Insulin therapy in 2011

Czech version

Authors: J. Perušičová
Authors‘ workplace: Interní klinika 2. lékařské fakulty UK a FN Motol Praha, přednosta prof. MUDr. Milan Kvapil, CSc., MBA
Published in: Vnitř Lék 2011; 57(11): 930-936
Category: Birthday

Overview

Current medicine, including insulin therapy of type 1 and type 2 diabetes, emphasises “individualized” treatment approach. The basic requirements for such approach include: early initiation of insulin therapy, minimizing adverse drug reactions (hypoglycaemia, weight gain, poorer quality of life) and selection of the best insulin regimen. Therapy has to achieve long-term satisfactory diabetes control to prevent chronic vascular complications. Treatment should aim at reducing HbA_1c levels as well as limiting postprandial glycaemia (fluctuations of glucose levels before and after food increase the risk of vascular complications). It has been confirmed that insulin therapy improves secretory function of β-cells and insulin sensitivity. The requirement for early insulin initiation is based on the “metabolic memory” phenomenon; improved glycaemic compensation (even if it is followed by decompensation) has a positive effect on the risk of delayed complications. Novel agents and technologies are being developed: insulin inhalation and oral formulation, ultra-short and ultra-long insulin analogues as well as insulin-producing stem cells and artificial intelligence techniques.

Key words:
early insulin therapy – insulin analogues – the aims of insulin therapy

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