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Relationship Between Insulin And Glucose

Facts About Diabetes And Insulin

Facts About Diabetes And Insulin

Diabetes is a very common disease, which, if not treated, can be very dangerous. There are two types of diabetes. They were once called juvenile-onset diabetes and adult diabetes. However, today we know that all ages can get both types so they are simply called type 1 and type 2 diabetes. Type 1, which occurs in approximately 10 percent of all cases, is an autoimmune disease in which the immune system, by mistake, attacks its own insulin-producing cells so that insufficient amounts of insulin are produced - or no insulin at all. Type 1 affects predominantly young people and usually makes its debut before the age of 30, and most frequently between the ages of 10 and 14. Type 2, which makes up the remaining 90 percent of diabetes cases, commonly affects patients during the second half of their lives. The cells of the body no longer react to insulin as they should. This is called insulin resistance. In the early 1920s, Frederick Banting, John Macleod, George Best and Bertram Collip isolated the hormone insulin and purified it so that it could be administered to humans. This was a major breakthrough in the treatment of diabetes type 1. Insulin Insulin is a hormone. Hormones are chemical substances that regulate the cells of the body and are produced by special glands. The hormone insulin is a main regulator of the glucose (sugar) levels in the blood. Insulin is produced in the pancreas. To be more specific, it's produced by the beta cells in the islets of Langerhans in the pancreas. When we eat, glucose levels rise, and insulin is released into the bloodstream. The insulin acts like a key, opening up cells so they can take in the sugar and use it as an energy source. Sugar is one of the top energy sources for the body. The body gets it in many forms, but mainly as carbohydr Continue reading >>

How Insulin And Glucagon Work To Regulate Blood Sugar Levels

How Insulin And Glucagon Work To Regulate Blood Sugar Levels

The pancreas secretes insulin and glucagon, both of which play a vital role in regulating blood sugar levels. The two hormones work in balance. If the level of one hormone is outside the ideal range, blood sugar levels may spike or drop. Together, insulin and glucagon help keep conditions inside the body steady. When blood sugar is too high, the pancreas secretes more insulin. When blood sugar levels drop, the pancreas releases glucagon to bring them back up. Blood sugar and health The body converts carbohydrates from food into sugar (glucose), which serves as a vital source of energy. Blood sugar levels vary throughout the day but, in most instances, insulin and glucagon keep these levels normal. Health factors including insulin resistance, diabetes, and problems with diet can cause a person's blood sugar levels to soar or plummet. Blood sugar levels are measured in milligrams per decilitre (mg/dl). Ideal blood sugar ranges are as follows: Before breakfast - levels should be less than 100 mg/dl for a person without diabetes and 70-130 mg/dl for a person with diabetes. Two hours after meals - levels should be less than 140 mg/dl for a person without diabetes and less than 180 mg/dl for a person with diabetes. Blood sugar regulation Blood sugar levels are a measure of how effectively an individual's body uses glucose. When the body does not convert enough glucose for use, blood sugar levels remain high. Insulin helps the body's cells absorb glucose, lowering blood sugar and providing the cells with the glucose they need for energy. When blood sugar levels are too low, the pancreas releases glucagon. Glucagon forces the liver to release stored glucose, which causes the blood sugar to rise. Insulin and glucagon are both released by islet cells in the pancreas. These cells Continue reading >>

The Relationship Between Sleep Apnea And Diabetes

The Relationship Between Sleep Apnea And Diabetes

November is National Diabetes Month. Who knew that diabetes and obstructive sleep apnea (OSA) could be related? People who have both do, and are probably the most compliant with continuous positive airway pressure (CPAP) therapy because they know its benefit to both conditions. Consider this: Diabetes is a worldwide epidemic. Meanwhile, sleep-disordered breathing often remains undiagnosed and, therefore, untreated. A correlation between both conditions is notsurprising, as today's research confirms. Which Came First: OSA or Diabetes? Researchers have known about this relationship for more than two decades. A key study led by Rees in 1981 reported the high incidence of sleep breathing disorders in diabetics. Many studies since then have shown independent associations between sleep apnea, glucose intolerance and insulin resistance. Today, insulin resistance is a well-known risk factor for diabetes. But can one cause the other?It's complicated. Having diabetes could cause sleep breathing problems. Having OSA can lead to diabetes. Many diabetics are also obese, and obesity itself can lead to OSA. On the other hand, a person may not be diabetic at all, or live in a pre-diabetic state, and they may not even be obese. Should that person develop OSA, they are more likely to also develop diabetes if they don't treat their OSA. What Statistics Show According to Dr. Osama Hamdy, director at the Inpatient Diabetes Program at Boston's Joslin Diabetes Center, OSA affects about half of all diabetics. A 2014 study in the American Journal of Respiratory and Critical Care Medicine shows that for nondiabetics, 1 in 3 patients with severe OSA will also develop diabetes. Other studies show that when the severity of OSA increases, insulin resistance and glucose intolerance increase as well. Continue reading >>

