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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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Drug Dosage Regimen: Overview01:15

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A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
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Dosage Regimen: Fixed Dose01:01

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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...
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Rational Dosage Regimen: Maintenance Dose and Loading Dose01:24

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A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
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Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

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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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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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Updated: Jun 4, 2025

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The Effective Use by Primary Care Clinicians of a Comprehensive Computerized Insulin Dose Adjustment Algorithm.

Mayer B Davidson1,2

  • 1Charles R. Drew University, Los Angeles, CA, USA.

Journal of Diabetes Science and Technology
|December 23, 2024
PubMed
Summary
This summary is machine-generated.

Primary care clinicians can now improve diabetes management using computerized insulin dose adjustment algorithms (CIDAAs). These tools help lower HbA1c levels in patients requiring insulin, enhancing glycemic control.

Keywords:
computerized insulin dose adjustment algorithmscontinuous glucose monitoringinsulin therapyprimary careremote glucose monitoringtelemedicine

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Area of Science:

  • Endocrinology
  • Diabetes Management
  • Health Informatics

Background:

  • Primary care clinicians (PCCs) manage most diabetes patients, but many struggle with insulin therapy due to time and experience limitations.
  • Poor glycemic control in insulin-treated patients remains a significant challenge in primary care settings.

Purpose of the Study:

  • To evaluate the effectiveness of comprehensive computerized insulin dose adjustment algorithms (CIDAAs) in improving glycemic control managed by PCCs.
  • To assess the impact of CIDAAs on HbA1c levels and clinical workflow in primary care.

Main Methods:

  • Development and utilization of FDA-cleared and CE-marked CIDAAs providing glucose analysis and insulin dose recommendations.
  • PCCs used CIDAAs for analysis of patient glucose readings (in-person or remote) and accepted/modified recommended insulin dose adjustments.
  • Prospective studies involving poorly controlled and real-world patient populations managed by PCCs over 4-6 months.

Main Results:

  • In poorly controlled patients, HbA1c levels decreased by 1.7% (from 9.7%) over 4-6 months.
  • In a combined cohort, HbA1c levels improved by 0.7% (from 8.3%) over 6.4 months.
  • CIDAAs facilitated significant improvements in glycemic control and saved PCC time.

Conclusions:

  • Comprehensive CIDAAs empower PCCs to effectively manage insulin therapy and improve glycemic control in diabetes patients.
  • These algorithms offer a valuable tool for enhancing diabetes care in primary care settings, addressing challenges of time and experience.
  • CIDAAs contribute to better patient outcomes and optimize PCC efficiency, allowing focus on broader patient needs.