Insulin: Rates and Routes of Delivery

Abstract

Treatment of the diabetic patient with insulin can generally be considered in the context of two clinical situations: the management of acute, severe disorders of carbohydrate metabolism (ketoacidosis and hyperosmolar coma) and the long-term regulation of blood glucose concentration. For the former, the goal is rapid repletion of insulin, fluid, and electrolyte deficits. The optimal long-term objectives in the insulin-treated diabetic patient include not only reduction of blood glucose to normal but prevention of microangiopathy as well. Current trends and research suggest that the management of both situations, which has varied little since the introduction of insulin over 50 years . . .