Peptide hormone regulating glucose metabolism. Binds insulin receptor, activates PI3K/Akt pathway, promotes glucose uptake, glycogen synthesis, and lipogenesis. Modern analogs modify pharmacokinetic profile to achieve rapid-acting or long-acting coverage.
Type 1 and Type 2 diabetes management. Reference standard for glucose control in clinical practice worldwide.
Hypoglycemia. Hypokalemia. Lipodystrophy at injection sites.
No peptide has more clinical trial data in human history. First isolated 1921 (Banting & Best). First recombinant DNA-produced drug (1982). WHO Essential Medicine. Multiple large CVOTs.
- 1.ORIGIN Investigators, NEJM 2012 — insulin glargine neutral for CV events vs standard care over 6.2 years. n=12,537
- 2.Marso et al., NEJM 2017 (DEVOTE) — degludec noninferior for CV safety (HR 0.91) with 40% lower rate of severe hypoglycemia. n=7,637
Weight gain and hypoglycemia remain class limitations. Access and cost barriers in certain markets.
Ultra-long-acting formulations. Closed-loop insulin delivery (artificial pancreas) integration.