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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.
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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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Insulin: Biosynthesis, Chemistry, and Preparation01:25

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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.
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Diabetes: Management and Pharmacotherapy01:15

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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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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
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Building a Data-Driven Multiple Daily Insulin Therapy Model Using Smart Insulin Pens.

Rocio Harbison1, Michele Hecht1, Janice MacLeod2

  • 1Advanced Endocrinology and Diabetes Clinic, Houston, TX, USA.

Journal of Diabetes Science and Technology
|August 25, 2020
PubMed
Summary

Connected devices like smart insulin pens offer a new way to manage diabetes remotely. This approach enables data-driven care models and virtual support for patients receiving injection therapy.

Keywords:
connected healthdata-drivendigital healthmultiple daily insulin therapynumeracysmart insulin pentherapeutic inertiavalue-based care

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Area of Science:

  • Digital Health
  • Diabetes Management
  • Health Informatics

Background:

  • The proliferation of connected health devices, including glucose monitors, smart insulin pens, and fitness trackers, presents opportunities for data-driven healthcare.
  • Patient and healthcare provider interest in virtual care and remote monitoring is increasing due to evolving payment and practice models.

Purpose of the Study:

  • To explore the potential of connected devices in creating a data-driven clinical practice model with remote monitoring capabilities.
  • To use diabetes as a case study and smart insulin pens as a specific use case to illustrate this approach.

Main Methods:

  • Defining the category and characteristics of smart insulin pens.
  • Describing the key features of a data-driven practice model.
  • Outlining the steps for integrating smart insulin pen remote monitoring into diabetes care for injection therapy patients.

Main Results:

  • Connected devices facilitate remote patient monitoring and virtual care delivery.
  • Smart insulin pens offer a specific use case for data-driven diabetes management.
  • The integration of these technologies can enhance diabetes care for patients on injection therapy.

Conclusions:

  • A data-driven clinical practice model incorporating remote monitoring via smart insulin pens is feasible and beneficial for diabetes care.
  • This approach supports the evolution towards virtual care and personalized medicine.
  • Further implementation of smart insulin pen technology can improve patient outcomes and healthcare efficiency.