title: Glycemic management of diabetes by insulin therapy.
abstract: Recent technological innovations as insulin analogue formulation, devices for insulin delivery and glucose monitoring have allowed diabetic patients to improve their glycemic control and decrease their level of burden due to diabetes. Intensive insulin therapy via insulin pens, subcutaneous or intraperitoneal insulin infusions using pumps instead of vials and syringes, are associated with improved absorption reproducibility, HbA1c levels, reduced risk of hypo- or hyperglycemia, and increased quality of patient's life. These currently used systems are discussed in this review as well as the future of exogenous insulin therapy: closed loop system, the artificial pancreas, and oral insulin delivery. Glucose homeostasis is directly linked to glycemic regulated by portal insulin administration, thus endogenous insulin therapy might be the most promising treatment to "cure" diabetes. Consequently, pancreas and islet transplantation, and the bioartificial pancreas are described.
authors: Laboratoire Hormonologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. nathalie.reix@chru-strasbourg.fr
authors: N
authors: N
authors: Reix
authors: S
authors: S
authors: Sigrist
authors: B
authors: B
authors: Heurtault
authors: A
authors: A
authors: Agin
authors: F
authors: F
authors: Moreau
authors: M
authors: M
authors: Pinget
authors: N
authors: N
authors: Jeandidier
mesh_terms: D015415:Biomarkers / Q000097:blood; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007263:Infusions, Parenteral / Q000379:methods; D055104:Infusions, Subcutaneous / Q000379:methods; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D011788:Quality of Life; D015203:Reproducibility of Results; D012306:Risk
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin