Insulin Use

  • Ronald A. Codario
Chapter
Part of the Current Clinical Practice book series (CCP)

Abstract

Several clinical trials covering thousands of patient cohorts have clearly demonstrated the correlation between the long-term macro and microvascular complications of diabetes and poorly controlled blood glucose with the subsequent benefits of tighter glycemic control. This data has made us all much more aware that insulin, used even in the early stages of diabetes, to insure proper control, can be invaluable in reducing mortality and morbidity. In fact, earlier insulin use reduces glucose toxicity, allows endogenous insulin to function more efficiently and reduces the strain on the deteriorating beta cell [1].

Key Words

Insulin therapy Human insulin preparations Insulin analogs Intermediate-acting insulins Pre-mixed insulins Biphasic insulins Multiple daily injections (MDI) Infusion pumps General therapeutic principles 

References

  1. 1.
    Bastyr EJ, et al. Therapy focused on lowering postprandial glucose, not fasting glucose, may be superior for lowering A1C. Diabetes Care. 2000;23:1236–1241.PubMedCrossRefGoogle Scholar
  2. 2.
    Mudulair S, Edelman SV. Insulin therapy in type-2 diabetes. Endocrinol Metab Clin North Am. 2001;30:935–982.CrossRefGoogle Scholar
  3. 3.
    Nathan DM, Buse JB, Davidson MB. American Diabestes Association: European Association for Study of Diabetes. Medical management of hyperglycemia in type-2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. Diabetes Care. 2006;29(8):1963–1972.Google Scholar
  4. 4.
    Mayfield J, White RD. Insulin therapy for type-2 diabetes: rescue, augmentation and replacement of beta cell function. Am Fam Physician. 2004;70:489–500.PubMedGoogle Scholar
  5. 5.
    Burge MR, Schade DS. Insulins. Endocrinol Metab Clin North Am. 1997;26:575–598.PubMedCrossRefGoogle Scholar
  6. 6.
    Kudlacek S, et al. The effect of insulin treatment on HbA1C, body weight and lipids in type 2 diabetic patients with secondary failure to sulfonylureas. Horm Metab Res. 1992;24:478–483.PubMedCrossRefGoogle Scholar
  7. 7.
    American Diabetes Assoicaiton. Standards of medical care for patients with diabetes mellitus. Diabetes Care. 2002;25(suppl 1):S33–S49.Google Scholar
  8. 8.
    Hermann LS. Optimizing therapy for insulin treated type 2 diabetes mellitus. Drugs Aging. 2000;17:283–294.PubMedCrossRefGoogle Scholar
  9. 9.
    United Kingdom Prospective Diabetes Study group. (1998). A randomized trial of efficacy of addition of metformin to sulfonylurea. Diabetes Care. 21:87–92.CrossRefGoogle Scholar
  10. 10.
    The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on development and progression of long term complications in insulin dependent diabetes mellitus. N Engl J Med. 1993;329:977–986.CrossRefGoogle Scholar
  11. 11.
    Van den Berghe G, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2002;346:1587–1588.Google Scholar
  12. 12.
    Bastyr EJ, Stuart CA, Brodows RG. Therapy focused on lowering postprandial glucose, not fasting glucose, may be superior for lowereing A1C. Diabetes Care. 2000;23:1236–1241.PubMedCrossRefGoogle Scholar
  13. 13.
    DeVeciana M, et al. Targeting postprandial glucose in gestational diabetics improves HbA1C outcomes over 6 weeks. N Engl J Med. 1995;333:1239.Google Scholar
  14. 14.
    Mudaliar S, Edelman SV. Insulin therapy in type 2 diabetes. Endocrinol Metab Clin North Am. 2001;30:935–982.PubMedCrossRefGoogle Scholar
  15. 15.
    Rosenstock J, et al. Basal insulin therapy in type 2 diabetes: 28 week comparison of insulin glargine and NPH insulin. Duiabetes Care. 2001;24:631–636.CrossRefGoogle Scholar
  16. 16.
    Unger J. Targeting glycemic controlin the primary care setting. Female Patient. 2003;28:12–16.Google Scholar
  17. 17.
    Heller S, Kurtzhals P, et al. Insulin aspart: promising early results borne out in clinical practice. Expert Opin Pharmacother. 2002;3:183–195.PubMedCrossRefGoogle Scholar
  18. 18.
    Antsiferov M, et al. Within patient variability in postprandial glucose excursion with lispro insulin analog compared with regular insulin. Diabetologia. 1995;38(suppl 1):A190.Google Scholar
  19. 19.
    Home PD, et al. Insulin Aspart Study Group. Improved glycemic control with insulin aspart: a multicenter randomized double blind crossover trial in type 1 diabetic patients. Diabetes Care. 1998;21:1904–1909.Google Scholar
  20. 20.
    Rolla A. Pharmacokinetic and pharmacodynamic advantages of insulin analogues and premixed insulin analogues over human insulins. Am J Med. 2008;121:S9–S19.PubMedCrossRefGoogle Scholar
  21. 21.
    Holleman F, et al. Comparison of Lispro and regular human insulin in the correction of incidental hyperglycemia. Diabetes Care. 1996;19:1426–1429.PubMedCrossRefGoogle Scholar
