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Related Concept Videos

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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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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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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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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.
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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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Insulin (Technique) Induced Hypoglycaemia.

Adlyne Reena Asirvatham1, Shriraam Mahadevan2, Balasubramaniam Sathish Kumar3

  • 1Assistant Professor, Department of Endocrinology, Diabetes and Metabolism, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India.

Journal of Clinical and Diagnostic Research : JCDR
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PubMed
Summary

Hypoglycemia, a common insulin therapy side effect, can stem from incorrect injection sites, techniques, or needle size. This case highlights less common causes of recurrent hypoglycemia, stressing the need for thorough clinical evaluation and patient education.

Keywords:
HypoglycaemiaIntradermal insulinSpotted dermopathy

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Area of Science:

  • Endocrinology
  • Pharmacology

Background:

  • Hypoglycemia is a frequent adverse effect of insulin therapy, alongside weight gain.
  • Common causes include insulin overdose, improper injection technique, site errors, and meal-insulin timing mismatches.

Observation:

  • A patient presented with recurrent episodes of hypoglycemia.
  • Examination revealed spotted dermopathy at insulin injection sites, indicative of intradermal administration.
  • The patient's hypoglycemia was attributed to a combination of incorrect insulin site, technique, and needle size.

Findings:

  • Intradermal insulin administration can lead to faster systemic circulation compared to subcutaneous injection.
  • Less common factors, such as needle size and specific injection techniques, can significantly contribute to hypoglycemia in lean individuals.

Implications:

  • This case underscores the importance of meticulous clinical examination for diagnosing less common causes of hypoglycemia.
  • Effective patient education regarding proper insulin injection techniques, site rotation, and appropriate needle selection is crucial for preventing adverse events.
  • Understanding the nuances of insulin delivery routes can improve patient safety and therapeutic outcomes.