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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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Discharge Summary Forms01:31

Discharge Summary Forms

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The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
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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.
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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.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
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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.
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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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Improving IV Insulin Administration in a Community Hospital
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Developing a Diabetes Discharge Order Set for Patients With Diabetes on Insulin.

Elizabeth Miles1, Melissa McKnight2, Claire C Schmitz3

  • 1Division of Hospital Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.

Journal of Diabetes Science and Technology
|March 28, 2024
PubMed
Summary

Implementing an insulin discharge order set improved supply ordering for diabetes patients. While it didn't change insulin regimen intensification, the order set aids in providing necessary supplies and education for better post-discharge care.

Keywords:
diabetes mellitusdiabetes order setinsulinpatient safety

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Area of Science:

  • Internal Medicine
  • Endocrinology
  • Pharmacology

Background:

  • Insulin is a high-risk medication frequently associated with prescribing errors.
  • Diabetes patients face higher hospitalization rates and prolonged stays due to medication errors.
  • Common insulin prescription errors include missing orders, incorrect insulin types, and inadequate regimen intensification.

Purpose of the Study:

  • To explore system-based interventions and educational tools to reduce insulin prescribing errors.
  • To improve the quality of insulin discharge regimens for patients with diabetes.

Main Methods:

  • A needs assessment and baseline chart review were performed.
  • A diabetes discharge order set was adapted and implemented after beta testing.
  • Post-intervention chart reviews assessed the impact of the order set.

Main Results:

  • 98% of providers desired an insulin discharge order set.
  • High utilization of the order set increased the rate of ordering all necessary supplies from 27% to 55%.
  • No significant change was observed in the intensification of insulin regimens for uncontrolled diabetes at discharge.

Conclusions:

  • A diabetes discharge order set can enhance the provision of essential insulin supplies upon discharge.
  • The order set has the potential to improve patient education and promote appropriate insulin regimens.
  • Further interventions may be needed to address insulin regimen intensification at discharge.