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How recombinant insulin analogs improve insulin therapy of diabetes mellitus:pathophysiology, clinical practice and recommendations.

Jan Tatoń, Zvonko Milicevic, Barbara Mozejko-Pastewka, Małgorzata Bernas, Anna Czech, Jan Skrha

Med Sci Monit 2001; 7(4): RA848-859

ID: 421060

According to the latest prognoses, 300 million people are expected to sufferfrom diabetes (particularly type 2) in 2025; diabetes will become a new epidemics of the coming century.Therefore it is so important to get acquainted with the pathomechanism of diabetes-related disordersand the possibilities of effective treatment. During the last decade, numerous prospective epidemiologicalstudies have been completed, which have considerably extended our knowledge of the pathomechanism ofdisturbances and their effect on late complications of diabetes. Resistance to insulin has an importantrole in the etiology of type 2 diabetes. However, there is substantial evidence indicating that impairmentor regression of rapid insulin secretion phase at the early stage of the disease is a factor of no lesserimportance. The lack of appropriate insulin concentration after the stimulation by food ingestion (first30 min after the meal), leads to permanent, treatment-resistant hyperglycemia. The postulated attemptsto obtain a 'nearly normoglycemic' condition, as well as the results of prospective epidemiological studiesproving that achieving this aim improves the prognosis of diabetic patients, prompt the researchers tosearch for the drugs or treatment schedules, which could effectively restore the impaired insulin secretion,and its early phase in particular, in type 2 diabetes. Human insulin analogs and their pre-formulatedcommercially available mixtures seem very promising in this respect.

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