Insulin therapy in the 21st century as recommended by the ADA is with designer insulins.Modification of the human Insulin molecule led on the discovery of Insulin analogs.The greatest advantage of Insulin analogs are its predictable duration of action.The long acting analog, Glargine(Lantus) is the first peakless Insulin in the world.The short acting analog Lispro and aspart have very short duration of action so that they need not have fear of Hypoglycemia during sleep.We have thousands of patients on analogs on regular telemedicine follow-up and maintains HbA1c targets of below 6.5%. Analog Insulins though more expensive are better choices for intensive glycemic control and to prevent the progression of microvascular complications.

The quest for duplicating insulin delivery like the human pancreas has led on to the discovery of insulin pumps.