Why is there less risk of hypoglycemia with the newer analogs ?

The most likely reason for the lower risk for hypoglycemia with newer insulin analogs is that their pharmacokinetic/pharmacodynamic profiles more closely match those for normal physiologic insulin secretion. That is, long-acting insulin analogs do not have a distinct peak in their time-action profiles; therefore, patients do not have abnormally high insulin levels between meals or at night that can lead to hypoglycemia. Rapid-acting insulin analogs, when taken appropriately with meals, facilitate glucose disposal, but do not have a duration of action that extends far beyond the immediate postmeal period when this action is needed. Thus, they do not lead to postmeal hypoglycemia.
There is also evidence that the relationship between insulin dose and response is different with rapid-acting insulin analogs vs regular human insulin. The peak effect with a rapid-acting insulin analog occurs at the same time regardless of the dose, but may be delayed with increasing doses of regular human insulin. This contributes to the increased risk for postprandial hypoglycemia associated with higher doses of regular human insulin.

En otras palabras basta ya de usar esa porquería llamada NPH... El riesgo de hipoglicemias severas es estadísticamente muy importante en su contra... Por el otro lado todos al salir de médicos generales en Guatemala, solo sabemos usar NPH o la regular/cristalina, NI MODO, solo eso hay en nuestros hospitales escuela, y los análogos son más caros... Como siempre los fregados son los pacientes... Si buscamos encontraremos programas de canje para las insulinas análogas y lugares donde existen a menor precio... Hagamos lo máximo posible x nuestros pacientes...

Fuente original: http://cme.medscape.com/viewarticle/712441?src=cmemp&uac=85318MZ