Current perspective in insulin therapy in the management of diabetes mellitus

Area of Science:

• Endocrinology
• Pharmacology

Background:

• Insulin therapy, since 1922, is crucial for managing diabetes, restoring normal blood glucose levels, and preventing complications.
• Oral hypoglycemic agent (OHA) failure is a primary reason for initiating insulin therapy in type-2 diabetes.
• Insulin is also vital for diabetic patients with kidney or liver disease when OHAs are contraindicated.

Purpose of the Study:

• To review the efficacy and indications of insulin therapy in diabetes management.
• To compare the properties and administration of different insulin types.
• To evaluate the comparative efficacy of human versus animal insulin.

Main Methods:

• Literature review of insulin therapy, its indications, and types.
• Pharmacological properties and administration methods of various insulins were analyzed.
• Comparative efficacy of human and animal insulin was assessed based on existing evidence.

Main Results:

• Insulin therapy effectively normalizes blood glucose, suppresses ketogenesis, and delays diabetic complications.
• Common indications include type-2 diabetes with OHA failure and contraindications for OHAs in renal or hepatic disease.
• Human insulin efficacy is well-established, with no evidence suggesting animal insulin inferiority.

Conclusions:

• Insulin remains a cornerstone therapy for diabetes, offering significant benefits in glycemic control and complication prevention.
• Different insulin formulations and administration methods cater to varied patient needs.
• Both human and animal insulins are effective, challenging any perceived superiority of human insulin.