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Diabetes mellitus pp 69–82Cite as

Physiologische Grundlagen der Insulinsubstitution

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Summary

Insulin replacement in an insulin deficient state has been a routine treatment since more than 60 years, but the strategy applied remains a conventional pharmacological one for the majority of patients. Attempts to mimic more closely physiological insulin release when designing strategies of insulin replacement were delayed by the success of conventional insulin treatment in reducing the incidence of diabetic ketoacidosis and coma. However, the rising prevalence of diabetes associated complications forced a reappraisal of the available forms of insulin therapy. From this it was concluded that algorithms for more appropriate insulin replacement must be derived from normal endogenous insulin release. Such a strategy perceives basal (=fasting) and prandial insulin requirement as separate and independent entities and requires the patient to correct immediately blood glucose values beyond given target levels. Such functional insulin treatment permits up to 50% of type I diabetic patients to consistently renormalize their HbA1c levels, and helps pregnant type I diabetic patients to maintain near-euglycemia throughout pregnancy. It is the aim of this overview to discuss physiological knowledge of insulin release and carbohydrate metabolism pertinent to the design of a rational strategy for functional insulin treatment.

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Authors
  1. W. Waldhäusl
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Editors and Affiliations

  1. Medizinische Klinik III und Poliklinik, Klinikum der Justus-Liebig-Universität Gießen, Rodthohl 6, 6300, Gießen, Deutschland

    Reinhard G. Bretzel

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© 1990 Springer-Verlag · Heidelberg

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Waldhäusl, W. (1990). Physiologische Grundlagen der Insulinsubstitution. In: Bretzel, R.G. (eds) Diabetes mellitus. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-74610-9_5

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  • DOI: https://doi.org/10.1007/978-3-642-74610-9_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-74611-6

  • Online ISBN: 978-3-642-74610-9

  • eBook Packages: Springer Book Archive

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