Exercise, Blood Glucose, And Insulin

Exercise, Blood Glucose, And Insulin

Insulin dependent diabetes mellitus, also known as type 1 diabetes, causes severe neurological and cardiovascular disorders. Insulin plays a crucial role in maintaining glucose levels within the circulatory system. Glucose levels that are unregulated in the DM 1 patient may lead to possible life threatening situations. These situations can be either acute, such as diabetic (hyperglycemic) coma; or chronic, such as distal neuropathy and atherosclerosis. The proper education of exercise, nutrition, and monitoring of blood glucose levels is crucial. Physical therapists should necessitate this education for our patients that their acts are imperative to a healthy life. Diabetes is a condition that can be managed to an extent. Management will reduce the health care costs and promote longevity to our patient’s lives. The role of our profession in patient education is important. Exercise and nutrition has shown to reduce the amounts of insulin required for our bodies.1 As physical therapists, we must promote the benefits of exercise and nutrition to diabetes patients. The relationship between exercise, blood glucose, and insulin will be broken down into the following categories: exercise and it’s effects on blood glucose, exercise and it’s effects on insulin, and insulin and it’s effects on blood glucose. These categories will demonstrate the effects of pharmacologic interventions and non-pharmacologic interventions on diabetes. The best possible solution for control of blood glucose levels will be explored. This will demonstrate the importance of insulin injections vs. nutrition/exercise and their effects on blood glucose levels. The final section of this mini-paper will discuss the appropriate regime to be used for a patient with Insulin Dependent Diabetes Mellitus ( Continue reading >>

Hyperbolic Relationship Between Insulin Secretion And Sensitivity On Oral Glucose Tolerance Test

Hyperbolic Relationship Between Insulin Secretion And Sensitivity On Oral Glucose Tolerance Test

The utility of the disposition index as a measure of β-cell compensatory capacity rests on the established hyperbolic relationship between its component insulin secretion and sensitivity measures as derived from the intravenous glucose tolerance test (IVGTT). If one is to derive an analogous measure of β-cell compensation from the oral glucose tolerance test (OGTT), it is thus necessary to first establish the existence of this hyperbolic relationship between OGTT-based measures of insulin secretion and insulin sensitivity. In this context, we tested five OGTT-based measures of secretion (insulinogenic index, Stumvoll first phase, Stumvoll second phase, ratio of total area-under-the-insulin-curve to area-under-the-glucose-curve (AUCins/gluc), and incremental AUCins/gluc) with two measures of sensitivity (Matsuda index and 1/Homeostasis Model of Assessment for insulin resistance (HOMA-IR)). Using a model of log(secretion measure) = constant + β × log(sensitivity measure), a hyperbolic relationship can be established if β is approximately equal to −1, with 95% confidence interval (CI) excluding 0. In 277 women with normal glucose tolerance (NGT), the pairing of total AUCins/gluc and Matsuda index was the only combination that satisfied these criteria (β = −0.99, 95% CI (−1.66, −0.33)). This pairing also satisfied hyperbolic criteria in 53 women with impaired glucose tolerance (IGT) (β = −1.02, (−1.72, −0.32)). In a separate data set, this pairing yielded distinct hyperbolae for NGT (n = 245) (β = −0.99, (−1.67, −0.32)), IGT (n = 116) (β = −1.18, (−1.84, −0.53)), and diabetes (n = 43) (β = −1.37, (−2.46, −0.29)). Moreover, the product of AUCins/gluc and Matsuda index progressively decreased from NGT (212) to IGT (193) to diabetes (1 Continue reading >>

Carbohydrates And Blood Sugar

Carbohydrates And Blood Sugar

When people eat a food containing carbohydrates, the digestive system breaks down the digestible ones into sugar, which enters the blood. As blood sugar levels rise, the pancreas produces insulin, a hormone that prompts cells to absorb blood sugar for energy or storage. As cells absorb blood sugar, levels in the bloodstream begin to fall. When this happens, the pancreas start making glucagon, a hormone that signals the liver to start releasing stored sugar. This interplay of insulin and glucagon ensure that cells throughout the body, and especially in the brain, have a steady supply of blood sugar. Carbohydrate metabolism is important in the development of type 2 diabetes, which occurs when the body can’t make enough insulin or can’t properly use the insulin it makes. Type 2 diabetes usually develops gradually over a number of years, beginning when muscle and other cells stop responding to insulin. This condition, known as insulin resistance, causes blood sugar and insulin levels to stay high long after eating. Over time, the heavy demands made on the insulin-making cells wears them out, and insulin production eventually stops. Glycemic index In the past, carbohydrates were commonly classified as being either “simple” or “complex,” and described as follows: Simple carbohydrates: These carbohydrates are composed of sugars (such as fructose and glucose) which have simple chemical structures composed of only one sugar (monosaccharides) or two sugars (disaccharides). Simple carbohydrates are easily and quickly utilized for energy by the body because of their simple chemical structure, often leading to a faster rise in blood sugar and insulin secretion from the pancreas – which can have negative health effects. Complex carbohydrates: These carbohydrates have mo Continue reading >>

