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Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

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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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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
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
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Oral Hypoglycemic Agents: Glinides01:06

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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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Dipeptidyl Peptidase 4 Inhibitors01:23

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Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
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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.
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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.
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Improving IV Insulin Administration in a Community Hospital
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Hypoglycemia Reduction Strategies in the ICU.

Susan Shapiro Braithwaite1,2, Dharmesh B Bavda3, Thaer Idrees3

  • 1, 1135 Ridge Road, Wilmette, IL, 60091, USA. susan.s.braithwaite@gmail.com.

Current Diabetes Reports
|November 4, 2017
PubMed
Summary

Minimizing hypoglycemia risk in intensive care units (ICUs) involves careful insulin dosing, glucose monitoring, and managing external factors. Proactive strategies are crucial for preventing hypoglycemia and improving patient outcomes.

Keywords:
Best practicesCritical careCritical care protocolsHypoglycemiaInsulin infusionInsulin protocol

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Area of Science:

  • Critical care medicine
  • Endocrinology
  • Clinical pharmacology

Background:

  • Hypoglycemia in the ICU is linked to increased patient mortality.
  • Effective glucose management is essential for critically ill adults.

Purpose of the Study:

  • To review strategies for reducing hypoglycemia risk in critically ill non-pregnant adult patients.
  • To identify key factors influencing hypoglycemia in the ICU setting.

Main Methods:

  • Literature review of studies on hypoglycemia risk reduction in ICUs.
  • Analysis of factors including insulin dosing, glucose monitoring, and external influences.

Main Results:

  • Insulin dosing protocols, glucose monitoring, and computerized systems impact hypoglycemia risk.
  • Strategies like IV insulin boluses for insulin resistance and managing carbohydrate exposure are important.
  • Adjusting antihyperglycemic therapy for renal impairment and considering medication interactions are critical.

Conclusions:

  • Caregivers must establish clear protocols for insulin therapy, carbohydrate exposure, and medication management.
  • System-wide quality improvement initiatives should prioritize hypoglycemia prevention in ICUs.