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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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Pathophysiology of Diabetes01:20

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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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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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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.
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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: Symptoms, Diagnosis, and Complications01:15

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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Improving IV Insulin Administration in a Community Hospital
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Delayed Access to Insulin During Pregnancy.

A Gabriela Rios-Ortega1, Donald C Simonson2, Moomtahina Fatima2

  • 1Division of Endocrinology, University Hospital "Dr. José E. González", Autonomous University of Nuevo Leon, Monterrey, Mexico.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|April 1, 2026
PubMed
Summary
This summary is machine-generated.

Delays in insulin access for pregnant patients with diabetes are common, affecting 15.5%. Black women and those facing insurance issues are disproportionately impacted, highlighting a need for improved access to essential diabetes medications during pregnancy.

Keywords:
gestational diabetesinsulin accesspregnancysocial vulnerabilitytype 2 diabetes

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Health Services Research

Background:

  • Gestational diabetes (GDM) and type 2 diabetes (T2DM) in pregnancy require timely insulin management.
  • Access to insulin can be a barrier for pregnant individuals, potentially impacting maternal and fetal health.
  • Understanding factors contributing to insulin access delays is crucial for optimizing care.

Purpose of the Study:

  • To determine the frequency of delayed insulin access in pregnant patients prescribed new insulin regimens.
  • To identify demographic, clinical, and social factors associated with these delays.
  • To examine the primary barriers to insulin access.

Main Methods:

  • Retrospective electronic health record review of 303 pregnant patients with GDM or T2DM newly prescribed insulin.
  • Insulin access delay defined as ≥7 days between prescription and dispensing.
  • Analysis included Social Vulnerability Index (SVI) and multivariable logistic regression.

Main Results:

  • 15.5% of patients experienced delayed insulin access.
  • Delayed access was significantly associated with Black race, single marital status, interpreter need, and high SVI.
  • Insurance issues (46.8%) and patient preference (27.6%) were primary barriers.
  • Black race (OR=6.01) and recent prescription years (2022-2024) remained significant predictors of delay.

Conclusions:

  • Insulin access delays are prevalent in pregnant patients with diabetes.
  • Black women and individuals in high SVI areas face disproportionately higher risks of delay.
  • Targeted interventions addressing insurance and social determinants are needed to improve insulin access and maternal-fetal outcomes.