Clinical Studies Relationship Of Glucose And Insulin Levels To The Risk Of Myocardial Infarction: A Case-control Study

Clinical Studies Relationship Of Glucose And Insulin Levels To The Risk Of Myocardial Infarction: A Case-control Study

Abstract OBJECTIVE To assess the relationship between dysglycemia and myocardial infarction in nondiabetic individuals. BACKGROUND Nondiabetic hyperglycemia may be an important cardiac risk factor. The relationship between myocardial infarction and glucose, insulin, abdominal obesity, lipids and hypertension was therefore studied in South Asians—a group at high risk for coronary heart disease and diabetes. METHODS Demographics, waist/hip ratio, fasting blood glucose (FBG), insulin, lipids and glucose tolerance were measured in 300 consecutive patients with a first myocardial infarction and 300 matched controls. RESULTS Cases were more likely to have diabetes (OR 5.49; 95% CI 3.34, 9.01), impaired glucose tolerance (OR 4.08; 95% CI 2.31, 7.20) or impaired fasting glucose (OR 3.22; 95% CI 1.51, 6.85) than controls. Cases were 3.4 (95% CI 1.9, 5.8) and 6.0 (95% CI 3.3, 10.9) times more likely to have an FBG in the third and fourth quartile (5.2–6.3 and >6.3 mmol/l); after removing subjects with diabetes, impaired glucose tolerance and impaired fasting glucose, cases were 2.7 times (95% CI 1.5–4.8) more likely to have an FBG >5.2 mmol/l. A fasting glucose of 4.9 mmol/l best distinguished cases from controls (OR 3.42; 95% CI 2.42, 4.83). Glucose, abdominal obesity, lipids, hypertension and smoking were independent multivariate risk factors for myocardial infarction. In subjects without glucose intolerance, a 1.2 mmol/l (21 mg/dl) increase in postprandial glucose was independently associated with an increase in the odds of a myocardial infarction of 1.58 (95% CI 1.18, 2.12). CONCLUSIONS A moderately elevated glucose level is a continuous risk factor for MI in nondiabetic South Asians with either normal or impaired glucose tolerance. Continue reading >>

Research Reveals A Surprising Link Between Melatonin And Type 2 Diabetes

Research Reveals A Surprising Link Between Melatonin And Type 2 Diabetes

We typically associate the hormone melatonin with sleep. However, melatonin is actually involved in the timing and synchronization of a number of different physiological functions throughout the body. One of these functions is the regulation of blood sugar. Recent research has found that a relatively large proportion of the human population is genetically predisposed to be more sensitive to the impact of this hormone on blood sugar control. This can lead to higher blood glucose levels and ultimately greater risk of developing type 2 diabetes. Here’s how it works, and what you can do about it. The sleep hormone and the pancreas Melatonin is produced by the pineal gland in the brain in response to darkness. Levels are typically very low during the day and reach their peak at night. Like other hormones, melatonin works by binding to compatible receptors – kind of like a lock and key. These receptors are found abundantly in the eyes and the brain, and when melatonin binds to them, they signal that it’s dark outside. For humans, this darkness signal indicates that it is the period when we rest, so this timing signal contributes to and is a part of a cascade of other responses that help initiate and maintain sleep . Strangely enough, we now know that these receptors are also found in the pancreas – specifically in pancreatic beta cells. By releasing insulin, beta cells regulate glucose levels in the blood. We have also discovered that when melatonin activates these receptors, insulin secretion is decreased. Circadian physiology and glucose metabolism Prior research in animals has suggested that there is a relationship between melatonin and glucose metabolism. Mice with mutations that eliminate their melatonin receptors exhibit higher insulin secretion from their islet Continue reading >>

Relationship Between Insulin-mediated Glucose Disposal And Lipid Metabolism In Man.

Relationship Between Insulin-mediated Glucose Disposal And Lipid Metabolism In Man.

