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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.
Short-acting insulins are divided into...
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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.
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: 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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Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

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Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
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Production of Pharmaceuticals01:30

Production of Pharmaceuticals

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Industrial insulin production uses genetically engineered E. coli expressing a proinsulin gene controlled by a tryptophan promoter and containing a methionine linker for later cleavage. The cells also carry ampicillin resistance for selective growth. Seed cultures are stored at −80 °C and production begins by thawing a small amount to inoculate starter cultures, which are progressively scaled to a 50,000-L bioreactor. In the bioreactor, E. coli grow in nutrient-rich media under...
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Improving IV Insulin Administration in a Community Hospital
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Flexibility in insulin prescription.

Sanjay Kalra1, Yashdeep Gupta2, Ambika Gopalakrishnan Unnikrishnan3

  • 1Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India.

Indian Journal of Endocrinology and Metabolism
|May 18, 2016
PubMed
Summary

Flexible insulin therapy in type 2 diabetes allows for variable injection timing and dosing, improving patient autonomy without compromising safety or efficacy. This approach enhances treatment adherence and quality of life.

Keywords:
Biphasic aspartbiphasic lisprodegludecdegludec aspartdetemirglargineglulisinehypoglycemiainsulin aspartlisproneutral protamine Hagedorntype 2 diabetes

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Area of Science:

  • Endocrinology and Metabolism
  • Pharmacology
  • Diabetes Management

Background:

  • Type 2 diabetes management often involves insulin therapy, which can be rigid and burdensome for patients.
  • Traditional insulin regimens may require strict adherence to meal times and frequent glucose monitoring, impacting daily life.
  • The need for more adaptable insulin treatment options is recognized to improve patient adherence and outcomes.

Purpose of the Study:

  • To define and explore the concept of flexibility in insulin preparations and regimens for type 2 diabetes.
  • To compare the relative flexibility of different insulin types (basal, prandial, dual-action) and intensive regimens.
  • To assess insulin utility using the biopsychosocial model, promoting flexible insulin usage.

Main Methods:

  • Conceptual exploration of insulin flexibility.
  • Comparative analysis of various insulin preparations and regimens based on defined flexibility criteria.
  • Application of the biopsychosocial model of health for assessment.

Main Results:

  • Flexibility in insulin therapy is defined by variable injection timing, meal-time gaps, and shared decision-making on dose frequency and quantum.
  • Different basal, prandial, and dual-action insulins, along with intensive regimens, exhibit varying degrees of flexibility.
  • Flexible insulin usage, guided by the biopsychosocial model, can be safely and effectively implemented.

Conclusions:

  • Flexible insulin regimens offer a patient-centered approach to type 2 diabetes management.
  • Increased flexibility in insulin therapy can enhance treatment adherence and quality of life.
  • Shared decision-making and a biopsychosocial perspective are key to optimizing flexible insulin strategies.