Comparing Normal Insulin Physiology and Insulin Dysfunction in Diabetes Mellitus: Constructing Optimal Insulin-Based Regimens

Guest: Janet B. McGill, MD, MA, FACE

The Centers for Disease Control and Prevention estimates that 9.3% of the US population has diabetes mellitus (DM), and that 27.8% of this population has undiagnosed DM. Patients with DM have twice the medical costs of those without DM, and the direct financial burden on the US healthcare system was $176 billion in 2012. All individuals with type 1 DM (5% of the diabetic population) require insulin to control blood glucose levels; in addition, many individuals with type 2 DM require insulin as the disease progresses. Exogenous insulin is available in rapid-, short-, intermediate-, and long-acting formulations, and the goals of therapy are to mimic endogenous insulin while reducing the risk for adverse events and complications. New routes of administration, such as oral and buccal, and new longer-acting insulins are in development to improve and optimize diabetes management. It is vital for clinicians who manage DM to have a thorough understanding of insulin therapy, including insulin physiology and its dysfunction seen in DM; an overview on current and emerging insulin therapies; and best practices on constructing insulin-based treatment regimens. This interactive activity will provide information on insulin physiology in individuals without DM, the physiologic dysfunction of insulin seen in patients ...