Journal Mobile

AJ Graveling, EA McIntyre
Journal Issue: 
Volume 39: Issue 2: 2009




Insulin  therapy  remains  the  cornerstone  of  treating  patients  with diabetes  mellitus. All  patients  with Type  1,  and  many  with Type  2,  diabetes  are treated with insulin. This article describes the discovery and evolution of insulin preparations and discusses current analogue, standard human and animal insulin
preparations available for prescription in the UK, highlighting the advantages and disadvantages  of  the  various  preparations. An  overview  of  initiating  insulin therapy and typical insulin doses and regimes is given. To update general physicians, the  necessary  adjustments  of  insulin  therapy  for  intercurrent  illness  are  briefly considered. There is an array of different insulin delivery devices for subcutaneous
insulin  injection,  which  can  be  confusing,  and  the  general  advantages  and disadvantages  of  such  devices  are  examined.  Recent  insulin  delivery  device advances  include  the  modern  continuous  subcutaneous  insulin  infusion  devices or external insulin pumps. Advances in this field are rapid and strive towards the development of a closed loop insulin delivery device. Continuous subcutaneous insulin infusion devices are discussed along with the existing guidelines for their use  in  the  UK.  Currently  continuous  subcutaneous  insulin  infusion  therapy  is more  widely  used  in  other  countries  compared  with  the  UK.  Finally,  future possible  methods  and  routes  of  insulin  delivery  are  reviewed,  including  inhaled, closed loop pump or oral.