Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

145
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...
145
Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

169
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...
169
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

236
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...
236
Dosage Regimen: Fixed Dose01:01

Dosage Regimen: Fixed Dose

1.9K
Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
1.9K
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

141
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...
141
Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

171
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
171

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Surgical Quality Assessment of paravertebral catheter placement in minimally invasive esophagectomy: an exploratory post hoc analysis of the PEPMEN- trial.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·2026
Same author

A Systematic Review and Expert Evaluation of Perioperative SGLT2 Inhibitor-Associated Ketoacidosis Case Reports.

Acta anaesthesiologica Scandinavica·2026
Same author

Associations between estradiol levels and subjective sleep parameters in a large cohort of men and women.

Endocrine connections·2026
Same author

The effects of sleep improving interventions in medical hospital wards: the WEsleep study - A randomized clinical trial.

European journal of internal medicine·2025
Same author

Taste preference of patients shortly after surgery in the Post Anaesthesia Care Unit (PACU).

Clinical nutrition ESPEN·2025
Same author

Update on the perioperative management of diabetes mellitus.

BJA education·2024

Related Experiment Video

Updated: Jun 6, 2025

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

18.8K

[Time to stop sliding scale insulin regimen].

E M Apperloo1,2, J Hermanides3, T M Vriesendorp4

  • 1Universitair Medisch Centrum Groningen, afd. Interne Geneeskunde, Groningen.

Nederlands Tijdschrift Voor Geneeskunde
|November 28, 2024
PubMed
Summary
This summary is machine-generated.

Strict glycemic control in hospitals carries risks like hypoglycemia. A basal-bolus insulin regimen is recommended over sliding scale insulin for better patient outcomes and reduced workload.

More Related Videos

Author Spotlight: Exploring the Impact of Reduced Resistance Exercise Volume on Metabolic Health
06:13

Author Spotlight: Exploring the Impact of Reduced Resistance Exercise Volume on Metabolic Health

Published on: December 1, 2023

1.0K
Studying the Hypothalamic Insulin Signal to Peripheral Glucose Intolerance with a Continuous Drug Infusion System into the Mouse Brain
08:32

Studying the Hypothalamic Insulin Signal to Peripheral Glucose Intolerance with a Continuous Drug Infusion System into the Mouse Brain

Published on: January 4, 2018

10.2K

Related Experiment Videos

Last Updated: Jun 6, 2025

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

18.8K
Author Spotlight: Exploring the Impact of Reduced Resistance Exercise Volume on Metabolic Health
06:13

Author Spotlight: Exploring the Impact of Reduced Resistance Exercise Volume on Metabolic Health

Published on: December 1, 2023

1.0K
Studying the Hypothalamic Insulin Signal to Peripheral Glucose Intolerance with a Continuous Drug Infusion System into the Mouse Brain
08:32

Studying the Hypothalamic Insulin Signal to Peripheral Glucose Intolerance with a Continuous Drug Infusion System into the Mouse Brain

Published on: January 4, 2018

10.2K

Area of Science:

  • Internal Medicine
  • Endocrinology
  • Clinical Pharmacy

Background:

  • Hyperglycemia on admission correlates with increased complications and mortality.
  • Evidence for strict glycemic control's benefits during hospitalization is limited, with risks including hypoglycemia, which is linked to mortality.
  • Current guidelines have advised against sliding scale insulin for nearly two decades due to ineffectiveness.

Purpose of the Study:

  • To evaluate the effectiveness of basal-bolus insulin regimens compared to sliding scale insulin for managing hyperglycemia in hospitalized patients.
  • To advocate for a paradigm shift in inpatient glucose management towards more nuanced and effective strategies.
  • To highlight the benefits of basal-bolus insulin in improving patient outcomes and reducing healthcare provider workload.

Main Methods:

  • Review of existing evidence and guidelines regarding inpatient glycemic control strategies.
  • Comparison of outcomes associated with sliding scale insulin versus basal-bolus insulin regimens.
  • Analysis of risks and benefits, including hypoglycemia and mortality, associated with different insulin protocols.

Main Results:

  • Sliding scale insulin regimens are largely ineffective and have been discouraged by guidelines for years.
  • Basal-bolus insulin regimens show promising outcomes and offer a more effective approach to glucose management.
  • Tolerating mild hyperglycemia may be preferable to aggressive control that risks hypoglycemia.

Conclusions:

  • A transition from sliding scale insulin to basal-bolus insulin regimens is recommended for managing elevated glucose levels in hospitalized patients.
  • Basal-bolus insulin provides a more effective and nuanced approach, leading to improved patient outcomes.
  • Adopting basal-bolus insulin regimens can enhance patient care while potentially lowering the workload for healthcare professionals.