[Reliable and new aspects of insulin therapy].

Abstract

New findings concerning the dynamic of insulin secretion, insulin action and pharmacokinetics of insulin preparations have caused a complete change of insulin therapy in diabetes mellitus (basis-bolus-concept). At the same time, the discrepancy between insulin substitution and physiologic conditions becomes evident. Even the use of human insulin or the development of insulin-pens and -pumps does not influence that fact. From the beginning of insulin therapy till now the subcutaneous injection of insulin is the safest and easiest way of application. By means of modified insulins (bioengineering) the physico-chemical process of insulin resorption could be elucidated in the last 4 years. In clinical experiments the intraperitoneal and nasal insulin administration is tested extensively. In the field of the intensified insulin therapy including near normoglycemic therapeutic goals the awareness of hypoglycemia is of particular importance.