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Related Concept Videos

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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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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SBAR II: Application of SBAR01:14

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SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
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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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Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

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The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
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Improving IV Insulin Administration in a Community Hospital
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Insulin Pump Malfunction During Hospitalization: Two Case Reports.

Eileen R Faulds1,2, Kathleen L Wyne1, Elizabeth O Buschur1

  • 11 Division of Endocrinology, Diabetes & Metabolism, The Ohio State University College of Medicine , Columbus, Ohio.

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Severe insulin pump malfunctions causing unintended insulin delivery and hypoglycemia are rare but serious events. This study highlights two such cases in hospitalized patients, emphasizing the need for increased awareness and education.

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Area of Science:

  • Medical Device Safety
  • Endocrinology
  • Patient Safety

Background:

  • Insulin pump failures are known, but severe events like unintended insulin boluses are infrequently reported.
  • This study investigates two cases of severe insulin pump malfunction during hospitalization.

Observation:

  • Both patients experienced severe hypoglycemia following an infusion site change and alarm.
  • Medical personnel witnessed rapid insulin spraying from the pump in both instances.
  • Insulin pump data downloads corroborated patient and staff accounts.

Findings:

  • Analysis of pump data and FDA MAUDE database identified similar events involving unintended reservoir piston movement.
  • These are the first reported cases of this specific malfunction in a hospital setting leading to severe hypoglycemia.

Implications:

  • Healthcare providers and patients require education on recognizing and managing insulin pump malfunctions.
  • Enhanced vigilance for "runaway pump" phenomena is crucial in inpatient diabetes management.
  • Further investigation into device failure mechanisms is warranted to prevent future occurrences.