[Insulin therapy for type 1 diabetes mellitus: past and present].
The discovery of insulin can be considered the milestone of diabetes mellitus history and a great achievement for its treatment. The first insulin available was the regular. Afterwards, Hagedorn added the protamine to the insulin, thus, creating the NPH insulin. In the 1950s an insulin free of protamine was synthesized: the lente insulin. With the advent of molecular biology, synthetic human insulin was synthesized using recombinant DNA technology. Most recently several types of insulin analogues were available, providing the patients with better metabolic control. Type 1 diabetes mellitus treatment includes plain substitution and individualization for short-acting plus long-acting insulin according to the physician's assistance, besides regular practice of physical activities and diet orientations. In type 1 diabetes mellitus the insulin of low variability is the best choice since basal/bolus insulin therapy or continuous subcutaneous insulin infusion pump can mimetize the physiological release of insulin by beta cells.
Pires
Antonio Carlos
AC
Faculdade de Medicina de São José do Rio Preto. fpires@terra.com.br
Chacra
Antonio Roberto
AR
D000293:Adolescent; D002675:Child, Preschool; D018849:Controlled Clinical Trials as Topic; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004334:Drug Administration Schedule; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000031:analogs & derivatives / Q000627:therapeutic use*; D007336:Insulin, Isophane / Q000627:therapeutic use; D049528:Insulin, Long-Acting / Q000627:therapeutic use; D019518:Postprandial Period / Q000187:drug effects; D013997:Time Factors; D055815:Young Adult
D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D007336:Insulin, Isophane