Individualized selection of insulin therapy helps achieve glycaemic control in type 1 or type 2 diabetes mellitus

摘要

The development of rapid-acting and long-acting insulin analogues has advanced the treatment of diabetes mellitus. Insulin therapy usually is not required at the onset of type 2 diabetes, but becomes necessary when endogenous insulin production is no longer adequate. In type 1 diabetes, a basal-bolus regimen of insulin therapy is required from the time of diagnosis.While the exogenous insulin available 25 years ago was exclusively animal in origin, the advancement of recombinant DNA genetic engineering has resulted in their use being largely replaced by that of human sequence insulin and more recently by that of human insulin analogues.These new types of insulin have ensured a vast supply of this life-saving medication for diabetic patients. Human sequence insulins produced by recombinant DNA technology are less immunogenic and allergenic than insulin extracted from animal sources; however, they do not result in physiological insulin levels, are not superior to animal-source insulins with regard to glycaemic control, and are shorter acting than the same type of animal-source insulin.