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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: Management and Pharmacotherapy01:15

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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

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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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Insulin: Biosynthesis, Chemistry, and Preparation01:25

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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.
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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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Type I Diabetes I: Introduction01:12

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Type 1 diabetes mellitus is a chronic metabolic disorder characterized by an absolute deficiency of insulin resulting from the autoimmune destruction of pancreatic β-cells. Although it can occur at any age, it is most commonly diagnosed in childhood, adolescence, or early adulthood. The loss of insulin production impairs cellular glucose uptake, resulting in persistent hyperglycemia and necessitating lifelong insulin therapy.Autoimmune Destruction of β-CellsThe hallmark of type 1...
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Updated: Apr 28, 2026

Improving IV Insulin Administration in a Community Hospital
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Insulin Therapy.

Pasquale Passarella1, Aidar R Gosmanov2

  • 1Division of Endocrinology, Department of Medicine, Albany Medical College, 25 Hackett BLVD third floor, MC 141, Albany, NY 12208 USA.

The Medical Clinics of North America
|April 26, 2026
PubMed
Summary
This summary is machine-generated.

Insulin therapy is a safe and effective inpatient diabetes management option. Proper initiation and dose titration consider patient factors to optimize blood glucose control and prevent hypoglycemia.

Keywords:
Inpatient diabetesInsulinNon-ICU setting

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Area of Science:

  • Endocrinology
  • Pharmacology

Background:

  • Diabetes management in hospitalized patients requires careful consideration of insulin therapy.
  • Insulin formulations include long-acting, short-acting, intermediate, and ultraconcentrated types.

Purpose of the Study:

  • To outline the safe and effective use of insulin for inpatient diabetes management.
  • To guide the initiation and dose titration of insulin in hospitalized patients.

Main Methods:

  • Review of evidence supporting insulin use in hospitalized patients.
  • Consideration of patient-specific factors for insulin initiation.
  • Systematic dose titration based on glycemic control and hypoglycemia.

Main Results:

  • Insulin is a versatile and effective inpatient diabetes treatment.
  • Evidence supports basal-bolus, basal-only, and supplemental insulin regimens.
  • Patient factors like weight, age, renal function, and nutritional status influence insulin initiation.

Conclusions:

  • Insulin therapy is a cornerstone of inpatient diabetes care.
  • Individualized patient assessment is crucial for safe and effective insulin initiation.
  • Systematic titration is essential for achieving glycemic targets and minimizing hypoglycemia.