[Factors limiting glycaemic control in insulin-treated type 2 diabetes]

Area of Science:

• Endocrinology
• Metabolic Diseases
• Pharmacology

Background:

• Insulin therapy is a cornerstone treatment for diabetes, preventing microvascular complications and potentially reducing cardiovascular risks.
• However, insulin use is linked to increased risks of hypoglycemia and weight gain, and concerns exist regarding intensive therapy and mortality.
• Insulin's mitogenic properties may also deter treatment initiation or intensification.

Purpose of the Study:

• To review evidence on long-term diabetes remission associated with transient intensified insulin therapy initiated at diagnosis.
• To compare the pharmacokinetic profiles and safety of analogue insulins versus human insulins.

Main Methods:

• Literature review of studies on intensified insulin therapy at diabetes diagnosis.
• Pharmacokinetic and clinical trial data analysis comparing analogue and human insulins.

Main Results:

• Evidence suggests that transient intensified insulin therapy at diagnosis can achieve long-term diabetes remission.
• Analogue insulins demonstrate comparable efficacy to human insulins.
• Analogue insulins are associated with a 20-30% lower risk of hypoglycemia compared to human insulins.

Conclusions:

• Transient intensified insulin therapy at diagnosis represents a potential strategy for achieving long-term diabetes remission.
• Analogue insulins provide a safer alternative to human insulins, with reduced hypoglycemia risk and similar efficacy.