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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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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.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
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Diabetes Mellitus: Type 2 and Gestational01:22

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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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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Insulin Formulations: Types and Delivery01:27

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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

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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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Updated: Mar 27, 2026

Improving IV Insulin Administration in a Community Hospital
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[When and why start insulin in type 2 diabetes?].

Louis Potier

    La Revue Du Praticien
    |January 12, 2016
    PubMed
    Summary

    Starting insulin therapy is crucial for type 2 diabetes patients when oral medications fail. This guide outlines initiating bedtime insulin, adjusting dosage, and managing hypoglycemia for better glycemic control.

    Area of Science:

    • Endocrinology
    • Metabolic Diseases
    • Pharmacology

    Context:

    • Type 2 diabetes management often requires escalating therapy when oral agents are insufficient.
    • Glycemic control targets may be missed despite combinations of oral antidiabetic agents.
    • Insulin therapy is indicated when HbA1c exceeds targets or weight loss is a concern.

    Purpose:

    • To provide a standardized approach for initiating insulin therapy in type 2 diabetes.
    • To outline the initial insulin dosage, titration schedule, and hypoglycemia management.
    • To emphasize the importance of patient education for successful insulin adoption.

    Summary:

    • Insulin initiation is recommended when 2-3 oral antidiabetic agents fail to achieve glycemic goals.
    • Treatment begins with bedtime intermediate-acting insulin, starting at 10 units or 0.2 units/kg.

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  • Dosage is titrated every 3 days by 2 units until fasting glucose targets are met; a 4-unit reduction is advised for hypoglycemia.

    • Impact:

    • Facilitates effective glycemic control in patients with type 2 diabetes.
    • Empowers patients with the knowledge and skills for self-management of insulin therapy.
    • Improves patient adherence and outcomes in insulin treatment regimens.