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Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

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...
Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

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 rapid-acting...
Insulin: Biosynthesis, Chemistry, and Preparation01:25

Insulin: Biosynthesis, Chemistry, and Preparation

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 primarily uses...
Inhaled Medications01:23

Inhaled Medications

Inhaled medications are crucial for managing chronic obstructive pulmonary disease (COPD) and asthma. They are essential for effective treatment and control, ensuring optimal respiratory health and well-being. Inhaled medication delivers drugs directly to the lungs, providing a rapid onset of action and reducing systemic side effects compared to oral or injectable medications. Three primary types of inhalation devices are used to administer these medications: nebulizers, metered-dose inhalers...
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

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 manages...
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

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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Improving IV Insulin Administration in a Community Hospital
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Published on: June 11, 2012

Inhaled Insulin: Place in Therapy.

Sanjay Kalra1, Saptarshi Bhattacharya2, Nitin Kapoor3

  • 1Department of Endocrinology, Bharti Hospital, Karnal, India; University Center for Research & Development, Chandigarh University, India.

JPMA. the Journal of the Pakistan Medical Association
|June 27, 2026
PubMed
Summary
This summary is machine-generated.

Inhaled insulin provides a convenient, non-injectable option for prandial glucose control in adults with diabetes. This framework simplifies its integration into clinical practice through strategic initiation, interchange, and intensification approaches.

Keywords:
Afrezza, diabetes, glycaemic control, insulin, person centred care, prandial insulin

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Area of Science:

  • Endocrinology
  • Pharmacology
  • Diabetes Management

Background:

  • Inhaled insulin offers a non-injectable alternative for diabetes management.
  • Current guidelines recommend inhaled insulin for prandial glucose control in adults.
  • Basal insulin requirements are not met by inhaled insulin alone.

Purpose of the Study:

  • To describe the rational placement of inhaled insulin in clinical practice.
  • To classify the use of inhaled insulin into distinct strategies.
  • To propose structured regimens and usage styles for inhaled insulin.

Main Methods:

  • Classification of inhaled insulin use into initiation, interchange, and intensification.
  • Suggestion of homologous (purist) and heterologous (hybrid) structured regimens.
  • Proposal of fixed, formative, and flexible usage styles.

Main Results:

  • A framework for the clinical use of inhaled insulin was developed.
  • Strategies for integrating inhaled insulin into existing treatment plans were defined.
  • Different usage styles were proposed to accommodate patient needs.

Conclusions:

  • The proposed framework simplifies and supports the use of inhaled insulin in clinical practice.
  • This approach aids clinicians in optimizing inhaled insulin therapy.
  • Enhanced patient adherence and glycemic control can be achieved through structured implementation.