December 2013, Volume 63, Issue 12

Editorial

Insulin Glargine - another gift for people with diabetes

Dr. Fatema Jawad

Insulin has been called the "Gift of Life" for people with Diabetes especially Type 1 Diabetes. Its discovery by Frederick Banting and Charles Best in 1921 brought a revolution in the history of medicine. Initially it was a crude pancreatic extract which gave back life and health to many children. Research continued to find better and improved insulins and the quest moved ahead. Animal insulins were improved to become less antigenic and were eventually replaced by synthetic insulins with a human formula. The search for new insulins led to the discovery of Insulin Analogues, which were less antigenic and provided bette

Message

Professor M. Zaman Shaikh

The potential advantages of the long-acting insulin analogues are reviewed in this special supplement of Journal of Pakistan Medical Association (JPMA).
Minimizing the risk of hypoglycemia while preventing the devastating complications of T2DM is a significant challenge facing primary care providers. The frequency of hypoglycemia in T2DM is difficult to quantify due to the heterogeneity of study populations and differing definitions of hypoglycemia. It appears, however, that the frequency of hypoglycemic events is rising due to the increasing use of insulin in T2DM in order to achieve target A1C levels. Extensive clinica

Message

Dr. Khursheed Khan

Type II diabetes mellitus is a progressive disorder which can be managed with oral antidiabetic initially but eventually most patients require insulin to maintain glucose control. Optimal insulin therapy should mimic the normal physiologic secretion of insulin and minimize the risk of hypoglycemia.
The normal physiologic pattern of insulin secretion by pancreatic b cells consists of
*  Sustained Basal insulin level throughout the day, and
*  Bursts of Bolus insulin after meal that slowly decay over 2 to 3 hours.
Morbidity and mortality rate is higher with diabetes. Also, the risk of develop

Message

Dr. Saeed A. Mahar

The potential advantages of the long-acting insulin analogues are reviewed in this special supplement of Journal of Pakistan Medical Association (JPMA).
As shown in many clinical studies of basal insulin vs. regular insulin there are no improvement in HbA1c levels; however, the ability to achieve improvement of HbA1c is often limited by hypoglycemia. Thus, in real-world settings, improvements in fact do occur. The findings from the study "Cost-effectiveness of insulin analogues for diabetes mellitus."by  Chris G. Cameron MSc, Heather A. Bennett BPharm PhD (CMAJ 2009;180(4):400-7) suggest that treatment wit

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