Intensive insulin therapy and microvascular disease) is central to the development of complications of diabetes mellitus. This evidence convinced most physicians who specialize in diabetes care that an important goal of treatment is to make the biochemical profile of the diabetic patient (blood lipids, HbA1c, etc.) as close to the values of non-diabetic people as possible. This is especially true for young patients with many decades of life ahead. A working pancreas continually secretes small amounts of insulin into the blood to maintain normal glucose levels, which would otherwise rise from glucose release by the liver, especially during the early morning dawn phenomenon.
Insulin the brand name Humulin. The vast majority of insulin currently used worldwide is now biosynthetic recombinant "human" insulin or its analogues. Recombinant insulin is produced either in yeast (usually "Saccharomyces cerevisiae") or "E. coli". In yeast, insulin may be engineered as a single-chain protein with a KexII endoprotease (a yeast homolog of PCI/PCII) site that separates the insulin A chain from a c-terminally truncated insulin B chain. A chemically synthesized c-terminal tail is then grafted onto insulin by reverse proteolysis using the inexpensive protease trypsin; typically the lysine on the c-terminal tail is protected with a chemical protecting group to