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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...
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...
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...
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...
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...

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Related Experiment Video

Updated: May 31, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Glycemic control in the ICU.

Moritoki Egi1, Simon Finfer2, Rinaldo Bellomo3

  • 1Department of Anesthesiology and Resuscitology, Okayama University Medical School, Okayama, Japan.

Chest
|July 7, 2011
PubMed
Summary
This summary is machine-generated.

Intensive glucose control in critically ill patients is not supported by recent studies. Current methods lack accuracy, and further research is needed to ensure safety before implementing strict glycemic targets.

Related Experiment Videos

Last Updated: May 31, 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
  • Clinical research

Background:

  • Hyperglycemia is prevalent in intensive care unit (ICU) patients, affecting up to 90%.
  • Initial studies suggested targeting normoglycemia (80-110 mg/dL) reduced mortality, but these findings were not consistently replicated.

Purpose of the Study:

  • To evaluate the evidence surrounding intensive glucose control in critically ill patients.
  • To discuss the implications of recent studies and current limitations in glycemic management.

Main Methods:

  • Review of landmark trials and recent multicenter studies (e.g., NICE-SUGAR).
  • Analysis of meta-analyses on intensive versus conventional glucose control.
  • Discussion of technological limitations in point-of-care glucose monitoring.

Main Results:

  • The NICE-SUGAR study reported increased mortality with intensive glucose control.
  • Recent meta-analyses do not support intensive glycemic control for critically ill patients.
  • Current point-of-care glucose monitoring systems lack the accuracy for tight glucose control.

Conclusions:

  • Current evidence does not support intensive glucose control in critically ill patients.
  • Moderate glycemic targets (144-180 mg/dL) are now recommended.
  • Future research should focus on the safety and feasibility of intensive glucose control using advanced technologies.