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Related Concept Videos

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.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
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Diabetes Mellitus: Overview and Type I Subtype01:22

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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.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
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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.
Short-acting insulins are divided into...
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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.
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
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Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

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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: Type 2 and Gestational01:22

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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...
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High-Efficiency Generation of Antigen-Specific Primary Mouse Cytotoxic T Cells for Functional Testing in an Autoimmune Diabetes Model
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Insulin immunotherapy for pretype 1 diabetes.

Laura M Jacobsen1, Desmond A Schatz

  • 1Department of Pediatrics, University of Florida, Gainesville, Florida, USA.

Current Opinion in Endocrinology, Diabetes, and Obesity
|June 6, 2021
PubMed
Summary

Biomarkers can identify individuals who may benefit from oral insulin therapy for type 1 diabetes (T1D). Personalized medicine approaches using these markers could improve treatment efficacy in T1D prevention.

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Area of Science:

  • Immunology
  • Endocrinology
  • Genetics

Background:

  • Loss of immune tolerance to insulin is implicated in type 1 diabetes (T1D) pathogenesis.
  • Insulin antigen therapy has shown limited success in clinical trials.
  • T1D heterogeneity influences patient response to immune therapies.

Purpose of the Study:

  • To review the role of biomarkers in predicting response to insulin therapy for T1D.
  • To explore personalized medicine strategies for T1D prevention and treatment.
  • To identify subpopulations that may benefit from oral insulin therapy.

Main Methods:

  • Posthoc analyses of clinical trials.
  • Identification and evaluation of biomarkers such as insulin autoantibodies, insulin response, and genetic factors.
  • Review of ongoing and completed prevention studies.

Main Results:

  • Biomarkers including high insulin autoantibody titer, low first phase insulin response, and high Diabetes Prevention Trial-Type 1 Risk Score identified at-risk individuals who benefited from oral insulin.
  • Human leukocyte antigen and INS VNTR polymorphism are potential biomarkers for future studies.

Conclusions:

  • While overall efficacy has been limited, oral insulin shows promise in specific subpopulations.
  • Refined biomarker testing is crucial for future clinical trials.
  • Oral insulin may be effective as part of combination therapies for T1D prevention.