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Related Concept Videos

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.
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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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Insulin: Biosynthesis, Chemistry, and Preparation01:25

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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.
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Dosage Regimen: Individualization01:24

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Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
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Insulin: The Receptor and Signaling Pathways01:28

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Insulin action is mediated through a receptor tyrosine kinase, akin to the IGF-1 receptor. The number of receptors per cell varies significantly, from 40 on erythrocytes to 300,000 on adipocytes and hepatocytes. The insulin receptor consists of linked α/β subunit dimers, forming a heterotetramer glycoprotein with two extracellular α subunits and two β subunits spanning the membrane. The α subunits inhibit the inherent tyrosine kinase activity of the β subunits, but...
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Diabetes Mellitus: Overview and Type I Subtype01:22

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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
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Improving IV Insulin Administration in a Community Hospital
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Classifying insulin regimens--difficulties and proposal for comprehensive new definitions.

A Neu1, K Lange2, T Barrett3

  • 1Children's Hospital, University Hospital Tuebingen, Germany.

Pediatric Diabetes
|April 14, 2015
PubMed
Summary
This summary is machine-generated.

Type 1 diabetes management requires individualized insulin regimens. This review proposes clear definitions for pediatric insulin therapy, aiming to reduce confusion and improve treatment comparisons for better diabetes care.

Keywords:
insulin regimenstreatmenttype 1 diabetes

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Area of Science:

  • Pediatric Endocrinology
  • Diabetes Management
  • Metabolic Disorders

Background:

  • Modern insulin regimens for type 1 diabetes are highly individualized, yet current concepts and nomenclature are confusing.
  • Lack of distinctiveness and inconsistent use of terms like 'conventional' and 'intensified therapy' hinder clear understanding among experts.
  • Existing terms such as Basal Bolus Concept (BBC), multiple daily injections (MDI), and flexible insulin therapy (FIT) lack consistent definitions.

Purpose of the Study:

  • To propose comprehensive and clearly defined terms for current insulin regimens in pediatric type 1 diabetes management.
  • To establish a simple, catchy, and comprehensive classification system for insulin therapy.
  • To facilitate comparison of therapeutic strategies by reducing existing confusion in insulin regimen terminology.

Main Methods:

  • Review of experiences from the Hvidoere Study Group (HSG), an international collaboration of 24 pediatric diabetes centers.
  • Analysis of benchmarking studies revealing a wide variety of applied insulin regimens and persistent differences in understanding among centers.
  • Inclusion of currently used terms within the proposed new classification framework.

Main Results:

  • Significant confusion and lack of consistency in the understanding and application of insulin regimen terminology among experienced pediatric diabetes centers.
  • Identification of commonly used but inconsistently defined terms like 'conventional', 'intensified therapy', BBC, MDI, and FIT.
  • Development of a proposed new classification system designed to be comprehensive, simple, and easily understood.

Conclusions:

  • A clear and consistent classification of insulin regimens is crucial for effective type 1 diabetes management in children and adolescents.
  • The proposed classification aims to resolve the current ambiguity and facilitate better comparison of treatment strategies.
  • Implementing standardized terminology will enhance communication and potentially improve therapeutic outcomes in pediatric diabetes care.