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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...
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Diabetes: Management and Pharmacotherapy01:15

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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.
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Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
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Improving IV Insulin Administration in a Community Hospital
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Reducing harm in patients using insulin.

Matthew Grissinger1, Michael J Gaunt2

  • 1Institute for Safe Medication Practices, Horsham, Pennsylvania.

The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists
|May 23, 2014
PubMed
Summary
This summary is machine-generated.

Insulin therapy for diabetic hyperglycemia can lead to medication errors. This article details common insulin errors in long-term care and offers strategies to reduce harm and improve patient safety.

Keywords:
ADE = Adverse drug eventAdverse drug eventBG = Blood glucoseBlood glucoseContributing factorsED = Emergency departmentHypoglycemiaISMP = Institute for Safe Medication PracticesInstitute for Safe Medication PracticesInsulinMAR = Medication administration recordMedication errorsNEISS-CADES = National Electronic Injury Surveillance System-Cooperative Adverse Drug Event SurveillanceRisk-reduction strategiesSliding scaleT1DM = Type 1 diabetes mellitus

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Area of Science:

  • Endocrinology
  • Pharmacology
  • Patient Safety

Background:

  • Hyperglycemia management in diabetic patients often involves insulin therapy.
  • Insulin use is frequently linked to medication errors, more so than other drug classes.
  • Long-term care facilities present unique challenges for medication administration.

Purpose of the Study:

  • To identify and highlight common medication errors associated with insulin use in long-term care settings.
  • To provide evidence-based recommendations for risk reduction strategies.
  • To enhance patient safety and prevent harm related to insulin therapy.

Main Methods:

  • Literature review of reported insulin-related medication errors in long-term care.
  • Analysis of error types and contributing factors.
  • Development of risk-mitigation strategies based on identified patterns.

Main Results:

  • Insulin medication errors are a significant concern in long-term care facilities.
  • Common errors include dosage inaccuracies, administration mistakes, and improper storage.
  • Specific risk factors in long-term care settings contribute to these errors.

Conclusions:

  • Implementing targeted risk-reduction strategies is crucial for safe insulin use.
  • Healthcare providers and facilities must address insulin medication errors proactively.
  • Improved protocols and staff education can minimize patient harm from insulin therapy.