Insulin is used always in type 1 diabetics, and sometimes in type 2, or adult onset diabetes. In a type 2 diabetic we start with diet and exercise changes, then if not controlled, we add medications
Diabetes Q&a: 70/30; "rule Of Fifths"; Split-mix; Basal-bolus-- Which Is Best?: Page 2 Of 2
A: There is no one "right"method for determining the appropriate initial insulin dosage for children with new-onset type 1 diabetes (T1D). Choosing an insulin regimen often involves a trade-off between accuracy and simplicity. The split-mix regimen. Until recently, most pediatric patients with T1D were started on a "2-shot split-mix" regimen, which combined short- and long-acting insulins in a single injection given twice daily at a total daily dose of approximately 1 unit/kg. Typically, two thirds of the total daily dose was given at breakfast and one third before dinner. Two thirds of the morning dose was given as long-acting insulin (such as NPH or Lente) and one third as short-acting (such as Regular or one of the rapid-acting analogs). Half of the evening dose was given as long-acting and half as short-acting insulin. For example, for a child who weighs 36 kg, the initial insulin doses would be 8 lispro/aspart plus 16 NPH at breakfast and 6 lispro/aspart plus 6 NPH at dinner. Many clinicians are now moving away from the 2-shot split-mix regimens because they are usually insufficient to meet intensive glycemic goals without unacceptable swings in blood sugar levels. Three-shot
A short video blog from the consumerjusticegroup.com explaining the FDA drug recall process.
Roche Launches Fda-cleared Diabetes App With Insulin Calculator In Us
Last month, Roche quietly launched its Accu-Chek Connect app, a diabetes management app which contains, among other things, an unprecented feature: a prescription insulin bolus calculator called Bolus Advisor. Roche has been selling the app in other countries for a little while, even issuing a brief recall in April in some of those countries. It received FDA clearance for the Android version of the app in mid-March and finally received clearance for the iOS version in early June, using the Android clearance as the predicate device. The app gives people with diabetes a choice of reports to help identify trends and patterns in blood sugar levels and lets them share their data with their caregiver or healthcare team via connected online accounts, email or text message. It receives data from the Accu-Chek Aviva Connect Bluetooth-enabled meter. As of June 27, the app is now available in the United States for both iOS and Android devices. “The development of the Accu-Chek Connect system underscores Roche Diabetes Care’s commitment to advancing technology that empowers people with diabetes to focus on the daily wins of managing diabetes and living life as normally and actively as poss
What is INSULIN SHOCK THERAPY? What does INSULIN SHOCK THERAPY mean? INSULIN SHOCK THERAPY meaning - INSULIN SHOCK THERAPY definition - INSULIN SHOCK THERAPY explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Insulin shock therapy or insulin coma therapy (ICT) was a form of psychiatric treatment in which patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks. It was introduced in 1927 by Austrian-American psychiatrist Manfred Sakel and used extensively in the 1940s and 1950s, mainly for schizophrenia, before falling out of favour and being replaced by neuroleptic drugs in the 1960s. It was one of a number of physical treatments introduced into psychiatry in the first four decades of the twentieth century. These included the convulsive therapies (cardiazol/metrazol therapy and electroconvulsive therapy), deep sleep therapy and psychosurgery. Insulin coma therapy and the convulsive therapies are collectively known as the shock therapies. Insulin coma therapy was a labour-intensive treatment that required trained staff and a special unit. Patients, who were almost invariably diagnosed with schizophrenia, were selected on the basis of having a good prognosis and the physical strength to withstand an arduous treatment. There were no standard guidelines for treatment; different hospitals and psychiatrists developed their own protocols. Typically, injections were administered six days a week for about two months. The daily insulin dose was gradually increased to 100150 units until comas were produced, at which point the dose would be levelled out. Occasionally doses of up to 450 units were used. After about 50 or 60 comas, or earlier if the psychiatrist thought that maximum benefit had been achieved, the dose of insulin was rapidly reduced before treatment was stopped. Courses of up to 2 years have been documented. After the insulin injection patients would experience various symptoms of decreased blood glucose: flushing, pallor, perspiration, salivation, drowsiness or restlessness. Sopor and comaif the dose was high enoughwould follow. Each coma would last for up to an hour and be terminated by intravenous glucose. Seizures sometimes occurred before or during the coma. Many would be tossing, rolling, moaning, twitching, spasming or thrashing around. Some psychiatrists regarded seizures as therapeutic and patients were sometimes also given electroconvulsive therapy or cardiazol/metrazol convulsive therapy during the coma, or on the day of the week when they didnt have insulin treatment. When they were not in a coma, insulin coma patients were kept together in a group and given special treatment and attention; one handbook for psychiatric nurses, written by British psychiatrist Eric Cunningham Dax, instructs nurses to take their insulin patients out walking and occupy them with games and competitions, flower-picking and map-reading, etc. Patients required continuous supervision as there was a danger of hypoglycemic aftershocks after the coma. In "modified insulin therapy", used in the treatment of neurosis, patients were given lower (sub-coma) doses of insulin. A few psychiatrists (including Sakel) claimed success rates for insulin coma therapy of over 80 percent in the treatment of schizophrenia; a few others argued that it merely sped up remission in those patients who would undergo remission anyway. The consensus at the time was somewhere in between - claiming a success rate of about 50 percent in patients who had been ill for less than a year (about double the spontaneous remission rate) with no influence on relapse. Sakel suggested the therapy worked by "causing an intensification of the tonus of the parasympathetic end of the autonomic nervous system, by blockading the nerve cell, and by strengthening the anabolic force which induces the restoration of the normal function of the nerve cell and the recovery of the patient." The shock therapies in general had developed on the erroneous premise that epilepsy and schizophrenia rarely occurred in the same patient. Another theory was that patients were somehow "jolted" out of their mental illness.
