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Related Concept Videos

Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

551
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...
551
Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

574
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...
574
Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

744
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
744
Insulin: Biosynthesis, Chemistry, and Preparation01:25

Insulin: Biosynthesis, Chemistry, and Preparation

1.1K
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...
1.1K
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

497
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...
497
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

782
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...
782

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Improving IV Insulin Administration in a Community Hospital
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CONCENTRATED INSULINS: CLINICAL UPDATE OF THERAPEUTIC OPTIONS.

Guillermo E Umpierrez, Elizabeth H Holt, Daniel Einhorn

    Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
    |April 28, 2020
    PubMed
    Summary
    This summary is machine-generated.

    Concentrated insulin formulations offer a valuable option for managing type 1 and type 2 diabetes, especially in patients with obesity and insulin resistance. These concentrated insulins reduce injection volume, potentially decreasing pain and the number of daily injections.

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    Area of Science:

    • Endocrinology
    • Pharmacology
    • Metabolic Diseases

    Background:

    • Improved glycemic control reduces diabetic complications.
    • Type 1 and type 2 diabetes management often requires insulin therapy, especially with disease progression and insulin resistance.
    • Obesity increases insulin requirements, necessitating concentrated insulin formulations.

    Purpose of the Study:

    • To provide a comprehensive overview of concentrated insulin products.
    • To analyze current evidence and expert guidance on concentrated insulins.
    • To enhance clinician confidence in prescribing and managing concentrated insulins.

    Main Methods:

    • Stepwise analysis of available concentrated insulin products.
    • Review of up-to-date scientific evidence.
    • Inclusion of expert guidance and commentary.

    Main Results:

    • Concentrated insulins (e.g., U200, U300, U500) offer an alternative to U100 insulin.
    • Low injection volume is a key advantage, potentially reducing pain and injection frequency.
    • These formulations aid in managing increased insulin needs in obese patients.

    Conclusions:

    • Concentrated insulins are beneficial for patients with type 1 and type 2 diabetes requiring higher insulin doses.
    • They offer practical advantages in terms of injection volume and patient comfort.
    • Clinicians can confidently utilize these products for improved diabetes management.