Newer Insulins: Making Early Insulin Initiation Safer and Simpler

315 Introduction In recent times, there have been two striking developments in the area of insulin therapy. On the therapy front, insulin therapy especially in type 2 diabetes has become a topic frequently reviewed in literature (Marre, 2000; Korytkowski, 2000). These reviews discuss the role of early insulin initiation in the light of the growing burden of type 2 diabetes coupled with the need for tighter control to prevent long-term complications. According to these reviews and also published data from Indian studies, barriers to early initiation include the fear of hypoglycemia, compliance issues related to meal-time injections and fear of injection itself. Interestingly, the other striking development on the insulin formulation front designer, newer insulin analogues, inhaled insulin, oral insulin appears to be addressing these very issues which are preventing the usage of insulin even when indicated as in the case of insulin-requiring type 2 diabetes patients. The role of insulin in Type 1, Gestational Diabetes, Secondary diabetes is unequivocal.