What Is Insulin Therapy?

This post was written with Consensus AI Academic Search Engine – please read our Disclaimer at the end of this article. Insulin therapy is a cornerstone in the management of diabetes mellitus, particularly for individuals with type 1 diabetes (T1D) and those with type 2 diabetes (T2D) who do not achieve adequate glycemic control with oral medications alone. This article explores various aspects of insulin therapy, including its types, administration methods, and its impact on patient outcomes.

Types of Insulin Therapy

Insulin therapy can be categorized into several types based on the timing and duration of action:

1. Prandial Insulin: This type of insulin is administered before meals to manage postprandial blood glucose levels. Studies have shown that recombinant human insulin (rHI) formulated with recombinant human hyaluronidase (INSULIN-PH20) is comparable to insulin lispro for postprandial glucose control in T1D patients3. 
2. Basal Insulin: Basal insulin provides a steady level of insulin to manage blood glucose levels throughout the day and night. It is often used in combination with prandial insulin in a basal-bolus regimen. Basal insulin detemir, for instance, has been shown to be effective when added to oral therapy in T2D patients, although it may result in less optimal glycemic control compared to prandial or biphasic insulin5. 
3. Biphasic Insulin: This is a premixed insulin that includes both basal and prandial components. It is typically administered twice daily and has been shown to be effective in managing blood glucose levels in T2D patients5. 

Methods of Administration

Insulin can be administered through multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) using an insulin pump:

1. Multiple Daily Injections (MDI): This method involves several injections of insulin throughout the day. A study comparing MDI with insulin pump therapy found that both methods are equally effective in managing T2D, although patients often prefer the convenience and flexibility of insulin pumps7. 
2. Insulin Pumps (CSII): Insulin pumps provide continuous insulin delivery and can be combined with glucose sensors for real-time monitoring. Sensor-augmented pump therapy has been shown to significantly improve glycated hemoglobin levels in T1D patients compared to MDI10. 

Impact on Patient Outcomes

Intensive insulin therapy has been associated with various benefits and risks:

1. Critically Ill Patients: Intensive insulin therapy in critically ill patients can reduce morbidity and mortality. For instance, maintaining blood glucose levels between 80 and 110 mg/dL significantly reduced mortality and complications such as bloodstream infections and acute renal failure in surgical ICU patients1. However, its benefits in medical ICU patients are less clear, with significant reductions in morbidity but not mortality2. 
2. Neurological Protection: Intensive insulin therapy has been shown to protect the central and peripheral nervous systems in ICU patients, reducing the risk of critical illness polyneuropathy and dependency on mechanical ventilation6. 
3. Newly Diagnosed T2D: Early intensive insulin therapy in newly diagnosed T2D patients can improve beta-cell function and increase the rate of glycemic remission compared to oral hypoglycemic agents9. 

Conclusion

Insulin therapy is a versatile and essential treatment for diabetes management, offering various types and methods of administration to suit individual patient needs. Intensive insulin therapy, while beneficial in many scenarios, requires careful monitoring to balance its advantages against potential risks. Further research is needed to optimize insulin therapy protocols and improve patient outcomes.

Disclaimer

The content presented in this blog is generated by Consensus, an AI-powered academic search engine, and is based on publicly available scientific literature. While every effort is made to provide accurate, up-to-date, and well-researched information, the content is intended for informational and educational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional before making any decisions regarding medical conditions, treatments, or medications. The AI system’s analysis may not cover all perspectives, emerging research, or individual cases, and it is not a substitute for professional expertise. Neither the blog publisher nor the developers of the AI-powered search engine are responsible for any actions taken based on the information provided in this content. Use of this information is at your own risk. Citations to the original scientific studies are included for reference, but these studies should be reviewed in full and interpreted with the guidance of a healthcare or research professional.

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