Effects of Periodic Intensive Insulin Therapy: An Updated Review.

Area of Science:

• Endocrinology and Metabolism
• Pharmacology
• Diabetology

Background:

• Conventional diabetes treatments like subcutaneous insulin and oral hypoglycemics fail to replicate physiological pulsatile insulin secretion.
• Advanced diabetes complications lack effective treatment options due to the insufficiency of current therapies.
• Intensive Insulin Therapy (IIT) aims to mimic normal pancreatic function, but its mechanisms are not fully understood.

Purpose of the Study:

• To review the pathophysiology of insulin secretion.
• To discuss current diabetes management therapies.
• To provide updates on IIT advancements and propose its mechanism of action.

Main Methods:

• Comprehensive literature search of PubMed, MEDLINE, Embase, and CrossRef databases.
• Inclusion of articles on insulin secretion, pulsatile insulin delivery, conventional therapies, transplantation, and IIT clinical trials.
• Qualitative analysis and categorization of findings related to insulin secretion mechanisms and diabetes management.

Main Results:

• Intensive Insulin Therapy (IIT) demonstrates efficacy in resolving diabetic ulcers, neuropathy, and nephropathy.
• IIT has been shown to reduce emergency room visits for diabetes-related issues.
• Proposed mechanisms for IIT's effectiveness include increased adipocyte insulin sensitivity and enhanced insulin receptor expression.

Conclusions:

• Recent advancements confirm IIT as a viable and effective treatment for both type 1 and type 2 diabetes mellitus.
• IIT's close simulation of normal pancreatic function significantly mitigates common diabetes complications compared to standard treatments.
• IIT represents a promising advancement in the comprehensive management of diabetes mellitus.