Practical guidelines on the use of insulin lispro in elderly diabetic patients.

Glucose tolerance deteriorates, and the prevalence of diabetes mellitus increases, with advancing age. Most elderly diabetic patients have type 2 (non-insulin-dependent) diabetes mellitus, but the prolonged survival of young people with type 1 (insulin-dependent) diabetes mellitus increases the prevalence of type 1 diabetes among the elderly. Approximately 25 to 29% of patients with type 2 diabetes mellitus are treated with insulin. Conventional therapy with regular and intermediate-acting insulin preparations does not mimic physiological insulin secretion. Subcutaneous administration of insulin lispro, a recently introduced insulin analogue, more closely mimics the time-action curve of endogenous insulin that is produced in response to meals. Its rapid onset and short duration of action allow for adequate control of postprandial glucose levels while reducing the risk of late postprandial hypoglycaemia. Insulin lispro offers improved glycaemic control, convenience and increased flexibility in insulin-treated patients with diabetes.