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Therapeutics of diabetes mellitus: focus on insulin analogues and insulin pumps.

Valla V - Exp Diabetes Res (2010)

Bottom Line: Longer-acting, basal insulin analogues provide concomitant improvements in safety, efficacy and variability of glycaemic control, followed by low risks of hypoglycaemia.This information enhances treatment options, provides a useful tool for self-monitoring and allows safer achievement of treatment targets.Progress in these fields is expected to facilitate and improve the quality of life of diabetic patients.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Applied Bioorganic Chemistry, Chemical Engineering Faculty, Aristotle University, 54124 Thessaloniki, Greece. vickyva@auth.gr

ABSTRACT

Aim: Inadequately controlled diabetes accounts for chronic complications and increases mortality. Its therapeutic management aims in normal HbA1C, prandial and postprandial glucose levels. This review discusses diabetes management focusing on the latest insulin analogues, alternative insulin delivery systems and the artificial pancreas.

Results: Intensive insulin therapy with multiple daily injections (MDI) allows better imitation of the physiological rhythm of insulin secretion. Longer-acting, basal insulin analogues provide concomitant improvements in safety, efficacy and variability of glycaemic control, followed by low risks of hypoglycaemia. Continuous subcutaneous insulin infusion (CSII) provides long-term glycaemic control especially in type 1 diabetic patients, while reducing hypoglycaemic episodes and glycaemic variability. Continuous subcutaneous glucose monitoring (CGM) systems provide information on postprandial glucose excursions and nocturnal hypo- and/or hyperglycemias. This information enhances treatment options, provides a useful tool for self-monitoring and allows safer achievement of treatment targets. In the absence of a cure-like pancreas or islets transplants, artificial "closed-loop" systems mimicking the pancreatic activity have been also developed.

Conclusions: Individualized treatment plans for insulin initiation and administration mode are critical in achieving target glycaemic levels. Progress in these fields is expected to facilitate and improve the quality of life of diabetic patients.

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Related in: MedlinePlus

The amino acid structure of rapid-acting insulin analogues. The molecular modifications on the insulin molecule are shown.
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Related In: Results  -  Collection


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fig1: The amino acid structure of rapid-acting insulin analogues. The molecular modifications on the insulin molecule are shown.

Mentions: Insulin lispro [20, 21] (Humalog) (Figure 1) is the first genetically engineered rapid-acting insulin analogue, approved for clinical use in 1996. Its structure differs from human insulin in the B-chain where proline at position 28 and lysine at position 29 are reversed, leading to a molecule with reduced capacity of self-association in solution (therefore faster absorbed, with higher peak serum levels and shorter action duration in comparison to regular insulin). Besides glycemic management, lispro improves the postprandial leptin and grehlin regulation of type 1 diabetic patients and may be used in cases of gestational diabetes.


Therapeutics of diabetes mellitus: focus on insulin analogues and insulin pumps.

Valla V - Exp Diabetes Res (2010)

The amino acid structure of rapid-acting insulin analogues. The molecular modifications on the insulin molecule are shown.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2877202&req=5

fig1: The amino acid structure of rapid-acting insulin analogues. The molecular modifications on the insulin molecule are shown.
Mentions: Insulin lispro [20, 21] (Humalog) (Figure 1) is the first genetically engineered rapid-acting insulin analogue, approved for clinical use in 1996. Its structure differs from human insulin in the B-chain where proline at position 28 and lysine at position 29 are reversed, leading to a molecule with reduced capacity of self-association in solution (therefore faster absorbed, with higher peak serum levels and shorter action duration in comparison to regular insulin). Besides glycemic management, lispro improves the postprandial leptin and grehlin regulation of type 1 diabetic patients and may be used in cases of gestational diabetes.

Bottom Line: Longer-acting, basal insulin analogues provide concomitant improvements in safety, efficacy and variability of glycaemic control, followed by low risks of hypoglycaemia.This information enhances treatment options, provides a useful tool for self-monitoring and allows safer achievement of treatment targets.Progress in these fields is expected to facilitate and improve the quality of life of diabetic patients.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Applied Bioorganic Chemistry, Chemical Engineering Faculty, Aristotle University, 54124 Thessaloniki, Greece. vickyva@auth.gr

ABSTRACT

Aim: Inadequately controlled diabetes accounts for chronic complications and increases mortality. Its therapeutic management aims in normal HbA1C, prandial and postprandial glucose levels. This review discusses diabetes management focusing on the latest insulin analogues, alternative insulin delivery systems and the artificial pancreas.

Results: Intensive insulin therapy with multiple daily injections (MDI) allows better imitation of the physiological rhythm of insulin secretion. Longer-acting, basal insulin analogues provide concomitant improvements in safety, efficacy and variability of glycaemic control, followed by low risks of hypoglycaemia. Continuous subcutaneous insulin infusion (CSII) provides long-term glycaemic control especially in type 1 diabetic patients, while reducing hypoglycaemic episodes and glycaemic variability. Continuous subcutaneous glucose monitoring (CGM) systems provide information on postprandial glucose excursions and nocturnal hypo- and/or hyperglycemias. This information enhances treatment options, provides a useful tool for self-monitoring and allows safer achievement of treatment targets. In the absence of a cure-like pancreas or islets transplants, artificial "closed-loop" systems mimicking the pancreatic activity have been also developed.

Conclusions: Individualized treatment plans for insulin initiation and administration mode are critical in achieving target glycaemic levels. Progress in these fields is expected to facilitate and improve the quality of life of diabetic patients.

Show MeSH
Related in: MedlinePlus