Boston ADA.

Newer formulations of insulin promise to be effective but also more costly than the insulin already on the market. New insulins coming up, more long-working Tresiba, higher concentration of the new Lantus U 300, new Humalog U-200 and so on.

Are they really worth it?

Con; New products are always welcome, but we have plenty of insulins now to use. More and more new insulin will simply raise the price to the point that will come unaffordable to many people, said prof David Nathan, prof of Harvard Medical School, US, a key person in the front for new perspective of diabetes.

Pro; And at the meeting another prof of Diabetes was arguing the other view point that yes, new insulins are worth the costs because they offer more options to achieve better management.

The life saving of insulin for type 1 diabetes is well recognized but in type 2 diabetes, prof Nathan, said that the management of type 2 is less widely recognized.

”Insulin is the oldest of our diabetes medications and widely recognized as being the most effective at lowering glycemic levels”, he said and continued; there are new formulations, new concentrations that heve been brought to the market and there are other formulations under development.

The problem is not a lack of variety – the real problem is the staggering price increases for new insulins in recent years. It is beyond my understanding that the price of NPH-insulin, 70 years old, is still too high, and at the same time there also becoming unaffordable, in many country nowadays.

Why?

The rise and price of insulin has risen well above the inflation year after year, he concluded. Tresiba for example for type 2, he said has no clinical advantages over Lantus or Levemir, although the pharmacokinetics are slightly different.

There are more than enough different formulations affordable to meet cinical needs for T2DM, he said.

"Our major focus should be instead on using the insulins we have for type 2 more appropriately. This is a real challenge. "

To get better metabolic control HbA1c by optimizing the care of the patient with T2DM.

More visits to the diabetic doctor and dicabetic nurse as well as dietician for type 1 per year, also for T2DM more GP doctor and nurse visits per year. More time for education is important and challenging

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