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Related Concept Videos

Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

150
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...
150
Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

135
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...
135
Insulin: Biosynthesis, Chemistry, and Preparation01:25

Insulin: Biosynthesis, Chemistry, and Preparation

332
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.
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
332
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

124
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...
124
Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

281
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.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
281
Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

2.3K
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...
2.3K

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Related Experiment Video

Updated: May 22, 2025

Improving IV Insulin Administration in a Community Hospital
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Premixed insulin: Advantages, disadvantages, and future.

Yan Xia1, Yun Hu1, Jian-Hua Ma2

  • 1Department of Endocrinology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi 214000, Jiangsu Province, China.

World Journal of Diabetes
|March 17, 2025
PubMed
Summary

Premixed insulin offers convenience for diabetes management but often leads to suboptimal blood glucose control. A new co-formulation of insulin degludec and insulin aspart aims to improve glycemic outcomes by addressing limitations of traditional premixed insulins.

Keywords:
Blood glucose controlDiabetesGlucose-lowering therapyInsulin antibodiesPremixed insulin

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Area of Science:

  • Endocrinology
  • Pharmacology
  • Metabolic Diseases

Background:

  • Premixed insulin formulations combine rapid-acting and intermediate-acting insulins for simplified diabetes management in type 1 and type 2 diabetes.
  • While convenient, fixed-ratio premixed insulins often result in inadequate glycemic control due to the inability to meet individual patient needs.
  • Factors such as variable absorption kinetics and potential immune responses can further compromise the efficacy of conventional premixed insulins.

Discussion:

  • The fixed ratios in traditional premixed insulins do not accommodate the dynamic and individualized requirements for glucose-lowering therapy.
  • Local absorption issues and systemic autoimmune reactions associated with co-formulated insulins can negatively impact overall glycemic control.
  • The development of novel insulin combinations seeks to overcome these inherent limitations of existing premixed insulin products.

Key Insights:

  • Co-formulation of insulin degludec and insulin aspart represents a novel approach to premixed insulin therapy.
  • This new combination aims to provide a more flexible and effective solution for patients requiring basal-bolus insulin regimens.
  • Addressing the shortcomings of conventional premixed insulins, this formulation may offer improved blood glucose management.

Outlook:

  • Further clinical evaluation is necessary to establish the long-term safety and efficacy of insulin degludec/insulin aspart co-formulation.
  • This innovative premixed insulin holds potential for enhancing patient convenience and achieving better glycemic control in diabetes management.
  • Future research may focus on optimizing dosing strategies and patient selection for this advanced insulin combination therapy.