Insulin therapy elimination

Ultralente or semilente insulin is used to eliminate nocturnal and early-morning hyperglycemia. Complications of Insulin Therapy... 

To facilitate multiple subcutaneous injections of insulin, particularly during intensive insulin therapy, portable pen-sized injectors have been developed. These contain cartridges of insulin and replaceable needles. Disposable insulin pens are also available for selected formulations. These include regular insulin, insulin lispro, insulin aspart, NPH insulin, and premixed 70%/30% and 50%/50% NPH/regular, 75% NPL/25% lispro, 50% NPL/50% lispro, and 70% NPA/30% aspart insulin. They have been well accepted by patients because they eliminate the need to carry syringes and bottles of insulin to the workplace and while traveling. 

Occasional patients have antibodies to injected insulin, but the significance of the antibodies is minimal. Human insulin therapy has not totally eliminated insulin allergies, although most patients have a local reaction that will dissipate over time. If the allergic reaction does not improve or is systemic, insulin desensitization can be carried out. Protocols for desensitization are available from major insulin manufacturers. While more common in the animal insulin era, lipohypertrophy is still seen in some patients with longstanding type 1 DM. Such patients give their insulin injections in the same site to minimize discomfort. Because insulin absorption from an area of lipohypertrophy is unpredictable, avoidance of injections into these areas is mandatory. 

Insulin therapy has been dramatically effective in eliminating keto-acidotic coma as a cause of death in diabetics. However, while prolonging life, insulin therapy does not prevent the occurrence of disabling complications of chronic diabetes, such as neuropathy, nephropathy, retinopathy and cataracts [ 13-Insulin therapy is only partially effective in normalizing glucose levels, and the occurrence of diabetic complications appears to be related to the severity and duration of diabetic hyperglycaemia. 

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