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Related Concept Videos

Diabetes: Management and Pharmacotherapy01:15

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...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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...
Diabetic Ketoacidosis l: Introduction01:25

Diabetic Ketoacidosis l: Introduction

DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...
Glucose Homeostasis: Regulation of Blood Glucose01:02

Glucose Homeostasis: Regulation of Blood Glucose

Carbohydrates consumed through foods are converted into glucose, a crucial energy source for the body. In the prandial state, high blood glucose levels stimulate the secretion of insulin from the pancreas. Insulin inhibits hepatic glucose production and stimulates glucose uptake and metabolism by muscle and adipose tissue. The excess glucose is converted into glycogen and stored in the liver and muscles.
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
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...

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Related Experiment Video

Updated: Jun 22, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Inpatient glycemic control: an evolving paradigm.

Naga M Yalla1, L Raymond Reynolds

  • 1Division of Endocrinology, University of Kentucky Medical Center, 800 Rose Street, Lexington, KY 40536-0298, USA.

Postgraduate Medicine
|June 4, 2009
PubMed
Summary

Intensive insulin therapy in intensive care units (ICUs) aimed to normalize glucose levels. However, subsequent trials showed increased hypoglycemia and failed to consistently improve outcomes, prompting a reevaluation of treatment goals.

Related Experiment Videos

Last Updated: Jun 22, 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:

  • Critical Care Medicine
  • Endocrinology
  • Metabolic Disorders

Background:

  • Hyperglycemia is linked to increased morbidity and mortality in various patient groups.
  • A 2001 study showed intensive insulin therapy in surgical ICUs reduced mortality by normalizing glucose levels.
  • This led to widespread adoption of intensive insulin therapy in ICUs globally.

Purpose of the Study:

  • To examine the evidence on intensive insulin therapy in critically ill patients.
  • To evaluate the shift from sliding-scale insulin to rational subcutaneous insulin protocols.
  • To inform current recommendations for glycemic management in ICUs.

Main Methods:

  • Review of landmark studies and subsequent multicenter trials on intensive insulin therapy.
  • Analysis of observational data linking hyperglycemia to patient outcomes.
  • Consideration of logistical challenges in implementing glycemic control protocols.

Main Results:

  • The initial Van den Berghe study demonstrated significant mortality reduction.
  • Subsequent multicenter trials reported increased hypoglycemia with intensive insulin therapy.
  • These trials did not consistently show improved outcomes compared to less intensive approaches.

Conclusions:

  • Hospitals and expert panels are reassessing intensive insulin therapy based on combined evidence.
  • Recommendations favor avoiding hyperglycemia with less aggressive glycemic targets in the critically ill.
  • Rational subcutaneous insulin protocols are recommended for non-critically ill patients, avoiding outdated methods.