017) Insulin analogues in type 1 diabetes mellitus: getting better all the time Nat. Rev. Endocrinol. doi:10.1038/nrendo.2017.39