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Related Concept Videos

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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Hyperglycemia01:29

Hyperglycemia

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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...
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Insulin: Dosing Regimen and Adverse Effects01:16

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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.
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Hypoglycemia and Glucagon01:15

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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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Acute Pancreatitis II: Clinical Manifestations and Management01:30

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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
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Hypoglycemia01:26

Hypoglycemia

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Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
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Hyperinsulinemic-euglycemic Clamps in Conscious, Unrestrained Mice
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Extreme hypertriglyceridemia managed with insulin.

Moe Thuzar1, Vasant V Shenoy2, Usman H Malabu2

  • 1Department of Endocrinology and Diabetes, The Townsville Hospital, Queensland, Australia; University of Queensland, Australia.

Journal of Clinical Lipidology
|December 16, 2014
PubMed
Summary
This summary is machine-generated.

Extreme hypertriglyceridemia management is critical. Intravenous insulin combined with fasting effectively lowers serum triglycerides (TG) rapidly, preventing severe complications.

Keywords:
DiabetesDyslipidemiaHypertriglyceridemiaInsulinPancreatitis

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Area of Science:

  • Endocrinology
  • Metabolic Disorders

Background:

  • Extreme hypertriglyceridemia poses a risk for acute pancreatitis.
  • Established consensus for acute management is lacking.

Purpose of the Study:

  • To evaluate the efficacy of insulin-based management for extreme hypertriglyceridemia.

Main Methods:

  • Retrospective review of 10 cases with extreme hypertriglyceridemia (mean TG 101.5 ± 23.4 mmol/L).
  • Patients managed with intravenous insulin and fasting, or intravenous insulin alone.

Main Results:

  • Serum TG decreased by 87 ± 4% in 24 hours with insulin and fasting.
  • Serum TG decreased by 40 ± 8.4% in 24 hours with insulin alone (P = .0003).
  • One patient developed a pancreatic pseudocyst; otherwise, the clinical course was uncomplicated.

Conclusions:

  • Intravenous insulin combined with fasting is an effective, simple, and safe strategy for immediate management of extreme hypertriglyceridemia.