Treating patients with type 1 diabetes to near-normal glycaemic levels significantly reduces the risk of microvascular complications and improves patient outcomes. Consequently, achieving and maintaining optimal glycaemic control is a key therapeutic aim and clear guidance regarding glycaemic targets now exists. The challenge is to achieve this level of control in routine clinical practice whilst minimising the treatment-related adverse events of hypoglycaemia and weight gain. The development of both rapid- and long-acting insulin analogues offers the potential to meet this challenge, with results from clinical trials indicating that analogue insulins have therapeutic benefits over older insulin preparations. However, it is important to see if these benefits can be repeated in non-clinical trial patient populations and, therefore, this article summarises the results from prospective audits of introducing insulin lispro and insulin glargine into routine clinical practice in patients with type 1 diabetes.
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