  22. 22.
    Schreiber SA, Haak T. Insulin glargine benefits patients with type-2 diabetes inadequately controlled on oral antidiabetic treatment. Diabetes Obes Metab. 2007;9:31–38.PubMedCrossRefGoogle Scholar
  23. 23.
    Raskin P, et al. A 16 week comparison of the novel analog insulin glargine and NPH insulin used with insulin lispro in patients with type 1 diabetes. Diabetes Care. 2000;23:1666–1671.PubMedCrossRefGoogle Scholar
  24. 24.
    Heinemann L, Linkeschova R, Rave K. Time-action profile of the long acting insulin analog insulin glargine. Diabetes Care. 2000;23:644–649.PubMedCrossRefGoogle Scholar
  25. 25.
    Lepore M, et al. Pharmacokinetics and parmacodynamics of subcutaneous injection of long acting human insulin glargine, NPH insulin, and ultralente human insulin and continuous subcutaneous infusion of insulin lispro. Diabetes. 2000;23:1137–1142.Google Scholar
  26. 26.
    Rosenstock J, Schwartz SL, Clark CM. Basal Insulin therapy in type-2 diabetes: 28 week comparison of insulin glargine and NPH insulin. Diabetes Care. 2001;24:631–636.PubMedCrossRefGoogle Scholar
  27. 27.
    Rosenstock J. Treatment of target study:glargine or NPH in insulin naïve patients with type-2 diabetes on oral agents. Diabetes. 2001;50(suppl 2):A129. Abstract 520-P.Google Scholar
  28. 28.
    Kelly JI, et al. Rapid decrease in clinically significant hypoglycemia with insulin glargine. Diabetes. 2002;51(suppl 2):A123.Google Scholar
  29. 29.
    Jonasson JM, Ljung R, Talbäck M. European Association for the Study of Diabetes. Insulin glargine and malignancy. Diabetologia. 2009:1418–1440.Google Scholar
  30. 30.
    Klein O, Lynge J, Endahl L. Insulin detemir and insulin glargine: similar time action profiles in subjects with type-2 diabetes. Diabetes. 2006;55(9 suppl):325.Google Scholar
  31. 31.
    Rosenstock J, Davies M, Home PD, Larsen J, Koenen C, Schernhaner G. A randomized 52 week treat to target trial comparing insulin detimir with insulin glargine when administered as add on to glucose lowering drugs in insulin naïve people with type-2 diabetes. Diabetologia. 2008;51:408–416.PubMedCrossRefGoogle Scholar
  32. 32.
    Meneghini L, Koenen C, Weng W, Selam JL. The usage fo a simplified self titration dosing guideline for insulin detimir in patients with type-2 diabetes – the PREDICTIVE study. Diabetes Obes Metab. 2007;357:1716–1730.Google Scholar
  33. 33.
    Luddeke HJ, Philotheou A, Horn-rosenberg K. PREDICTIVE: a global, prospective observational study to evaluate insulin detimir treatment in type1 and type 2 daibetes. Diabet Med. 2006;23(suppl 4):139.Google Scholar
  34. 34.
    Nathan DM, Buse JB, Davidson MD. Medical management of hyperglycemia in type 2 diabetes. Diabetes Care. 2009;32(1):193–203.PubMedCrossRefGoogle Scholar
  35. 35.
    Kovisto VA, Tuominen JA, et al. Lispro mix insulin as pre-meal therapy in type 2 diabetic patiens. Diabetes Care. 1999;22:459–462.CrossRefGoogle Scholar
  36. 36.
    Malone JK, et al. Improved postprandial glycemic control with Humalog Mix 75/25 after a standard test meal in patients with type 2 diabetes mellitus. Clin Ther. 2000;22:222–230.PubMedCrossRefGoogle Scholar
  37. 37.
    MassiBenedetti M, Humburg E, Dressler A, Ziemen M. A one year, randomized, muldticentre trial comparing insulin glragine with NPH insulin in combination with oral agents in patients with type-2 diabetes. Horm Metab Res. 2003;35:189–196.PubMedCrossRefGoogle Scholar
  38. 38.
    Yki-Jarvinen H, Ryysy L, Kauppila M, Kujansuu E, Lahti J. Effect of obesity on the response to insulin therapy in non-insulin dependent diabetes mellitus – The FINMIS study. J Clin Endocr Metab. 1997;82(12):4037–4043.PubMedCrossRefGoogle Scholar
  39. 39.
    Riddle MC, Rosenstock J, Gerich J. The Treat to Target trial. Diabetes Care. 2003;26:3080–3086.PubMedCrossRefGoogle Scholar
  40. 40.
    Cefalu WTR. Novel routes of insulin delivery for patients with type 1 or type 2 diabetes. Ann Med. 2001;33:579–586.PubMedGoogle Scholar
  41. 41.
    Stewart KM. Insulin delivery devices. J Pharm Pract. 2004;17:20–28.CrossRefGoogle Scholar
  42. 42.
    Wilson M, Weintreb J, Hoo GW. Intensive insulin therapy in critical care. Diabetes Care. 2007;30:1005–1011.PubMedCrossRefGoogle Scholar
  43. 43.
    Cook CB, Boyle ME, Cisar NS. Use of continuous subcutaneous insulin infusion/insulin pump therapy in the hospital setting. Diabetes Educ. 2006;32:130. Diabetes Educ. 2005;31:849–857.Google Scholar
  44. 44.
    Palumbo P. The case for insulin treatment early in type 2 diabetes. Clev Clin J Med. 2004;71(5):385–386.Google Scholar
  45. 45.
    Owens DR, Zinman B, Insulins today and beyond. Lancet. 2004;71(5):385–386.PubMedCrossRefGoogle Scholar

