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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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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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[Modified eProtocol-insulin for critically ill patients and application software].

Qiong Gu1,2, Lihui Zhang3, Weifeng Ying2

  • 1Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China.

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
|February 8, 2022
PubMed
Summary

Managing blood glucose in critically ill patients is vital. A new, personalized insulin dosing protocol and smart device app were developed for better glycemic control in China.

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Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Medical Informatics

Background:

  • Dysglycemia significantly impacts mortality in critically ill patients.
  • Current blood glucose management strategies may not suit all patients.
  • Individualized glycemic targets are needed based on patient-specific factors.

Purpose of the Study:

  • To develop a convenient and individualized insulin dosing protocol for critically ill patients.
  • To create a smart device application (APP) to support clinical insulin management.
  • To address the need for tailored glycemic control in the Chinese population.

Main Methods:

  • Development of a modified eProtocol-insulin using mathematical modeling.
  • Collaboration between clinicians and information engineers.
  • Creation of a user-friendly mobile application for clinical use.

Main Results:

  • A modified eProtocol-insulin tailored for the Chinese population was created.
  • An innovative smart device APP was developed for convenient clinical application.
  • This represents the first eProtocol-insulin and smart device APP for critically ill patients in China.

Conclusions:

  • Individualized blood glucose management is crucial for critically ill patients.
  • The developed eProtocol-insulin and APP offer a convenient solution for tailored insulin dosing.
  • This innovation aims to improve patient outcomes through precise glycemic control.