Ideal basal insulin: opportunities from designer proteins.

Ideally, the insulin therapy must aim at the creation of a near normal glycaemic profile without the barriers of unacceptable weight gain or hypoglycaemia. Provision of a flexible insulin regimen would further enhance adherence to the prescribed therapy and positively impact glycaemic control. Insulin degludec addresses many of the aspirations of ideal basal insulin. Long duration of action, flat pharmacodynamic profile, low day-to-day variability translate into benefits of predictable glucose excursions, lower risk of hypoglycaemia at same glycaemic level and effective glycaemic with one daily injection in individuals. In conclusion, insulin degludec represents an important advancement in the treatment of type 1 and 2 diabetes.