[Advantages of insulin Lispro (short-acting) in terminal kidney failure]

Diabetic management of dialysis patients with end-stage renal failure is often problematic. Renal failure interferes with the metabolism of glucose and insulin. Many of these diabetics have wide fluctuations in their daily blood glucose profile. The kinetics of regular insulin may be appreciably prolonged in consequence of the failure of renal insulin degradation, making the dose-effect profile of the insulin difficult to control, and hypoglycemia more likely. Intensified conventional insulin treatment (ICT) using the short-acting insulin, Lispro, facilitates the calculation of insulin requirements and helps to avoid large fluctuations in blood glucose levels. The present case report illustrates these difficulties in a patient on dialysis, and shows how ICT with Lispro can improve the quality of life of diabetics with renal failure.