Why is premixed insulin the preferred insulin? Novel answers to a decade-old question.
A wide range of sources have been used to create an equally wide range of types of insulin (rapid acting, fast acting, premixed, intermediate acting and long acting). While some of these insulins are no longer in clinical use, others are being used extensively across the world. Premixed insulin is the most frequently prescribed and used insulin in Asia; basal insulin is more extensively used in USA. As compared with basal insulin alone, premixed regimens tend to lower HbA1c to a larger degree while providing enhanced convenience. It is a challenge for diabetologists to assess the conflicting guidelines and decide which one to follow. This is especially true with regard to choosing appropriate insulin for initiation of therapy. Besides, ethnicity may play a key role in determining choice of insulin therapy among different populations. Here, the authors discuss the various factors, pharmacological as well as psychological, that have made premixed insulins the preferred insulin for type 2 diabetes in India and the many parts of Asia. The authors utilize well known theories of psychology, namely generalization, cognitive dissonance and concordance to provide a rational explanation for the preference for premixed insulin that Indian people with diabetes, and their physicians, have.
Bharti Hospital and B.R.I.D.E., Karnal.
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S
Kalra
Department of Psychiatry and De-addiction, Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, New Delhi.
Y P S
YP
Balhara
Department of Medicine, Osmania Medical College, 6-3-852/A, Ameerpet, Hyderabad.
B K
BK
Sahay
Department of Endocrinology, St. John's Medical College, Bangalore.
B
B
Ganapathy
Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry.
A K
AK
Das
D044466:Asian People; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000208:ethnology; D006801:Humans; D007004:Hypoglycemic Agents / Q000145:classification / Q000627:therapeutic use*; D007194:India; D007328:Insulin / Q000145:classification* / Q000627:therapeutic use*; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D044465:White People
D007004:Hypoglycemic Agents; D007328:Insulin