Video Experimental Relacionado
Updated: Jun 20, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
No hay riesgo de diabetes después del tratamiento de choque con insulina
T Bock1, C R Pedersen, K Josefsen
1Bartholin Instituttet, Kommunehospitalet, Copenhagen, Denmark.
Lancet (London, England)
|June 20, 1992
Resumen
El tratamiento profiláctico con insulina es seguro para prevenir la diabetes. Este estudio no encontró un aumento en el riesgo de desarrollar diabetes (dependiente o no de insulina) en pacientes no diabéticos que recibieron múltiples inyecciones de insulina.
Área de la Ciencia:
- Endocrinología Endocrinología.
- Inmunología Inmunología.
- La investigación clínica es la investigación clínica.
Sus antecedentes:
- La insulina profiláctica es efectiva en modelos animales para prevenir la diabetes mellitus dependiente de la insulina (IDDM, por sus siglas en inglés).
- Existen preocupaciones de seguridad con respecto a la insulina como un autoantígeno potencial que acelera la descompensación de las células beta en humanos prediabéticos.
- El riesgo de desarrollar diabetes por insulina profiláctica en humanos no está bien establecido.
Objetivo del estudio:
- Investigar la seguridad del tratamiento con insulina en individuos no diabéticos.
- Determinar si el tratamiento con insulina aumenta el riesgo de desarrollar posteriormente diabetes (IDDM y NIDDM).
Principales métodos:
- Estudio retrospectivo de 481 pacientes daneses tratados con terapia de choque con insulina para trastornos psiquiátricos.
- Análisis de los registros hospitalarios para la incidencia de la diabetes y la duración del seguimiento (promedio de 22 años).
- Análisis de muestras de sangre para glucosa, insulina, anticuerpos de islotes y anticuerpos de insulina en un subconjunto de pacientes.
Principales resultados:
- Solo se desarrolló 1 caso de IDDM, en comparación con los 1,3 casos esperados (p = 0,75).
- Se observaron 12 casos de diabetes mellitus no dependiente de insulina (NIDDM), frente a los 10,2 casos esperados (p = 0,45).
- No se encontró un aumento significativo en el riesgo de diabetes; la mayoría de los pacientes tenían niveles normales de glucosa / insulina y baja prevalencia de anticuerpos.
Conclusiones:
- El tratamiento con insulina de sujetos no diabéticos no aumentó el riesgo de desarrollar IDDM o NIDDM.
- Los ensayos clínicos para la prevención de IDDM utilizando insulina profiláctica se consideran seguros.
- El estudio apoya la seguridad del uso terapéutico de la insulina sin acelerar el inicio de la diabetes.
Videos de Conceptos Relacionados
01:16Insulin: 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...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
01:26Oral Hypoglycemic Agents: Biguanides and Glitazones
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...
01:06Oral 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...
01:19Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are typically...
Acarbose and miglitol are typically...
01:23Dipeptidyl Peptidase 4 Inhibitors
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a significant...
01:15Hypoglycemia and Glucagon
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...