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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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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: 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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Pathophysiology of Diabetes01:20

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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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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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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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Insulin therapy in pregnancy.

Sanjay Kalra1, Fatema Jawad2

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

JPMA. the Journal of the Pakistan Medical Association
|September 2, 2016
PubMed
Summary

This review details insulin therapy for diabetes in pregnancy, offering practical guidance on regimens, preparations, and dosing for both patients and healthcare providers.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Obstetrics

Background:

  • Diabetes in pregnancy requires careful management.
  • Insulin is the primary pharmacotherapy used.
  • Optimal glycemic control is crucial for maternal and fetal outcomes.

Purpose of the Study:

  • To review insulin regimens and preparations for diabetes in pregnancy.
  • To provide guidance on insulin use and dosing.
  • To offer a patient-centered and clinician-friendly approach to management.

Main Methods:

  • Literature review of insulin therapy in pregnancy.
  • Synthesis of information on insulin regimens and preparations.
  • Development of pragmatic management guidelines.
Keywords:
Aspart, Lispro, Insulin, Pregnancy, Detemir, Glargine, GDM, Type 1 diabetes, Type 2 diabetes.

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Main Results:

  • Comprehensive overview of available insulin types and delivery methods.
  • Guidance on initiating, adjusting, and monitoring insulin doses.
  • Emphasis on individualized treatment plans.

Conclusions:

  • Insulin therapy is essential for managing diabetes in pregnancy.
  • Effective management requires understanding various insulin options and patient-specific needs.
  • This review provides practical tools for optimizing insulin treatment.