Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jan 15, 2024; 15(1): 11-14
Published online Jan 15, 2024. doi: 10.4239/wjd.v15.i1.11
Individualized intensive insulin therapy of diabetes: Not only the goal, but also the time
Yun Hu, Hong-Jing Chen, Jian-Hua Ma
Yun Hu, Hong-Jing Chen, Department of Endocrinology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
Jian-Hua Ma, Department of Endocrinology, Nanjing First Hospital, Nanjing 210000, Jiangsu Province, China
Author contributions: Hu Y and Chen HJ drafted the initial manuscript; Ma JH conceptualized and revised the manuscript.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Hua Ma, MD, Professor, Department of Endocrinology, Nanjing First Hospital, No. 32 Gongqingtuan Road, Nanjing 210000, Jiangsu Province, China. majianhua@china.com
Received: October 27, 2023
Peer-review started: October 27, 2023
First decision: November 23, 2023
Revised: December 3, 2023
Accepted: December 25, 2023
Article in press: December 25, 2023
Published online: January 15, 2024

Intensive insulin therapy has been extensively used to control blood glucose levels because of its ability to reduce the risk of chronic complications of diabetes. According to current guidelines, intensive glycemic control requires individualized glucose goals rather than as low as possible. During intensive therapy, rapid blood glucose reduction can aggravate microvascular and macrovascular complications, and prolonged overuse of insulin can lead to treatment-induced neuropathy and retinopathy, hypoglycemia, obesity, lipodystrophy, and insulin antibody syndrome. Therefore, we need to develop individualized hypoglycemic plans for patients with diabetes, including the time required for blood glucose normalization and the duration of intensive insulin therapy, which deserves further study.

Keywords: Diabetes, Intensive therapy, Insulin, Treatment-induced neuropathy

Core Tip: Intensive insulin therapy is popular in the treatment of patients with diabetes. This article highlighted the effects and side effects of intensive insulin therapy. It is a warning against the use of insulin therapy without any limitations, such as the speed of blood glucose lowering and the duration of insulin therapy.