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Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

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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...
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Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

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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...
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Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

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Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
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Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

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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.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
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Insulin: Biosynthesis, Chemistry, and Preparation01:25

Insulin: Biosynthesis, Chemistry, and Preparation

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The endoplasmic reticulum (ER) of pancreatic β-cells synthesizes preproinsulin, which consists of a signal peptide, A and B chains, and a C-peptide. Preproinsulin is then cleaved and folded into proinsulin, which translocates to the Golgi apparatus for sorting and packaging into secretory granules. In these granules, enzymatic clipping generates insulin and C-peptide.
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
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Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

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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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Improving IV Insulin Administration in a Community Hospital
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Addressing barriers to effective basal insulin therapy.

V Mohan, M John, M Baruah

    The Journal of the Association of Physicians of India
    |October 22, 2014
    PubMed
    Summary

    Poor glycemic control in India necessitates improved insulin therapy. Insulin degludec offers a stable, long-acting solution with reduced hypoglycemia risk, enhancing diabetes management.

    Area of Science:

    • Endocrinology
    • Metabolic Diseases
    • Pharmacology

    Background:

    • Diabetes mellitus presents a global health challenge, particularly in India, with high average HbA1c levels (>9%) indicating poor glycemic control.
    • Current insulin therapies face limitations, including hypoglycemia risk and fixed administration schedules, hindering optimal diabetes management and quality of life.

    Purpose of the Study:

    • To evaluate the efficacy and safety of insulin degludec in addressing the limitations of existing basal insulins.
    • To assess the potential of insulin degludec in achieving optimal glycemic control with reduced hypoglycemia incidence.

    Main Methods:

    • The study focuses on the pharmacokinetic and pharmacodynamic properties of insulin degludec.
    • Comparative analysis of insulin degludec's glucose-lowering profile against currently available basal insulins.

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    Main Results:

    • Insulin degludec demonstrates a flat and stable glucose-lowering effect lasting over 42 hours.
    • The novel insulin exhibits a reduced risk of hypoglycemia compared to conventional basal insulins.

    Conclusions:

    • Insulin degludec effectively overcomes limitations of current basal insulins, offering improved 24-hour fasting hyperglycemia control.
    • Its predictable and prolonged action profile supports better glycemic management and potentially enhances patient quality of life.