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Type I diabetes and insulin therapy

I B Hirsch¹, R Farkas-Hirsch

¹University of Washington Diabetes Care Center, Seattle.

The Nursing Clinics of North America

|March 1, 1993

Summary

Intensive insulin therapy, a comprehensive diabetes management program, involves multiple insulin regimens. Understanding pharmacokinetic factors like absorption differences and injection site effects is crucial for effective type 1 diabetes treatment.

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Area of Science:

Endocrinology
Pharmacology
Diabetes Management

Background:

Intensive insulin therapy is a cornerstone of diabetes management.
It involves complex insulin regimens, requiring careful consideration of pharmacokinetic properties.

Purpose of the Study:

To review the pharmacokinetic considerations essential for prescribing insulin.
To discuss the advantages and disadvantages of various insulin regimens for type 1 diabetes.
To highlight the potential benefits of Continuous Subcutaneous Insulin Infusion (CSII).

Main Methods:

Literature review of pharmacokinetic issues related to insulin therapy.
Analysis of different insulin regimens, including traditional multiple injections and CSII.
Discussion of factors influencing insulin absorption.

Main Results:

Key pharmacokinetic factors influencing insulin absorption include insulin type (animal vs. human), intraindividual variability, injection site, and lag time.
Physiologic insulin regimens are recommended for type 1 diabetes.
Continuous Subcutaneous Insulin Infusion (CSII) offers theoretical advantages for many patients.

Conclusions:

Effective intensive insulin therapy requires a thorough understanding of insulin pharmacokinetics.
Healthcare professionals, particularly nurse specialists, must be knowledgeable about insulin regimens and diabetes algorithms.
Individualized treatment plans considering patient-specific factors are essential for optimal diabetes control.

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