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Role of insulin in the type 2 diabetes therapy: past, present and future.

Maria Rotella C, Pala L, Mannucci E - Int J Endocrinol Metab (2013)

Bottom Line: At the moment, there is no real consensus.Nevertheless, still many exciting expectations exist: the new insulin analogues, the technological options, the inhaled and oral insulin and the issue of transplantation.Furthermore, a lively research activity is currently ongoing, in order to make insulin therapy even safer and simpler for patients.

View Article: PubMed Central - PubMed

Affiliation: Obesity Agency, University of Florence Medical School, Careggi Teaching Hospital, Firenze, Italy.

ABSTRACT

Context: Since 2006 a relevant number of therapeutical algorithms for the management of type 2 diabetes have been proposed, generating a lively debate in the scientific community, particularly on the ideal timing for introduction of insulin therapy and on which drug should be preferred as add-on therapy in patients failing to metformin. At the moment, there is no real consensus. The aim of the present review is to summarize established knowledge and areas for debate with respect to insulin therapy in type 2 diabetes.

Evidence acquisition: In type 2 diabetic patients, insulin represents a therapy with a long and well-established history, but, considering the modern insulin therapy, several points must be carefully examined. The role played by the introduction of insulin analogues, the choice of insulin regimens, the ongoing debate on insulin and cancer, the cardiovascular effects of insulin, the role of insulin on β-cell protection and the actual clinical perspective in the treatment of the disease. Nevertheless, still many exciting expectations exist: the new insulin analogues, the technological options, the inhaled and oral insulin and the issue of transplantation.

Conclusions: Although insulin is the more potent hypoglicemic agent, the availability of a wider spectrum of therapeutic agents, many of which are better tolerated than insulin, has reduced the field of application for insulin treatment; presently, insulin is used only in those who cannot maintain an adequate glycemic control with other drugs. Furthermore, a lively research activity is currently ongoing, in order to make insulin therapy even safer and simpler for patients.

No MeSH data available.


Related in: MedlinePlus

Effects of Insulin on Different ReceptorsIGF-1R: insulin-like growth factor-1 receptor; IR-A: type A insulin receptor; IR-B: type B insulin receptor.
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fig3729: Effects of Insulin on Different ReceptorsIGF-1R: insulin-like growth factor-1 receptor; IR-A: type A insulin receptor; IR-B: type B insulin receptor.

Mentions: Insulin is capable of stimulating cell growth via the interaction with multiple receptors (Figure 1).


Role of insulin in the type 2 diabetes therapy: past, present and future.

Maria Rotella C, Pala L, Mannucci E - Int J Endocrinol Metab (2013)

Effects of Insulin on Different ReceptorsIGF-1R: insulin-like growth factor-1 receptor; IR-A: type A insulin receptor; IR-B: type B insulin receptor.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860110&req=5

fig3729: Effects of Insulin on Different ReceptorsIGF-1R: insulin-like growth factor-1 receptor; IR-A: type A insulin receptor; IR-B: type B insulin receptor.
Mentions: Insulin is capable of stimulating cell growth via the interaction with multiple receptors (Figure 1).

Bottom Line: At the moment, there is no real consensus.Nevertheless, still many exciting expectations exist: the new insulin analogues, the technological options, the inhaled and oral insulin and the issue of transplantation.Furthermore, a lively research activity is currently ongoing, in order to make insulin therapy even safer and simpler for patients.

View Article: PubMed Central - PubMed

Affiliation: Obesity Agency, University of Florence Medical School, Careggi Teaching Hospital, Firenze, Italy.

ABSTRACT

Context: Since 2006 a relevant number of therapeutical algorithms for the management of type 2 diabetes have been proposed, generating a lively debate in the scientific community, particularly on the ideal timing for introduction of insulin therapy and on which drug should be preferred as add-on therapy in patients failing to metformin. At the moment, there is no real consensus. The aim of the present review is to summarize established knowledge and areas for debate with respect to insulin therapy in type 2 diabetes.

Evidence acquisition: In type 2 diabetic patients, insulin represents a therapy with a long and well-established history, but, considering the modern insulin therapy, several points must be carefully examined. The role played by the introduction of insulin analogues, the choice of insulin regimens, the ongoing debate on insulin and cancer, the cardiovascular effects of insulin, the role of insulin on β-cell protection and the actual clinical perspective in the treatment of the disease. Nevertheless, still many exciting expectations exist: the new insulin analogues, the technological options, the inhaled and oral insulin and the issue of transplantation.

Conclusions: Although insulin is the more potent hypoglicemic agent, the availability of a wider spectrum of therapeutic agents, many of which are better tolerated than insulin, has reduced the field of application for insulin treatment; presently, insulin is used only in those who cannot maintain an adequate glycemic control with other drugs. Furthermore, a lively research activity is currently ongoing, in order to make insulin therapy even safer and simpler for patients.

No MeSH data available.


Related in: MedlinePlus