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Acta Medica Medianae
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INSULIN THERAPY TODAY
Saša Živić
Children Internal Clinic of the Clinic Center, Niš
The insulin classification regarding the duration of its effect gradually be-comes outdated; it is necessary to speak first about the muslin therapy regimes. The intensified insulin therapy regarding the type of multiple daily insulin injections becomes an indisputable standard. The progress in the "protein engineering" with the formation of a wide spectrum of insulin analogues provides for moving forward towards modem dialectology and the concept of strict individualization of the insulin therapy. The experience becomes a patten in creating two existing formulas of the insulin "short" analogues, namely HUMALAG with the replacement of the proline and lysinane places with those of 28 and 29, and NOVORAPID with aspartic acid at the 28th place m the B chain. The most recent long-effect analogues are created by amino acid changes with the glycine residual at the position A21 and two arginine added to the positions B31 and B32 - insulin "glargine" - LANTUS. The development of short and long effect analogues imposed the logical need for formulating "new" fixed insulin combinations as well. New combinations are made of two kinds of actual insulin, namely, the fast-effect analogues of the aspart type or lystro-insulin and protamine-retarded preparations - neutral protamine – lystro-insulin. Three kinds of combinations are made.
Key words: Short-effect analogues, long-effect analogues, fixed insulin combinations with analogues |