INSULIN THERAPY TODAY

The insulin classification regarding the duration of its effect gradually be-comes outdated; it is necessary to speak first about the insulin therapy regimes. The intensified insulin therapy regarding the type of multiple daily insulin injections be-comes an indisputable standard. The progress in the "protein engineering" with the formation of a wide spectrum of insulin analogues provides for moving forward to-wards modern diabetology and the concept of strict individualization of the insulin therapy. The experience becomes a pattern 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 in 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 ariginines added to the positions B31 and B32 - insulin "glargin" - LANTUS. The development of short and long effect analogues imposed the logical need for formulating "new" fixed insulin combination's as well. New combination's are made of two kinds of ac-tual insulin, namely, the fast-effect analogues of the aspart type or lystroinsulin and protamine-retarded preparations - neutral protamine - lystroinsulin. Three kinds of combinations are made.