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Related Concept Videos

Hypoglycemia01:26

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...
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
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...
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively manages...

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Related Experiment Video

Updated: Jun 28, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Severe hypoglycemia during intensive insulin therapy.

K-M Kaukonen1, M Rantala, V Pettilä

  • 1Department of Anesthesia and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki, Finland. maija.kaukonen@hus.fi

Acta Anaesthesiologica Scandinavica
|October 24, 2008
PubMed
Summary

Severe hypoglycemia is rare in intensive insulin therapy, affecting only 2.3% of patients. This study found no significant difference in mortality between patients who experienced severe hypoglycemia and those who did not.

Related Experiment Videos

Last Updated: Jun 28, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Area of Science:

  • Intensive care medicine
  • Endocrinology
  • Clinical research

Background:

  • Tight glycemic control is crucial for reducing mortality in intensive care unit (ICU) patients.
  • Previous studies on intensive insulin therapy were halted due to safety concerns, questioning its clinical application.
  • The incidence and impact of hypoglycemia during intensive insulin therapy require further investigation.

Purpose of the Study:

  • To determine the incidence of severe hypoglycemia in patients undergoing intensive insulin therapy.
  • To evaluate the effects of severe hypoglycemia on patient outcomes in the ICU.

Main Methods:

  • A prospective study was conducted in two tertiary care hospital ICUs over 17 months.
  • Nurse-driven intensive insulin therapy targeting blood glucose of 4-6 mmol/l was implemented.
  • Patients were categorized based on the occurrence of severe hypoglycemia (glucose ≤2.2 mmol/l).

Main Results:

  • Out of 1224 patients, severe hypoglycemia occurred in 2.3% of patients (36 measurements).
  • No significant differences were observed in patient demographics, severity scores, or length of stay between groups.
  • Hospital mortality rates were 25% for patients with severe hypoglycemia versus 15% for those without (P=0.16).

Conclusions:

  • Severe hypoglycemia is infrequent in clinical practice when employing intensive insulin therapy.
  • The study suggests that severe hypoglycemia may not significantly impact mortality in the ICU setting compared to previous trial data.