Vnitr Lek 2013, 59(6):440-443

Up-to-day trends in insulin therapy

A. Adamíková^*, J. Rybka

Diabetologické centrum, koordinátorka MUDr. Alena Adamíková, Ph.D., Interní klinika IPVZ Krajské nemocnice T. Bati, a.s., Zlín, přednosta prim. MUDr. Jiří Latta

Patients with type 2 diabetes mellitus have a double risk of development of cardiovascular diseases than patients without diabetes. Two thirds of patients with type 2 diabetes mellitus can die from heart attack or a cerebrovascular accident if it is not possible to influence these risks by procedures such as decreasing the blood pressure, cholesterol level, glycemia and to stop smoking. The recommendations of ADA/EASD for therapy of type 2 diabetes mellitus emphasizes that the therapy should be conducted in such a manner as to decrease the risk of cardiovascular complications and undesirable effects, primarily hypoglycemic events. A whole line of clinical studies, e. g. DCCT-EDIC, UKPDS have documented the importance of intensive insulin therapy for achievement of normoglycemia, decreasing risk of microangiopathic complications and in follow-up observation, also decreasing of cardiovascular risk. An ORIGIN study with insulin glargine documented the safety of therapy of long-acting insulin analog and also reduction of development of new diabetes from pre-diabetes. Insulin therapy with respect to the positive outcomes of study with insulin analogs moved up to the second line in algorithm therapy, immediately after metformin therapy and change of life style.

Keywords: insulin analogs; type 2 diabetes mellitus; hypoglycemia; cardiovascular diseases

Received: April 30, 2013; Published: June 1, 2013  Show citation