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Diabetes: Management and Pharmacotherapy

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...

Oral Hypoglycemic Agents: Biguanides and Glitazones

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...

Insulin: Dosing Regimen and Adverse Effects

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...

Diabetes Mellitus: Overview and Type I Subtype

Diabetes Mellitus: Overview and Type I Subtype

Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...

Type II Diabetes II: Pathophysiology

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.

Hypoglycemia

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...

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Updated: Jul 9, 2026

Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Pharmaco-economic issues for diabetes therapy.

Julia M Bottomley¹, Frank D Raymond

¹Amygdala Ltd, The Warren, Willian Road, Letchworth Garden City, Hertfordshire SG6 2AA, UK. jmb@amygdala.uk.com

Best Practice & Research. Clinical Endocrinology & Metabolism

|December 7, 2007

Summary

New diabetes medications show promise but face scrutiny over cost-effectiveness due to limited long-term data. Economic analyses suggest they are cost-effective, but real-world application faces challenges.

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Last Updated: Jul 9, 2026

Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Area of Science:

Pharmacoeconomics
Health Economics
Diabetes Management

Background:

Global trends show increasing diabetes prevalence and healthcare costs.
Rising pharmaceutical costs are a significant concern in diabetes care.
New antidiabetic medications are entering the market with limited long-term trial data.

Purpose of the Study:

To analyze pharmacoeconomic issues in diabetes management.
To evaluate the cost-effectiveness of new diabetes treatment options.
To discuss challenges in generating credible economic analyses for new diabetes technologies.

Main Methods:

Systematic review of pharmaco-economic literature on diabetes.
Analysis of evidence on antidiabetic pharmaceutical choices.
Summarization of economic analyses for new diabetes technologies.

Main Results:

Published economic models generally report new diabetes technologies as cost-effective.
Concerns exist regarding assumptions in economic modeling, leading to optimistic incremental cost-effectiveness ratios (ICERs).
Lack of robust long-term outcome and health-related quality of life data hinders cost-effectiveness evaluations.

Conclusions:

New diabetes drugs face challenges at the cost-effectiveness stage due to data limitations.
Authorities often restrict use when price advantages over comparators cannot be justified.
There is a need for credible, fit-for-purpose cost-effectiveness analyses for new diabetes technologies.