The NovolinPen (Squibb - Novo) is a device that uses prefilled cartridges to inject semisynthetic human insulin (Medical Letter, 25:63, 1983). Three formulations are available: regular insulin (Novolin R PenFill), NPH insulin isophane (Novolin N PenFill) and a mixture of 70% NPH and 30% regular (Novolin 70/30 PenFill). The NovolinPen is advertised as more accurate, more convenient and less expensive than conventional syringes and needles. The same device is marketed in Canada as the Novolin-Pen II (Connaught Novo). (An earlier device is also available as the Novolin-Pen in Canada and the...

The FDA has approved insulin lispro-aabc (Lyumjev – Lilly), a faster-acting formulation of insulin lispro (Humalog), for treatment of type 1 and type 2 diabetes in adults. Fiasp, a faster-acting formulation of insulin aspart (Novolog), was approved in 2017.

Several large European observational studies published on-line this summer have raised questions about whether use of insulin glargine increases the risk of cancer.

The FDA has approved Basaglar (Lilly/Boehringer Ingelheim), a "follow-on" 100 units/mL insulin glargine product similar to Lantus (Sanofi), which recently went off patent. A 300 units/mL formulation of insulin glargine (Toujeo) was approved in 2015.

The FDA has approved Toujeo (Sanofi), a more concentrated form of insulin glargine containing 300 IU/mL compared to the 100 IU/mL in Lantus (Sanofi). Lantus is nearing the end of its patent protection in the US, and biosimilars are expected to become available.

The FDA has approved Fiasp (Novo Nordisk), a new formulation of insulin aspart, to improve glycemic control in adults with diabetes. Fiasp is described by the manufacturer as faster-acting than conventional insulin aspart (Novolog).

The FDA has approved Semglee (Mylan), an insulin glargine product similar to Lantus, for treatment of type 1 diabetes in children and adults and type 2 diabetes in adults. Semglee is the second "follow-on" insulin glargine product to become available in the US; Basaglar, which is also similar to Lantus, was the first. Lantus is a recombinant analog of human insulin that forms microprecipitates in subcutaneous tissue, prolonging its duration of action to a mean of about 24 hours with no pronounced peak effect.

Troglitazone (Rezulin - Parke-Davis), the first of a new class of thiazolidinedione derivatives ('glitazones') for diabetes, has been marketed for oral treatment of noninsulin- dependent diabetes mellitus (NIDDM) in patients who take more than 30 units of insulin daily and still have a glycosylated hemoglobin concentration (HbA1c) of 8.5% or higher.

Insulin glargine-yfgn (Semglee – Viatris), a follow-on insulin glargine product, has now received interchangeability status with the reference product Lantus from the FDA. It is the first biosimilar insulin product to receive this designation in the US. Now a pharmacist can substitute Semglee for Lantus as a lower-cost alternative without permission from the prescriber.

Polycystic ovary syndrome (PCOS), an endocrine abnormality characterized by hyperandrogenism and anovulation, affects 5-10% of women of reproductive age in the US. It is often accompanied by obesity and insulin resistance. In recent years, antidiabetic drugs, although not approved for such use by the FDA, have been tried for treatment of this disorder. This review describes the effectiveness of metformin and the thiazolidinediones in women with PCOS. Also included is a dosage and cost table for some insulin-sensitizing drugs.