Therapy with insulin

Abstract

The aim of the present chapter is to describe insulin treatment in diabetic patients. Since the Diabetes Control and Complications Trial and the United Kingdom Prospective Survey Study, it has been recommended intensive treatment of type 1 and type 2 diabetes patients to achieve good control and avoid chronic complications secondary to poor metabolic control. The recommended therapy of type 1 diabetes patients consists of intensive insulin treatment (basal-bolus), using multiple daily insulin injections (three to four injections per day of basal and prandial insulin) or continuous subcutaneous insulin infusion therapy. To type 2 diabetes patients is recommended initially to begin changes in lifestyle (diet, cholesterol control, weight reduction, blood pressure control, physical activity and tobacco avoidance) associated to metformin and, if good control is not achieved another therapy must be implemented (insulin, sulfonylurea, thiazolidinedione (pioglitazone), or DPP-4 inhibitors). In this chapter we review different ways of insulin treatment in type 1 and type 2 diabetes patients.