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A Journal on Endocrine System Diseases

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Minerva Endocrinologica 2013 March;38(1):29-46

language: English

Glycemic management of diabetes by insulin therapy

Reix N. 1, 2, Sigrist S. 3, Heurtault B. 1, 4, Agin A. 1, 2, Moreau F. 3, 5, 6, Pinget M. 3, 5, 6, Jeandidier N. 3, 5, 6

1 Laboratoire Hormonologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France;
2 Université de Strasbourg/CNRS, ICube UMR 7357, Fédération de Médecine Translationnelle de Strasbourg, Institut de Physique Biologique, Strasbourg, France;
3 DIATHEC, Centre Européen d’Etude du Diabète, Université de Strasbourg, Strasbourg, France;
4 Equipe de Biovectorologie, Laboratoire de Conception et Application de Molécules Bioactives, UMR 7199 CNRS/Université de Strasbourg, Illkirch, France;
5 Structure d’Endocrinologie, Diabète-Nutrition et Addictologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France;
6 Université de Strasbourg, Strasbourg, France


Recent technological innovations as insulin analogue formulation, devices for insulin delivery and glucose monitoring have allowed diabetic patients to improve their glycemic control and decrease their level of burden due to diabetes. Intensive insulin therapy via insulin pens, subcutaneous or intraperitoneal insulin infusions using pumps instead of vials and syringes, are associated with improved absorption reproducibility, HbA1c levels, reduced risk of hypo- or hyperglycemia, and increased quality of patient’s life. These currently used systems are discussed in this review as well as the future of exogenous insulin therapy: closed loop system, the artificial pancreas, and oral insulin delivery.
Glucose homeostasis is directly linked to glycemic regulated by portal insulin administration, thus endogenous insulin therapy might be the most promising treatment to “cure” diabetes. Consequently, pancreas transplantation, islet engrafment and the bioartificial pancreas are described.

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