Related Experiment Video
Updated: Feb 14, 2026
05:58
Measuring Relative Insulin Secretion using a Co-Secreted Luciferase Surrogate
Published on: June 25, 2019
8.0K
Insulin Matters: A Practical Approach to Basal Insulin Management in Type 2 Diabetes.
Lori Berard1, Noreen Antonishyn2, Kathryn Arcudi3
1Winnipeg Regional Health Authority, Winnipeg Diabetes Research Group, Health Sciences Centre, Winnipeg, MB, Canada. ldberard@gmail.com.
Summary
Many Canadians with type 2 diabetes (T2D) struggle to reach A1C targets. Expert recommendations aim to simplify insulin initiation and intensification, improving glycemic control and reducing complications.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacology
Background:
- Hyperglycemia in diabetes is linked to severe complications.
- Improved glycemic control, particularly A1C levels, reduces microvascular and cardiovascular risks.
- Canadian guidelines recommend A1C targets of ≤7.0% or ≤6.5% for type 2 diabetes (T2D) patients.
Purpose of the Study:
- To address the challenge of suboptimal glycemic control in T2D patients in Canada.
- To provide practical guidance on insulin initiation and titration for healthcare professionals.
- To simplify and expedite diabetes treatment advancement.
Main Methods:
- A panel of Canadian experts (GPs, nurses, endocrinologists, pharmacists, etc.) reviewed evidence and clinical practices.
- The panel focused on simplifying insulin therapy for T2D management.
- Recommendations were developed for the broader diabetes healthcare community.
Main Results:
- Half of Canadians with T2D are not meeting recommended A1C targets.
- Delayed treatment advancement, especially insulin initiation and intensification, is a major barrier.
- The article summarizes expert panel recommendations for improving insulin management.
Conclusions:
- Effective insulin management is crucial for achieving glycemic targets in T2D.
- Simplified protocols for insulin initiation and titration can improve patient outcomes.
- These recommendations aim to enhance the care of T2D patients in Canada.
Related Concept Videos
01:27Insulin Formulations: Types and Delivery
797
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...
Short-acting insulins are divided into...
797
01:22Diabetes Mellitus: Type 2 and Gestational
5.1K
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...
5.1K
01:05Insulin Secretory Vesicles
7.0K
Insulin secretory vesicles release insulin to stimulate blood glucose uptake and regulate carbohydrate metabolism. When the blood glucose levels increase, glucose enters the pancreatic β-islet cells through glucose transporters. Once inside, glucose is metabolized through glycolysis, the citric acid cycle, and the electron transport chain, producing ATP. This increase in ATP concentration closes ATP-sensitive potassium channels, leading to depolarization of the membrane and the opening of...
7.0K
01:28Insulin: The Receptor and Signaling Pathways
3.5K
Insulin action is mediated through a receptor tyrosine kinase, akin to the IGF-1 receptor. The number of receptors per cell varies significantly, from 40 on erythrocytes to 300,000 on adipocytes and hepatocytes. The insulin receptor consists of linked α/β subunit dimers, forming a heterotetramer glycoprotein with two extracellular α subunits and two β subunits spanning the membrane. The α subunits inhibit the inherent tyrosine kinase activity of the β subunits, but...
3.5K
01:25Insulin: Biosynthesis, Chemistry, and Preparation
1.5K
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...
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
1.5K
01:16Insulin: Dosing Regimen and Adverse Effects
844
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...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
844