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Related Concept Videos

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: Dosing Regimen and Adverse Effects01:16

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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.
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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 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.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
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Hypoglycemia and Glucagon01:15

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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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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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Hypoglycemia in Diabetes.

The Nursing clinics of North America·2017
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Diabetes Management in the Critical Care Setting: Insulin Infusions.

Marjorie R Ortiz1

  • 1Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Critical Care Nursing Clinics of North America
|January 31, 2025
PubMed
Summary

Continuous insulin infusions effectively manage hyperglycemia in critically ill patients. Protocols, nursing care, and transition strategies are crucial for safe and beneficial use in the intensive care unit (ICU).

Keywords:
Critical care nursingInpatient hyperglycemia managementInsulin dripIntravenous insulin infusion

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Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Nursing Practice

Background:

  • Hyperglycemia is a frequent complication in critically ill patients.
  • Managing blood glucose levels is essential for patient outcomes in the intensive care unit (ICU).

Purpose of the Study:

  • To review the benefits and risks associated with continuous insulin infusions for hyperglycemia.
  • To outline essential components of insulin infusion protocols.
  • To describe nursing management and transition strategies for insulin infusions.

Main Methods:

  • Literature review of current practices and evidence regarding insulin infusion therapy.
  • Discussion of established protocols and nursing considerations.
  • Analysis of patient transition protocols from insulin infusions.

Main Results:

  • Continuous insulin infusions offer a method for glycemic control in critically ill patients.
  • Specific protocols and vigilant nursing management are key to minimizing risks.
  • Structured transition plans are necessary for safe discontinuation.

Conclusions:

  • Continuous insulin infusions are a valuable tool for managing hyperglycemia in the ICU.
  • Adherence to protocols and skilled nursing care optimize patient safety and therapeutic benefits.
  • Effective transition strategies are vital for continuity of care.