| Abstract: |
This article is part of a 12-part series for physicians in training that reviews the fundamentals of diabetes care; this article summarizes the use of insulin and Incretins. The author notes that insulin has been combined with additives and modified at the molecular level to changes its pharmacokinetic properties. Some insulin preparations accelerate insulin’s effects in the bloodstream, and others prolong the pharmacokinetic profile. The author describes specific drugs, including regular insulin, insulin analogs, inhaled insulin, protamine solutions, zinc solutions, and long-acting insulin analogs, including glargine and detemir. The article outlines standard insulin regimens, newer insulin regimens, the approach to initiating insulin therapy, and the use of incretins, such as exenatide, and the amylin analog, pramlintide. The author emphasizes that good understanding of the pharmacokinetics of insulin action and proper management on insulin regimens allow health care providers and patients to control blood glucose levels and safely avoid hypoglycemia and hyperglycemia. 32 references. |