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Insulin's Role in Diabetes Management: After 90 Years, Still Considered the Essential "Black Dress"

It has been 93 years since Banting and Best extracted insulin in Scottish physiologist J.J.R. Macleod’s laboratory and, with the help of their fellow Canadian chemist James B. Collip, used it to successfully treat a cachectic boy, Leonard Thompson, who suffered from life-threatening diabetes. Since... Full description

Journal Title: Diabetes care December 2015, Vol.38(12), pp.2200-3
Main Author: Cefalu, William T
Other Authors: Rosenstock, Julio , Leroith, Derek , Riddle, Matthew C
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: E-ISSN: 1935-5548 ; PMID: 26604276 Version:1 ; DOI: 10.2337/dci15-0023
Link: http://pubmed.gov/26604276
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recordid: medline26604276
title: Insulin's Role in Diabetes Management: After 90 Years, Still Considered the Essential "Black Dress"
format: Article
creator:
  • Cefalu, William T
  • Rosenstock, Julio
  • Leroith, Derek
  • Riddle, Matthew C
subjects:
  • Medicine
ispartof: Diabetes care, December 2015, Vol.38(12), pp.2200-3
description: It has been 93 years since Banting and Best extracted insulin in Scottish physiologist J.J.R. Macleod’s laboratory and, with the help of their fellow Canadian chemist James B. Collip, used it to successfully treat a cachectic boy, Leonard Thompson, who suffered from life-threatening diabetes. Since that time, insulin therapy has become the mainstay of treatment for patients with type 1 diabetes and a cornerstone therapy for many individuals with type 2 diabetes. Over the years, many changes in insulin therapy have occurred, including new formulations, new delivery systems, and additional therapeutic tactics. We are on the brink of a new and exciting era with increasingly reliable and easy-to-use continuous glucose monitoring as part of a closed-loop delivery system. This new “artificial pancreas” system, with its carefully modulated insulin (which remains the key component), may soon be ready for clinical use. In addition, an impressive array of new oral and injectable agents for type 2 diabetes has been developed over the past 20 years. Many thought that these could replace injected insulin in a therapeutic regimen, or at least delay its use. Yet, the reality is that insulin will always be needed for type 1 diabetes until a cure is found and progressive insulin deficiency is a fundamental defect of type 2 diabetes. Furthermore, supplementation of endogenous insulin continues to be necessary for large numbers of individuals with type 2 diabetes. Meanwhile, the other classes of therapeutic agents are vying for a strategic position alongside insulin in clinical regimens for type 2 diabetes, and there is an unmet need for adjuvant therapies to mitigate the treatment challenges in type 1 diabetes as well. To dramatize the continuing role of insulin in the management of diabetes, we propose an analogy from the world of clothing and fashion: Insulin is and will remain …
language: eng
source:
identifier: E-ISSN: 1935-5548 ; PMID: 26604276 Version:1 ; DOI: 10.2337/dci15-0023
fulltext: fulltext
issn:
  • 19355548
  • 1935-5548
url: Link


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descriptionIt has been 93 years since Banting and Best extracted insulin in Scottish physiologist J.J.R. Macleod’s laboratory and, with the help of their fellow Canadian chemist James B. Collip, used it to successfully treat a cachectic boy, Leonard Thompson, who suffered from life-threatening diabetes. Since that time, insulin therapy has become the mainstay of treatment for patients with type 1 diabetes and a cornerstone therapy for many individuals with type 2 diabetes. Over the years, many changes in insulin therapy have occurred, including new formulations, new delivery systems, and additional therapeutic tactics. We are on the brink of a new and exciting era with increasingly reliable and easy-to-use continuous glucose monitoring as part of a closed-loop delivery system. This new “artificial pancreas” system, with its carefully modulated insulin (which remains the key component), may soon be ready for clinical use. In addition, an impressive array of new oral and injectable agents for type 2 diabetes has been developed over the past 20 years. Many thought that these could replace injected insulin in a therapeutic regimen, or at least delay its use. Yet, the reality is that insulin will always be needed for type 1 diabetes until a cure is found and progressive insulin deficiency is a fundamental defect of type 2 diabetes. Furthermore, supplementation of endogenous insulin continues to be necessary for large numbers of individuals with type 2 diabetes. Meanwhile, the other classes of therapeutic agents are vying for a strategic position alongside insulin in clinical regimens for type 2 diabetes, and there is an unmet need for adjuvant therapies to mitigate the treatment challenges in type 1 diabetes as well. To dramatize the continuing role of insulin in the management of diabetes, we propose an analogy from the world of clothing and fashion: Insulin is and will remain …
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