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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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Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

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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...
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Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

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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...
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Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

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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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Hormones Regulating Blood Glucose01:16

Hormones Regulating Blood Glucose

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Insulin is released by beta cells of the pancreas when blood glucose levels are high. It facilitates glucose absorption and utilization in insulin-dependent cells with insulin receptors on their plasma membranes. Insulin promotes glucose uptake by increasing the number of glucose transport proteins in the cell membrane, allowing glucose to enter the cell. As a result, glucose utilization and ATP production are enhanced.
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Updated: Aug 19, 2025

Improving IV Insulin Administration in a Community Hospital
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Bistable insulin response: The win-win solution for glycemic control.

Javed Akhtar1,2,3,4, Yukun Han3,4, Shangchen Han4

  • 1School of Medicine|Life and Health Sciences, The Chinese University of Hong Kong, Shenzhen 518172, China.

Iscience
|December 5, 2022
PubMed
Summary
This summary is machine-generated.

Muscles exhibit a bistable insulin response, crucial for safe and rapid blood sugar control. This switch-like mechanism, with specific thresholds, helps prevent both low and high blood sugar levels.

Keywords:
Human metabolismmathematical biosciences

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Area of Science:

  • Biochemistry
  • Physiology
  • Mathematical Biology

Background:

  • Glycemic control requires rapid and safe insulin response.
  • Bistability in muscle insulin signaling is a theoretical prediction for achieving this control.

Purpose of the Study:

  • To experimentally validate the bistability hypothesis of muscle insulin response.
  • To investigate the in vitro and in vivo relevance of this bistability.
  • To identify potential biomarkers for metabolic complications.

Main Methods:

  • Cellular experiments using C2C12 myotubes.
  • Single-cell analysis via Förster resonance energy transfer (FRET).
  • Cultured cell analysis using immunoblotting.
  • Mathematical modeling of glucose-insulin dynamics.

Main Results:

  • Demonstrated bistable insulin response in C2C12 myotubes.
  • Identified switch-on and switch-off thresholds at approximately 300 pM and 100 pM insulin, respectively.
  • Mathematical model confirmed bistability's necessity for interpreting data and understanding glucose-insulin dynamics.

Conclusions:

  • Bistability mediates the body's ability to prevent both hypoglycemia and hyperglycemia.
  • The switch-on threshold serves as a potential biomarker for metabolic complications, linked to body composition.