The Physiologic Replacement of Insulin

Abstract

ALTHOUGH insulin was discovered and first administered more than 65 years ago,^{1 , 2} the goal of physiologic replacement remains elusive, despite major advances in our understanding of insulin's physiologic effects, chemistry, kinetics, and action. In this article I shall evaluate the pharmacologic features and use of insulin in the context of current practices in the management of insulin-dependent diabetes mellitus.As background, it will be useful to review briefly the physiology of insulin synthesis and secretion.³ Insulin is synthesized in the beta cells of the islets of Langerhans as a single polypeptide precursor, preproinsulin, which is subsequently converted to proinsulin, an . . .