Disclosed is a method for obtaining glucose-regulated expression of active
insulin in the cells of a mammalian subject. The method involves
delivering into the subject a genetic construct comprising a coding
sequence for a human proinsulin operably connected a promoter functional
in the host cells. The construct includes a glucose responsive regulatory
module having at least one glucose inducible regulatory element
comprising a pair of CACGTG motifs linked by a five base nucleotide
sequence, which confers glucose inducible expression of the proinsulin
coding sequence. To ensure proper processing of the proinsulin to active
insulin, the coding sequence was modified to direct the synthesis of a
mutant proinsulin polypeptide having amino acid sequences that can be
cleaved to mature insulin in suitable host cells, such as hepatocytes.