What is Nephrotic syndrome (NPH)?

From the Research

NPH insulin should be used with caution and consideration of newer insulin analogs, as the most recent and highest quality study suggests that switching from NPH insulin to insulin glargine 300 U/mL can improve glycemic control and reduce the risk of hypoglycemia in patients with type 2 diabetes 1.

Key Points

• NPH insulin is an intermediate-acting insulin that begins working within 1-2 hours after injection, reaches peak effectiveness in 4-12 hours, and lasts approximately 18-24 hours.
• The timing of NPH insulin is important, as its peak action can cause hypoglycemia if not coordinated with meals.
• Unlike long-acting insulin analogs, NPH has a more pronounced peak effect, which can be both an advantage when timed with meals and a disadvantage due to increased hypoglycemia risk.
• Regular blood glucose monitoring is essential when using NPH insulin to ensure proper dosing and timing.
• A study published in 2022 found that switching from NPH insulin to insulin glargine 300 U/mL improved glycemic control and reduced the risk of hypoglycemia in patients with type 2 diabetes, particularly in older patients and those with a longer disease duration 1.

Considerations

• When using NPH insulin, it is essential to consider the patient's individual needs and adjust the dosing and timing accordingly.
• Newer insulin analogs, such as insulin glargine 300 U/mL, may offer improved glycemic control and reduced hypoglycemia risk compared to NPH insulin.
• The choice of insulin therapy should be based on the individual patient's needs and medical history, as well as the most recent and highest quality evidence available.
• Other studies have also compared the efficacy and safety of NPH insulin with other insulin analogs, such as insulin detemir and insulin glargine, and found similar results 2, 3, 4.
• However, the most recent and highest quality study suggests that insulin glargine 300 U/mL may be a better option for patients with type 2 diabetes, particularly in older patients and those with a longer disease duration 1.