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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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Insulin Secretory Vesicles01:05

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Insulin secretory vesicles release insulin to stimulate blood glucose uptake and regulate carbohydrate metabolism. When the blood glucose levels increase, glucose enters the pancreatic β-islet cells through glucose transporters. Once inside, glucose is metabolized through glycolysis, the citric acid cycle, and the electron transport chain, producing ATP. This increase in ATP concentration closes ATP-sensitive potassium channels, leading to depolarization of the membrane and the opening of...
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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.
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Glucagon-like Receptor Agonists01:24

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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.
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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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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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Related Experiment Video

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Measuring Relative Insulin Secretion using a Co-Secreted Luciferase Surrogate
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Insulin-Related Suicides-3 Cases.

Joseph A Prahlow, Marcel Castor, Prentiss Jones

    Academic Forensic Pathology
    |November 13, 2024
    PubMed
    Summary

    Insulin overdose and cessation of insulin therapy are dangerous actions that can lead to suicide. This case series examines three instances of insulin-related suicides, highlighting the risks associated with this life-saving medication.

    Keywords:
    Forensic pathologydiabetesinsulinintentional medication withdrawalmedication cessationoverdosesuicide

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    Area of Science:

    • Endocrinology
    • Toxicology
    • Psychiatry

    Background:

    • Insulin is a vital hormone for life, crucial for managing diabetes.
    • Exogenous insulin is a life-saving treatment for individuals with insufficient endogenous insulin production.
    • However, insulin, like other medications, carries risks, including intentional misuse leading to adverse outcomes.

    Purpose of the Study:

    • To present a case series of insulin-related suicides.
    • To analyze the different methods of insulin misuse in suicidal acts.
    • To raise awareness about the potential for intentional self-harm involving insulin.

    Main Methods:

    • Case series review.
    • Analysis of three distinct cases of insulin-related suicide.
    • Examination of intentional insulin overdose and cessation of insulin therapy.

    Main Results:

    • Two cases involved intentional insulin overdose.
    • One case involved the purposeful cessation of insulin therapy by a dependent diabetic.
    • All three cases resulted in suicide.

    Conclusions:

    • Insulin misuse, through overdose or cessation, can be a method for suicide.
    • Healthcare providers should be aware of these risks when managing patients on insulin therapy.
    • Further research into prevention strategies for insulin-related self-harm is warranted.