[Insulin aspart (B28 Asp-insulin), which is produced by recombinant DNA technology, is a fast-acting insulin analogue. Due to the aspartate for proline substitution at position 28 of the Bchain, the insulin molecule's tendency for selfassociation is diminished, therefore, insulin aspart rapidly dissociates into dimeric and monomeric forms and absorbs quickly and easily after subcutaneous administration. Compared to human regular insulin, insulin aspart has a faster onset of activity, a higher plasma peak and a shorter duration of action. Overall, the pharmacokinetic profile of insulin aspart better mimics the physiological postprandial insulin secretion. Therefore, insulin aspart can be used for prandial insulin substitution in order to decrease postprandial blood glucose excursion. It should be administered immediately before meals, but some observations suggest that it can also be used after finishing meal. This allows a more flexible lifestyle for patients. Insulin aspart can be used in both type 1 and type 2 diabetes. Compared to regular human insulin, a moderate decrease in the HbA1c values and fewer nocturnal hypoglycaemic events are expected from insulin aspart use. Insulin aspart is appropriate for pump treatment as well. It has recently been approved for use in pregnancy, whereas for children and adolescents the expected benefits should be weighed against the more modest clinical experience available. Similarly to other insulin analogues, results of long-term clinical investigations with insulin aspart with regard to the development of complications are not yet available.]

[The prevalence of type 2 diabetes mellitus has recently dramatically increased worldwide. While many factors contribute to the startling data, including changes in the diagnostic criteria of glucose intolerance, increase of life expectancy, manifestation of diabetes at younger ages, and increased detection of unrecognized diabetes due to more efficient screening, the genuine, steep rise in the incidence of diabetes is explained by the increasing prevalence of obesity. Among the late complications of both diabetes and obesity, cardiovascular diseases are particularly important. Insulin resistance due to visceral obesity plays a central role in the pathomechanism of type 2 diabetes. In the prevention of both type 2 diabetes and obesity, non-pharmacological intervention such as life style changes should be considered first. Supplementary pharmacological treatment should target all cardiovascular risk factors.]

[Incretin mimetics represent a new group of antidiabetic drugs. They bind to their own receptor on the beta-cell membrane and increase insulin secretion in a glucosedependent manner. Thus, they rarely cause hypoglycaemia. Furthermore, they significantly reduce body weight and other cardiovascular risk factors. Accordingly, they can be considered as an optimal group of antidiabetic drugs. The author reviews the clinical efficacy and safety of currently available incretin mimetics.]

[The level of glycaemic control necessary to achieve optimal outcomes in subjects with type 1 diabetes mellitus typically requires intensified insulin therapy using multiple daily injections or continuous subcutaneous insulin infusion (CSII). For CSII, the insulins of choice are the rapid-acting insulin analogues: insulin aspart, insulin lispro and insulin glulisine. The advantages of CSII over multiple daily injections in adult and paediatric populations with type 1 diabetes include superior glycaemic control, lower insulin requirements and better health-related quality of life/patient satisfaction. An association between CSII and reduced hypoglycaemic risk is more consistent in children/adolescents than in adults. The use of CSII is widely recommended in both adult and pediatric type 1 diabetes mellitus populations, but is limited in pregnant patients. The review also discusses the result of the “A non-interventional trial to observe the effect of the use of Accu Chek Combo device on quality of life and metabolic control“(COM-1101-HU 1.3).]