Diabetes Mellitus: Designer Approach of Therapy

Abstract

Diabetes mellitus is a worldwide health problem that causes serious disability. Its complications like renal failure, amputation and loss of eyesight are a huge social burden and its economic costs are enormous. Being a central aetiological factor ‘insulin’ is the mainstay of therapy. There are ranges of conventional to newer insulins. Insulin has come through various stages with the latest being the advent of recombinant DNA technology. The native insulin molecule is modified via substitution, replacement or addition of some amino acids to form ‘insulin analogues’ along with changes in biological activity and pharmacological profile. These insulin analogues are both rapid (aspart, lispro & glulisine) as well as long acting (glargin & detemir), and are popularly known as designer insulins. A recent addition is degludec. Other newer approaches are incretin mimetics and amylin analogues .The development of designer insulin has helped to create a series of analogues of insulin that achieve better glycaemic control. This article highlights an interesting story of insulin from discovery to the most recent designer one.