Design of Insulin Variants for Improved Treatment of Diabetes - Peptide and Protein Design for Biopharmaceutical Applications - page 247

7

Design of Insulin Variants for
Improved Treatment of
Diabetes

Thomas Hoeg-Jensen

7.1 INTRODUCTION

Prior to the discovery of insulin in Toronto around 1920 [1], diabetes was a
terminal disease, a death sentence. The miraculous recovery of diabetes
patients following treatment with insulin from animal pancreatic extracts
prompted fast establishment of industrial production of insulin, and dia-
betes changed from a terminal to a manageable disorder.
However, although patients could now survive diabetes treatment for
many years, it gradually became clear that living with diabetes often
resulted in long-term complications such as damage to eyes, kidneys,
heart and the cardiovascular system. Diabetes is today the most common
course of blindness, and the life expectancy for diabetes patients is lower
compared to the average population.
Large-scale clinical studies have shown that intensive insulin treatment
can limit the risk of long-term complications from diabetes [2,3]. Intensive
insulin care involves monitoring of blood glucose several times a day and
adjustments of the timing and dosing of insulin administrations (Figure 7.1)
[4] in order to approach the tightly regulated glucose levels of a healthy