Insulin Therapy For Challenging Patient Cases
Initiating and advancing insulin therapy in patients with type 2 diabetes mellitus can be challenging. However, with the availability of insulin analogs with more physiologic profiles, and with the initiation of simple insulin regimens (eg, the use of basal insulin administered once daily), an opportunity is created to empower patients to self-titrate their insulin. Self-titration can reduce the burden on the physician as well as improve glycemic control in patients. More options for intensifying insulin now exist, including gradually adding prandial insulin (referred to as a basal “plus” strategy) or using premixed insulin analogs for patients with relatively consistent lifestyles and habits. More-concentrated forms of insulin, such as U-500 insulin, may be helpful for patients requiring very large doses of insulin. The key is to match the insulin regimen to the patient; engage in dialogue to understand the patient's lifestyle, concerns, and skill sets; and develop, through a shared decision-making process, appropriate individualized treatment recommendations. The present review article focuses on the use of insulin replacement therapy in challenging patient cases. Approximate
In Review In non-critically ill patients with type 2 diabetes mellitus, is a basal-bolus insulin regimen more effective and safer for glycemic control as compared to sliding-scale regular insulin? Bottom Line In non-critically ill patients with type 2 diabetes mellitus, a basal-bolus insulin regimen is more effective for glycemic control as compared to sliding-scale regular insulin. There were no significant differences in the incidence of hypogl ...
We all know about bolus, but do you know how basal insulin works? Here’s the inside story. Any person with diabetes on insulin therapy knows that you need insulin when you eat a meal. Using a see-saw as an analogy, food and insulin balance each other out. Too much food and not enough insulin, you have hyperglycemia. Too much insulin and not enough food, and you have hypoglycemia. But most people who use insulin also realize that it’s not just ...
Basal insulin refers to the insulin required to control your blood sugar in the absence of food intake. A certain amount of insulin is always necessary to keep the blood sugar in the normal range, even in the absence of eating for prolonged periods. Without any insulin in the body, the starch, fat, and protein in the body will break down with severe health consequences, as occurs in people with type 1 diabetes. The amount of insulin that the body ...
back to Overview It's time for lunch. Your blood sugar is 165 mg/dl (9.2 mmol/L). You have a big slice of pizza, a bag of chips, and a cold Diet Coke waiting for you. How much insulin do you take? I can think of a few ways this goes: There’s not much to think about. You always eat the same thing and always take the same amount of insulin. You define the phrase “creature of habit.” You hate thinking about all of this stuff, so you just guess ...
Dec 5 (Reuters) - NOVO NORDISK A/S: * XULTOPHY REPORTED A BETTER OPTION THAN BASAL-BOLUS INSULIN THERAPY TO MANAGE TYPE 2 DIABETES BY PARTICIPANTS IN THE DUAL VII CLINICAL TRIAL * THIS WAS REPORTED BY PEOPLE WITH TYPE 2 DIABETES WHOSE BLOOD SUGAR WAS NOT CONTROLLED ON INSULIN GLARGINE U100 WITH METFORMIN, AND WHO COMPLETED QUALITY-OF-LIFE QUESTIONNAIRES AS PART OF THE DUAL VII CLINICAL TRIAL * MORE PEOPLE PREFERRED TO STAY ON XULTOPHY COMPARED WI ...
Objective: To compare the efficacy and safety of insulin glulisine (GLU), a new rapid-acting insulin analogue, injected 0 to 15 minutes before or immediately after meals, with regular human insulin (RHI), injected 30 to 45 minutes before meals. Methods: Patients with type 1 diabetes (N = 860) received once-daily insulin glargine and subcutaneous injections of either GLU (premeal or postmeal) or premeal RHI in this open-label, randomized, controll ...