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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...
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...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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...

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Updated: Jun 2, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

[How much insulin does the critical ill need?].

Konstantin Mayer1, Markus A Weigand, Werner Seeger

  • 1Medizinischen Klinik II für Innere Medizin, Pneumologie und Internistische Intensivmedizin, Universitätsklinikum, Gießen und Marburg, Germany. Konstantin.Mayer@uglc.de

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
|April 13, 2011
PubMed
Summary
This summary is machine-generated.

Tight glucose control in critically ill patients showed initial survival benefits but later trials revealed no advantage and increased mortality. Hyperglycemia may be an adaptive stress response, influenced by medications and nutrition.

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Hyperinsulinemic-Euglycemic Clamp in the Conscious Rat
11:12

Hyperinsulinemic-Euglycemic Clamp in the Conscious Rat

Published on: February 7, 2011

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Last Updated: Jun 2, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Hyperinsulinemic-Euglycemic Clamp in the Conscious Rat
11:12

Hyperinsulinemic-Euglycemic Clamp in the Conscious Rat

Published on: February 7, 2011

Area of Science:

  • Critical care medicine
  • Endocrinology
  • Metabolic disorders

Context:

  • Blood glucose concentration is a dynamic parameter in critically ill patients.
  • Initial studies suggested survival benefits from tight glucose control.
  • Subsequent large trials failed to confirm these benefits, with some showing increased mortality.

Purpose:

  • To analyze the complex interplay between metabolism, nutrition, and glucose control in critical illness.
  • To evaluate the impact of hyperglycemia as a potential adaptive stress response.
  • To examine how exogenous factors like medications and nutritional support influence glucose metabolism and insulin therapy.

Summary:

  • Hyperglycemia in critical illness might be an adaptive stress response, not solely a detrimental factor.
  • Catecholamines, glucosteroids, and nutritional strategies (hypo- or hypercaloric) significantly affect insulin response and glucose metabolism.
  • Nutritional therapy must be individualized to the patient's current state, avoiding both excessive calories and energy deficits.

Impact:

  • Revises the understanding of hyperglycemia in critical care, suggesting it may have adaptive roles.
  • Highlights the need for individualized nutritional and insulin therapy strategies in critically ill patients.
  • Emphasizes avoiding iatrogenic hypoglycemia while managing blood glucose within a targeted range.