Insulin Therapy In Type1DM

Insulin Therapy In Type1DM

H. Delshad  M.D

Endocrinologist

Research Institute For Endocrine Sciences

Pulsatile insulin secretion

Insulin is normally secreted in coordinated secretory bursts.

In humans, pulses occur about every 10 minutes.

After oral ingestion of glucose (arrow), which produces a glucose stimulus and an incretin effect, an increase in the amplitude of the bursts is seen, as well as an increase in frequency, with intervals decreasing from about 7 to 5 minutes.

Insulin therapy in T1 DM: Key points

50. Discovery of Insulin in 1921 provided a life- sustaining therapy for a previously fatal wasting condition.
50. Insulin dramatically shifted the prognosis of T1DM to that of a chronic disease characterized by devastating long-term micro-and macro vascular complications.
50. The focus of treatment has changed significantly since 1922, with emphasis now directed toward the avoidance of complications and optimization of patient quality of life.
50. The DCCT and other studies have provided adequate evidence that there is a direct relationship between HbA1c  and progression of diabetic complications and optimization of glycemic control can significantly reduce the risk of vascular complications.