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Related Concept Videos

Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

145
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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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.
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: Biosynthesis, Chemistry, and Preparation01:25

Insulin: Biosynthesis, Chemistry, and Preparation

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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.
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...
322
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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Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

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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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Oral Hypoglycemic Agents: Glinides01:06

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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...
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Improving IV Insulin Administration in a Community Hospital
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Advance Insulin Injection Technique and Education With FITTER Forward Expert Recommendations.

David C Klonoff1, Lori Berard2, Denise Reis Franco3

  • 1Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA.

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Summary

Proper insulin injection technique is crucial for effective diabetes management. Updated global guidelines from the FITTER Forward initiative offer evidence-based recommendations for healthcare professionals and people with diabetes.

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Area of Science:

  • Endocrinology and Metabolism
  • Diabetes Care
  • Medical Device Technology

Background:

  • Suboptimal insulin therapy outcomes and complications are frequently linked to inadequate injection technique and training.
  • Existing global best practices for insulin injection technique were last updated in 2016.
  • A comprehensive update reflecting new evidence and expert perspectives is needed.

Purpose of the Study:

  • To present updated, evidence-based global recommendations for insulin injection technique and training.
  • To address unmet needs in diabetes management related to insulin delivery.
  • To empower healthcare professionals and individuals with diabetes through improved education.

Main Methods:

  • The FITTER Forward initiative convened 16 diabetes specialists from 13 countries (2023-2024).
  • Recommendations were developed based on new evidence and modern expert perspectives.
  • Content is organized into four key sections for clinical application.

Main Results:

  • Foundational science influencing injection device design, user experience, and outcomes.
  • Detailed procedures for insulin pen and syringe use, including storage and disposal.
  • Strategies for reducing lipodystrophy, particularly lipohypertrophy.
  • Framework for structured injection technique training programs.

Conclusions:

  • The FITTER Forward recommendations provide a critical update to global insulin injection best practices.
  • Improved injection technique and comprehensive training are essential for optimizing diabetes management and patient outcomes.
  • These guidelines aim to enhance the ability of healthcare professionals to guide safe and effective insulin delivery.