Abstract
Impaired insulin secretion, although to different degrees, is present in all forms of diabetes mellitus. Thus insulin treatment is de facto an endocrine substitutive therapy in diabetes and it could be indicated in all forms of the disease. Of course insulin treatment is mandatory in type 1 diabetes, but it is also strongly advised in gestational diabetes, and it is still one of the most rationale options in type 2 diabetes. Since the discovery of insulin and its first clinical use in 1923, insulin therapy is greatly evolved, and the use of the most modern insulin analogues in combination allows today achievement of much more physiological glucose profiles with less and less hypoglycemia risk in subjects with diabetes. These advancements are reviewed in this chapter, together with risks, side effects, and limitations that still make insulin treatment a complex therapy. Insulin treatment needs to be coupled with appropriate patient education and empowerment. Self blood glucose monitoring must be carefully implemented and diet and lifestyle need to be optimized. However, the final goal of the joined efforts of patients and caregivers is to adapt treatment to life and not life to treatment. Progresses in insulin treatment are taking us very close to this goal.
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Consoli, A. (2018). Insulin Treatment. In: Bonora, E., DeFronzo, R. (eds) Diabetes Epidemiology, Genetics, Pathogenesis, Diagnosis, Prevention, and Treatment . Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-45015-5_21
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