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Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects01:16

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...
Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into rapid-acting...
Insulin: Biosynthesis, Chemistry, and Preparation01:25

Insulin: Biosynthesis, Chemistry, and Preparation

The endoplasmic reticulum (ER) of pancreatic β-cells synthesizes preproinsulin, which consists of a signal peptide, A and B chains, and a C-peptide. Preproinsulin is then cleaved and folded into proinsulin, which translocates to the Golgi apparatus for sorting and packaging into secretory granules. In these granules, enzymatic clipping generates insulin and C-peptide.
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment primarily uses...
Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
Production of Pharmaceuticals01:30

Production of Pharmaceuticals

Industrial insulin production uses genetically engineered E. coli expressing a proinsulin gene controlled by a tryptophan promoter and containing a methionine linker for later cleavage. The cells also carry ampicillin resistance for selective growth. Seed cultures are stored at −80 °C and production begins by thawing a small amount to inoculate starter cultures, which are progressively scaled to a 50,000-L bioreactor. In the bioreactor, E. coli grow in nutrient-rich media under sterile, tightly...
Diabetes Mellitus: Introduction01:26

Diabetes Mellitus: Introduction

Diabetes mellitus consists of chronic metabolic disorders characterized by persistent hyperglycemia. This elevated blood glucose results from defects in insulin secretion, impaired insulin action, or both. Insulin, produced by pancreatic β-cells, is essential for maintaining glucose homeostasis by facilitating cellular glucose uptake for energy or storage. Disruptions in insulin production or function lead to glucose accumulation in the bloodstream, causing the clinical features and long-term...

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Updated: Jul 3, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Lessons in initiating insulin in clinical practice.

Surendra K Sharma1, Jing Ping Yeo, Alan Garber

  • 1MG Medical College, Jaipur, India. sksharma7@gmail.com

Diabetes Research and Clinical Practice
|August 2, 2008
PubMed
Summary

Insulin therapy, including biphasic insulin aspart 30 (BIAsp 30), offers significant improvements in type 2 diabetes (T2DM) management over oral drugs. Early insulin initiation in T2DM patients shows efficacy with a low risk of hypoglycemia.

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Improving IV Insulin Administration in a Community Hospital
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Published on: June 11, 2012

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Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Insulin therapy demonstrates superior glycemic control (FPG, HbA1c) in type 2 diabetes (T2DM) compared to oral antidiabetic drugs (OADs).
  • There is an increasing trend towards earlier insulin initiation in T2DM management.
  • Randomized trials show positive outcomes with insulin-naïve patients using aggressive titration.

Purpose of the Study:

  • To compare the efficacy of biphasic insulin aspart 30 (BIAsp 30) in insulin-naïve T2DM patients from the PRESENT study with existing randomized controlled trial (RCT) data.
  • To provide guidance on initiating insulin therapy in T2DM patients.
  • To highlight the efficacy, safety (low hypoglycemia risk), and patient-centric benefits of BIAsp 30.

Main Methods:

  • Review article comparing observational data (PRESENT study) with RCTs.
  • Focus on insulin-naïve T2DM patients (monotherapy or with OADs).
  • Analysis of BIAsp 30 efficacy, safety, and patient experience.

Main Results:

  • BIAsp 30 demonstrated efficacy in inadequately controlled T2DM patients, both as monotherapy and with OADs.
  • Comparison with RCTs supports the effectiveness of BIAsp 30 in insulin-naïve patients.
  • Therapy is associated with a low risk of hypoglycemia.

Conclusions:

  • Biphasic insulin aspart 30 (BIAsp 30) is an effective option for initiating insulin therapy in T2DM.
  • Early insulin use, particularly with BIAsp 30, can improve glycemic control with minimal hypoglycemia.
  • Modern delivery devices can enhance patient adherence and reduce psychological barriers to insulin therapy.