Welcoming you for any type of article submission for the upcoming issue on/before February 26, 2021.

Research Article
Volume 5 Issue 3 - 2020
Accelerated Intensive Insulin Therapy and its Benefits on Compliance and Glycemic Control
Michael Alexander1, Allison Cimler2, John Elliott2 and Jonathan RT Lakey1,3*
1Department of Surgery, University of California Irvine, Orange, CA, USA
2Alium Health, Scottsdale, AZ, USA
3Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA
*Corresponding Author: Jonathan RT Lakey, Professor, Director, Clinical Islet Program, Department of Surgery and Biomedical Engineering, University of California Irvine, Orange, CA, USA.
Received: February 15, 2020; Published: February 27, 2020


Background: Intensive insulin therapy (IIT) simulates normal pancreatic function by closely matching the periodicity and amplitude of insulin secretion in healthy non-diabetic subjects. This is achieved by injecting intravenous (IV) insulin in a pulsatile manner and in a pattern matching the observed blood glucose level. This therapy has shown positive beneficial effects on secondary complications of diabetes. However, the duration of each session for this therapy has been associated with lower patient compliance and a high number of hyperglycemic events during insulin therapy.

Objective: We have demonstrated that a shorter IIT protocol duration can improve both patient compliance and reduce the incidence of hyperglycemic events during treatment.

Method: We analyzed the de-identified records of Type 1-2 diabetic patients treated at Diabetic Innovations, LLC. from 2016 - 2019 for reasons related to treatment stopping and discontinuance. A secondary analysis was done on the incidence of hyperglycemic events in patient that underwent both the original IIT protocol and the shortened protocol.

Results: We found that the duration of each treatment (4 hours) in the original protocol is one of the main causes of patients discontinuing their IIT. Analysis of patients who moved from the original to the shorter protocol showed that the shorter protocol with more frequent insulin pulses is associated with reduction in incidence of hyperglycemic events during IIT.

Conclusion: Reducing the length of the IIT protocol into 2 x 1-hour sessions, with 4 minute intervals between insulin pulses, can result in better glycemic control, in addition to potentially improving patient adherence to treatment.

Keywords: Diabetes; Insulin; Infusion; Intravenous Therapy; Hyperglycemic Events


  1. The DCCT Research Group. “Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial”. The Journal of Pediatrics 125.2 (1994): 177-188.
  2. UK Prospective Diabetes Study Group. “U.K. Prospective diabetes study 16: Overview of 6 years’ therapy of type II diabetes: A progressive disease”. Diabetes 44.11 (1995): 1249-1258.
  3. Katsoyannis PG. “The chemical synthesis of human and sheep insulin”. The American Journal of Medicine 40.5 (1966): 652-661.
  4. Aoki TT., et al. “Chronic intermittent intravenous insulin therapy: a new frontier in diabetes therapy”. Diabetes Technology and Therapy 3.1 (2001): 111-123.
  5. Dong S., et al. “Effects of Periodic Intensive Insulin Therapy: An Updated Review”. Current Therapeutic Research 90 (2019): 61-67.
  6. Mirbolooki MR., et al. “Pulsatile intravenous insulin therapy: the best practice to reverse diabetes complications?” Medical Hypotheses 73.3 (2009): 363-369.
  7. Elliott J., et al. “Microburst Insulin Infusion: Results of Observational Studies - Carbohydrate Metabolism, Painful Diabetic Neuropathy, and Hospital/Emergency Department Utilization”. Journal of Diabetes, Metabolic Disorder and Control 4.4 (2017): 116-121.
  8. Chang A and Philis-Tsimikas A. “Periodic Intensive Insulin Therapy Remains Experimental”. Current Therapeutic Research, Clinical and Experimental 91 (2019): 24.
  9. Lakey J. “Efficacy of Periodic Intensive Insulin Therapy on secondary complications of diabetes warrants larger prospective randomized clinical trials”. Current Therapeutic Research, Clinical and Experimental 91 (2019): 23.
  10. Nakashima Koji., et al. “Practical application of short-term intensive insulin therapy based on the concept of "treat to target" to reduce hypoglycaemia in routine clinical site”. Scientific Reports 10.1 (2020): 1552.
  11. Ritzel RA., et al. “Glucose stimulates pulsatile insulin secretion from human pancreatic islets by increasing secretory burst mass: dose-response relationships”. Journal of Clinical Endocrinology and Metabolism 88.2 (2003): 742-747.
  12. Claus TH., et al. “Dual-acting peptide with prolonged glucagon-like petide-1 receptor agonist and glucagon receptor antagonist activity for the treatment of type 2 diabetes”. Journal of Endocrinology 192.2 (2007): 371-380.
  13. Matveyenko A., et al. “Pulsatile portal vein insulin delivery enhances hepatic insulin action and signaling”. Diabetes 61.9 (2012): 2269-2279.
  14. Hunter SJ., et al. “Association between insulin secretory pulse frequency and peripheral insulin action in NIDDM and normal subjects”. Diabetes 45.5 (1996): 683-686.
Citation: Jonathan RT Lakey., et al. “Accelerated Intensive Insulin Therapy and its Benefits on Compliance and Glycemic Control”. EC Endocrinology and Metabolic Research 5.2 (2020): 01-05.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

December Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 23, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.