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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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Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Blood Pressure Imbalances and Circulatory Shock01:24

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Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
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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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Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

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The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
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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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Related Experiment Video

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Improving IV Insulin Administration in a Community Hospital
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Insulin Shocks.

Joseph White1, Nicholas Corwin1

  • 1Case Western Reserve University.

Journal of Health Politics, Policy and Law
|July 22, 2022
PubMed
Summary
This summary is machine-generated.

Shocking news about insulin prices reveals a flawed US healthcare system. Rebates, not lower patient costs, inflate drug prices, making life-saving insulin unaffordable for many.

Keywords:
PBMdrug priceshealth careinsulinrationing

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Area of Science:

  • Health Economics
  • Pharmaceutical Policy
  • Public Health

Background:

  • The US healthcare system faces challenges in drug pricing and accessibility.
  • The high cost of insulin has led to rationing and tragic outcomes for some patients.
  • Current pricing structures, particularly rebates, are implicated in affordability issues.

Purpose of the Study:

  • To analyze the impact of the current US healthcare system on insulin affordability.
  • To examine the consequences of rebate-based discount structures on patient access to insulin.
  • To challenge common understandings of US healthcare, insurance, and payment systems.

Main Methods:

  • Qualitative analysis of news reports and healthcare system structures.
  • Examination of the relationship between drug pricing, insurance policies, and patient out-of-pocket costs.
  • Critique of the political and economic factors influencing pharmaceutical pricing.

Main Results:

  • The current system encourages higher list prices for insulin.
  • Rebate systems, intended to lower costs, paradoxically increase affordability challenges for uninsured or high-cost-sharing patients.
  • The structure of discounts significantly impacts patient access and affordability.

Conclusions:

  • The US healthcare system's approach to insulin pricing is counterproductive.
  • Reforms are needed to ensure lower individual prices for patients, rather than relying on rebate systems.
  • Addressing insulin affordability requires a fundamental reevaluation of healthcare payment and political structures.