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Clin Cornerstone. 2001;4(2):50-64.

Insulin therapy: optimizing control in type 1 and type 2 diabetes.

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  • 1University of Texas Southwestern Medical Center at Dallas, Dallas Diabetes and Endocrine Center, Dallas, Texas, USA.


Insulin has been available for therapeutic use for more than 75 years and remains a powerful pharmacologic tool with nearly unlimited potential to lower plasma glucose levels in patients with diabetes. Required essentially by all patients with type 1 diabetes and many patients with type 2 diabetes, insulin is capable of restoring near-normoglycemia--the primary treatment goal to forestall the onset and progression of long-term complications. Attainment and maintenance of near-normal glycemic control can be achieved with the use of insulin replacement strategies designed to simulate the physiologic, nondiabetic patterns of insulin secretion in response to 24-hour postabsorptive and postprandial glucose profiles. This article reviews the physiologic basis and current therapeutic agents for optimal insulin replacement and provides practical clinical guidelines and strategies to achieve near-normal glycemic control in patients with either type 1 or type 2 diabetes.

[PubMed - indexed for MEDLINE]
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