Insulins

Abstract

In healthy individuals, insulin secretion from the pancreatic beta cells (endogenous) varies throughout the day according to plasma glucose concentration and the behavior of hormones acting on glucose metabolism. By dividing and examining endogenous insulin secretion into two periods, prandial and basal secretions, the insulin treatments for type 2 diabetes mellitus (T2DM) can be determined. Prandial secretion: Rapid and peak insulin secretion (prandial/bolus secretion) in the pancreas in the prandial/early postprandial period prevents postprandial blood glucose from rising above physiological limits. In treating T2DM patients requiring insulin therapy, rapid/shortacting insulins are administered for prandial secretion. Prandial insulin doses consist of two components: insulin (feeding dose) required to keep glucose elevations within physiological limits after meals and insulin needed to correct if the glucose level detected before meals is higher than the target (correction dose). Basal secretion: Non-peaked secretion (basal secretion) regulates hepatic glucose production and glucose metabolism in skeletal muscle and fatty tissues and controls blood glucose levels during fasting periods. In treating T2DM patients who require insulin therapy, medium/long/very long acting insulins are administered for basal secretion. In this section, different insulins used for the treatment of diabetes will be discussed.