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Insulin therapy in 2011


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 HbA1c 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


Sources

1. Abe S, Inoue G, Yamada S et al. Two-way crossover comparison of insulin glargine and insulin detemir in basal-bolus therapy using continuous glucose monitoring. Diabetes Metab Syndr Obes 2011; 4: 283–288.

2. Barag SH. Insulin Therapy for Management of Type 2 Diabetes Mellitus: Strategies for Initiation and Long-term Patient Adherence. J Am Osteopath Assoc 2011; 111 (7 Suppl 5): S13–S19.

3. Benroubi M. Fear, guilt feelings and misconceptions: Barriers to effective insulin treatment in type 2 diabetes. Diabetes Res Clin Pract 2011; 93 (Suppl 1): S97–S99.

4. Blevins T. Control of postprandial glucose levels with insulin in type 2 diabetes. Postgrad Med 2011; 123: 135–147.

5. Boldo A, Comi RJ. Clinical Experience with U-500 Insulin: Risks and Benefits. Endocr Pract 2011; 29: 1–17.

6. Cengiz E, Sherr JL, Weinzimer SA et al. New-generation diabetes management: glucose sensor-augmented insulin pump therapy. Expert Rev Med Devices 2011; 8: 449–458.

7. Curran K, Nichols E, Xie E et al. An intensive insulinotherapy mobile phone application built on artificial intelligence techniques. J Diabetes Sci Technol 2010; 4: 209–220.

8. Danne T, Kordonouri O, Holder M et al. Prevention of Hypoglycemia by Using Low Glucose Suspend Function in Sensor-Augmented Pump Therapy. Diabetes Technol Ther 2011; Aug 9. [Epub ahead of print].

9. Das AK, Shah S. History of diabetes: from ants to analogs. J Assoc Physicians India 2011; 59 (Suppl): 6–7.

10. Gerber PA, Spirk D, Brändle M et al. Regional differences of glycaemic control in patients with type 2 diabetes mellitus in Switzerland: a national cross-sectional survey. Swiss Med Wkly 2011; 141: w13218.

11. Godfrey KJ, Mathew B, Bulman JC et al. Stem cell-based treatments for Type 1 dia­betes mellitus: bone marrow, embryonic, hepatic, pancreatic and induced pluripotent stem cells. Diabet Med 2011; Aug 29. [Epub ahead of print].

12. Heise T, Tack CJ, Cuddihy R et al. A new-generation ultra-long-acting basal insulin with a bolus boost compared with insulin glargine in insulin-naive people with type 2 diabetes: a randomized, controlled trial. Diabetes Care 2011; 34: 669–674.

13. Hermanns N, Kulzer B, Maier B et al. The effect of an education programme (MEDIAS 2 ICT) involving intensive insulin treatment for people with type 2 diabetes. Patient Educ Couns 2011; Jun 27. [Epub ahead of print].

14. Hisasue J, Fukuyama S, Nakagaki N et al. Inhalative administration of insulin using a new bubble jet atomization device. Fukuoka Igaku Zasshi 2011; 102: 215–222.

15. Holt P. Taking hypoglycaemia seriously: diabetes, dementia and heart disease. Br J Community Nurs 2011; 16: 246–249.

16. Hu Y, Li L, Xu Y et al. Short-Term Intensive Therapy in Newly Diagnosed Type 2 Diabetes Partially Restores Both Insulin Sensitivity and β-Cell Function in Subjects With Long-Term Remission. Diabetes Care 2011; 34: 1848–1853.

17. Lavernia F. What options are available when considering starting insulin: premix or basal? Diabetes Technol Ther 2011; 13 (Suppl 1): S85–S92.

18. Levin PA, Mersey JH, Zhou S et al. Clinical Outcomes Using Long-Term Combination Therapy With Insulin Glargine and Exenatide In Patients With Type 2 Diabetes. Endocr Pract 2011; 8: 1–28.

19. Lin CH, Huang CH, Tsai JS et al. Effects of a novel short-term continuous subcutaneous insulin infusion program evaluated by continuous glucose monitoring on young adult type 1 diabetic patients in Taiwan. Endocr J 2011; Aug 9. [Epub ahead of print].

20. Mooradian AD. Special considerations with insulin therapy in older adults with diabetes mellitus. Drugs Aging 2011; 28: 429–438.

21. Niswender KD. Basal insulin: physiology, pharmacology, and clinical implica­tions. Postgrad Med 2011; 123: 17–26.

22. Niu M, Lu Y, Hovgaard L et al. Liposomes containing glycocholate as potential oral insulin delivery systems: preparation, in vitro characterization, and improved protection against enzymatic degradation. Int J Nanomedicine 2011; 6: 1155–1166.

23. Owens DR. Insulin preparations with prolonged effect. Diabetes Technol Ther 2011; 13 (Suppl 1): S5–S14.

24. Pennartz C, Schenker N, Menge BA et al. Chronic Reduction of Fasting Glycemia With Insulin Glargine Improves First- and Second-Phase Insulin Secretion in Patients With Type 2 Diabetes. Diabetes Care 2011; 34: 2048–2053.

25. Ranjit Unnikrishnan I, Anjana RM, Mohan V. Importance of controlling diabetes early – the concept of metabolic memory, legacy effect and the case for early insulinisation. J Assoc Physicians India 2011; 59 (Suppl): 8–12.

26. Renard E, Dubois-Laforgue D, Guerci B on Behalf Of The Variability Study Group. Non-Inferiority of Insulin Glargine Versus Insulin Detemir on Blood Glucose Variability in Type 1 Diabetes Patients: A Multicenter, Randomized, Crossover Study. Dia­betes Technol Ther 2011; Aug 2 [Epub ahead of print].

27. Simon AC, DeVries JH. The future of basal insulin supplementation. Dia­-betes Technol Ther 2011; 13 (Suppl 1): S103–S108.

28. Starkman H, Frydman E, Bustami R. Glargine basal-bolus insulin regimen versus insulin pump therapy: comparison of glycemic control. J Pediatr Endocrinol Metab 2011; 24: 369–371.

29. Swinnen SG, Simon AC, Holleman F et al. Insulin detemir versus insulin glargine for type 2 diabetes mellitus. Cochrane Database Syst Rev 2011; 7: CD006383.

30. Zarogoulidis P, Papanas N, Kouliatsis G et al. Inhaled Insulin: Too Soon To Be Forgotten? J Aerosol Med Pulm Drug Deliv 2011; 24: 213–223.

31. Zeng L, Lu H, Deng H et al. Noninferiority Effects on Glycemic Control and β-Cell Function Improvement in Newly Diagnosed Type 2 Diabetes Patients: Basal Insulin Monotherapy Versus Continuous Subcutaneous Insulin Infusion Treatment. Diabetes Technol Ther 2011; Aug 30 [Epub ahead of print].

32. Zhu FF, Zhang PB, Zhang DH et al. Generation of pancreatic insulin-producing cells from rhesus monkey induced pluripotent stem cells. Diabetologia 2011; 54: 2325–2336.

33. Ziesmer AE, Kelly KC, Guerra PA et al. U-500 Regular Insulin Use In Insulin Resistant Type 2 Diabetic Veteran Patients. Endocr Pract 2011; 8: 1–15.

Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 11

2011 Issue 11

Most read in this issue
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