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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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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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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...
821
Insulin: Biosynthesis, Chemistry, and Preparation01:25

Insulin: Biosynthesis, Chemistry, and Preparation

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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.
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
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Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

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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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Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

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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 15, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

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New Insulin Delivery Recommendations.

Anders H Frid1, Gillian Kreugel2, Giorgio Grassi3

  • 1Department of Endocrinology, Skane University Hospital, Malmö, Sweden.

Mayo Clinic Proceedings
|September 6, 2016
PubMed
Summary
This summary is machine-generated.

New diabetes injection and infusion guidelines emphasize using the shortest needles, avoiding intramuscular injections, and proper site rotation to prevent lipohypertrophy. Addressing psychological factors and safe sharps disposal are crucial for effective diabetes management.

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Area of Science:

  • Endocrinology
  • Diabetes Management
  • Medical Device Technology

Background:

  • Primary care professionals frequently manage diabetes injection and infusion therapies.
  • Limited guidelines exist to support healthcare providers and patients in these therapies.
  • The Forum for Injection Technique and Therapy: Expert Recommendations (FITTER) workshop convened to address this gap.

Purpose of the Study:

  • To provide practical, comprehensive recommendations for diabetes injection and infusion techniques.
  • To establish evidence-based guidelines informed by international expert consensus.
  • To improve the safety, efficacy, and patient experience of diabetes therapies.

Main Methods:

  • Development of recommendations based on a large international survey of current practices.
  • Consensus-building and vetting by 183 diabetes experts from 54 countries.
  • Organization of recommendations around key themes: anatomy, physiology, pathology, psychology, and technology.

Main Results:

  • Shortest needles (4-mm pen, 6-mm syringe) are recommended as first-line, being safe, effective, and less painful.
  • Intramuscular injections are advised against due to the risk of severe hypoglycemia.
  • Lipohypertrophy is a common complication; injections/infusions into these sites should be avoided, and proper site rotation is essential for prevention.
  • Psychological barriers to insulin therapy require proactive management.
  • Safe disposal of sharps is critical to prevent blood-borne pathogen transmission.

Conclusions:

  • Adherence to the new recommendations can enhance therapy effectiveness and patient outcomes.
  • Improved injection techniques and site management can reduce complications like lipohypertrophy.
  • Addressing psychological aspects and ensuring safe practices contribute to better long-term diabetes care and potentially lower costs.