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DIABETES MELLITUS: INSULIN AND ORAL COMPOUNDS
Patients with insulin-dependent diabetes always require insulin. The kind and amount of insulin are determined by the physician. Intermediate-acting insulin (NPH, globin, lente) is widely used. It reaches peak activity in 9 hours and activity extends over 24 hours. It is often used in combination with a short-acting insulin (regular, crystalline) which has a peak activity in 3 to 4 hours, and a duration of 6 to 8 hours. Long-acting insulins (PZI – protamine zinc, and lente) are used less frequently. Insulin must be given by injection because it would be digested and made inactive if given by mouth.
Patients with insulin-resistant diabetes can almost always be managed successfully with diet alone, or with diet and oral compounds. These compounds are not insulin, but sulfonylureas including tolbutamide (Orinase), tolazamide (Tolinase), chlorpropamide (Diabinese), and acetohexamide (Dymelor). Their action is to stimulate the pancreas to produce insulin.
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