[The new insulins].
The discovery and the use of insulin more than 80 years ago is considered one of the greatest medical breakthroughs of the 20th century. Very rapid progresses led to disposition of very pure and human insulins with different pharmacokinetic profiles. Nevertheless the pharmacokinetics of those conventional rapid and long acting insulin where very far away from the physiological pattern of insulin secretion. It is thus very difficult, using those conventional insulins to obtain a good metabolic control without a very high risk of hypoglycemia. To obtain a good metabolic control and to limit frequent hypoglycemia is essential, on one hand to avoid the apparition and evolution of micro and macroangiopatic complications as well for type 1 as for type 2 diabetic patients, and, on the on the other hand to allow good quality of life for people with diabetes. The use of rapid acting analogues lispro, aspart and glulisine (quicker and shorter action when compared to classical rapid acting insulin) and of long acting analogues glargine and detemir (pharmacokinetic profile without peak of action and very low intra subject coefficient of variability) allowed to reach more easily a good metabolic control with a low risk of hypoglycemia. Progresses are of course still needed to ameliorate the situation of insulin treated diabetic people.
Krzentowski
G
G
Service d'Endocrinologie, C.H.U. de Charleroi, Polyclinique de La Madeleine.
D048909:Diabetes Complications / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D012307:Risk Factors
D007004:Hypoglycemic Agents; D007328:Insulin