Supplementary Readings

  1. Boehm BO, et al. Premixed insulin aspart 30 vs. premixed human insulin 70/30 twice daily: a randomized trial in type 1 and type 2 diabetic patients. Diabet Med. 2002;19:393–399.PubMedCrossRefGoogle Scholar
  2. Dornhorst A, Luddeke HJ, Sreenan S. Safety and efficacy of insulin detimirin clinical practice. Int J Clin Pract. 2007;61:523–528.PubMedCrossRefGoogle Scholar
  3. Hermann L. Combination therapy with insulin and metformin (The Fin-Fat Study). Endocr Pract. 1998;4(6).Google Scholar
  4. Hirsch IB, et al. Role of insulin in management of surgical patients with diabetes mellitus. Diabetes Care. 1990;13:980–991.PubMedCrossRefGoogle Scholar
  5. Home P, Kurtzhals P. Insulin detimir: from concept to clinical experience. Expert Opin pharmacother. 2006;7:325–343.PubMedCrossRefGoogle Scholar
  6. Meneghini LF, Rosenberg KH, Loenen C. Insulin detimir improves glycemic control with less hypoglycemia and no weight gain in patients with type-2 diabetes. Diabetes Obes Metab. 2007;9:418–427.PubMedCrossRefGoogle Scholar
  7. Ordoubadi FF, et al. Glucose-insulin-potassium therapy for treatment of acute myocardial infarction: an overview of randomized placebo-controlled trials. Circulation. 1997;96:1152–1156.CrossRefGoogle Scholar
  8. Raslova K, Bogoev M, Raz I. Insulin detemir and insulin aspart. Diabetes Res Clin Pract. 2004;66:193–201.PubMedCrossRefGoogle Scholar
  9. Standl E. Insulin analogues-state of the art. Horm Res. 2002;57(suppl 1):4045.Google Scholar
  10. Van den Berghe G, Wouters P, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345:1359–1367.PubMedCrossRefGoogle Scholar
  11. Queale WS, et al. Glycemic control and sliding scale insulin use in medical inpatients with diabetes mellitus. Arch Intern Med. 1997;157:545–552.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Ronald A. Codario
    • 1
  1. 1.University of Pennsylvania Health System Thomas Jefferson University HospitalPhiladelphiaUSA

Personalised recommendations