Table 1.

Benefits, potential uses, cautions, and side effects of recently FDA-approved insulins.

Insulin Type	Benefits	Potential Use	Cautions	Side Effects
Insulin Human Inhalation Powder [19]	Rapid on, rapid off mitigate postprandial hyperglycemia	Hyperglycemia correction, prandial insulin dosing, patients with lipodystrophy or needle phobia	Spirometry (FEV1) prior to use, then every 6–12 months, contraindicated in chronic lung disease & active lung cancer, caution use in those who smoke, severe hypoglycemia	Bronchospasm, hypoglycemia, throat pain/irritation
Fast-acting insulin aspart [11,12,13]	Rapid on, rapid off	Hyperglycemia correction, prandial insulin dosing, may be given within 20 minutes of the start of a meal	Severe hypoglycemia	Hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, weight gain
Glargine U300 [25]	Duration of action > 24 hours, can be given at any time during the day rather than the same time each day	Patients who have difficulty remembering to take insulin at the same time each day	Titrate dose no more frequently than every 3–4 days to minimize risk of hypoglycemia, a higher daily dose may be needed than Glargine U100 insulin	Hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, pruritis, rash edema, weight gain
Degludec [30]	Duration of action > 24 hours, can be given at any time during the day rather than the same time each day, pediatric patients	Patients who have difficulty remembering to take insulin at the same time each day, those needing greater than 80 units of basal insulin each day (up to 160 units in a single dose), those who experience pain with insulin injections (physiologic pH)	Titrate doses no more frequently than every 3–4 days to minimize risk of hypoglycemia, doses should be given no less than 8 hours apart, no conversion needed between U100 and U200 insulins	Hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, pruritis, rash, edema, weight gain