To assess the possible effects of lipid metabolism on insulin-mediated glucose disposal, 18 nondiabetic Pima Indian women (age 18-35 yr) were studied using 1-14C-palmitate infusion to measure free fatty acid turnover rate followed by a euglycemic clamp (clamp) to measure in vivo insulin-mediated glucose disposal (M). Indirect calorimetry was performed in the basal state and during the clamp. This was used to assess glucose oxidation rate, lipid oxidation rate, and to calculate nonoxidative glucose disposal (storage). Basal and clamp lipid oxidation rate correlated with basal plasma free fatty acid concentration (r = 0.81, P less than or equal to 0.0001, r = 0.67, P less than 0.003, respectively). The fall in lipid oxidation was highly correlated with the increase in glucose oxidation during the insulin infusion (r = 0.96, P less than or equal to 0.0001). The clamp lipid oxidation rate negatively correlated with the glucose oxidation rate (r = -0.85, P less than 0.0001) and with the M value (r = -0.60, P less than 0.01) but was not correlated with the clamp glucose storage (r = -0.2, P = 0.4). On the other hand, glucose storage appeared to make a greater contribution to the difference in M value between the upper and lower extremes of M than did glucose oxidation, as evidenced by an increase in glucose storage of 0.59 mg/kg fat-free mass times minute per 1 mg/kg fat-free mass times minute increase in glucose disposal. The M value was negatively correlated with obesity as measured by percent body fat (r = -0.64, P less than 0.004), but neither basal free fatty acid concentration, basal free fatty acid turnover, basal lipid oxidation, nor clamp lipid oxidation correlated with percent body fat. We conclude that an interaction of lipid and glucose metabolism in a glucose fat Continue reading >>

Doctor, I Have A Question.? What Is The Relationship Between Diabetes And Glaucoma? Written By Louis R. Pasquale, Md, Farvo

Doctor, I Have A Question.? What Is The Relationship Between Diabetes And Glaucoma? Written By Louis R. Pasquale, Md, Farvo

Assoc. Professor of Ophthalmology, Harvard Medical School Director, Glaucoma Service, Massachusetts Eye & Ear The relationship between diabetes and glaucoma can be controversial and confusing. First we must understand that there are two types of diabetes. In type 1 diabetes (T1D), there is a complete loss of the pancreatic beta cells that make insulin. The profound inability to make insulin in T1D necessitates that nearly all patients with this condition be treated with insulin replacement therapy. In type 2 diabetes (T2D), the cells that make insulin are not destroyed. In fact, T2D patients can typically make more insulin than patients without diabetes. When blood sugar levels are high, the secreted insulin is ineffective at lowering blood glucose levels, producing a state of insulin resistance. The treatment of T2D is often directed at lifestyle measures that reduce insulin resistance like diet and exercise, although some of these patients also require medications to lower blood sugar. Second, we must understand that there are many different types of glaucoma so we must both specify the type of diabetes (T1D or T2D) and the type of glaucoma we are referring to when we examine the relation between diabetes and glaucoma. One thing is clear: uncontrolled T1D or T2D for a long enough period will lead to the development of diabetic retinopathy, consisting of leaking blood vessels and poor retinal blood supply that disrupts retinal function. Left unchecked the retina becomes starved for oxygen and develops new blood vessels and the stimulus for new blood vessel formation can travel to the anterior segment of the eye. This triggers new blood vessel formation in the ocular anterior segment and interferes with the normal internal drainage system of the eye leading to elevated Continue reading >>

The Predictive Relationship Between Baseline Insulin And Glucose With Subclinical Carotid Atherosclerosis After 5 Years In A Multi-ethnic Cohort

The Predictive Relationship Between Baseline Insulin And Glucose With Subclinical Carotid Atherosclerosis After 5 Years In A Multi-ethnic Cohort

Highlights • Ethnicity sometimes modifies the relationship between insulin and glucose with subclinical atherosclerosis. • Ethnic minorities showed lower progression of atherosclerosis with increasing insulin or glucose compared with Europeans. • South Asians showed evidence of insulin resistance after five years of follow up. Abstract We aimed at exploring the relationship between baseline insulin and glucose and the progression of carotid atherosclerosis in a multi-ethnic cohort. Males and females (n = 797) of European, Chinese, South Asian and Aboriginal origin were assessed as part of the Multicultural Community Health Assessment Trial (MCHAT) study for socio-demographics, smoking status, fasting insulin and glucose at baseline. IMT, plaque area and total area were assessed after 5 years. A total of 545 participants returned after 5 years for a follow-up assessment. Average age of the study participants was 47.5 (SD 8.9) years. At baseline, the median and interquartile range for insulin was 62.0 (49.5) pmol/L, and glucose was 5.2 (0.60) mmol/L. Baseline glucose and insulin predicted the 5-year progression of atherosclerosis in our models, after adjusting for covariates. We found significant insulin-ethnicity interactions in the IMT model (p = 0.044) with the slope of the relationship showing that for every percentage change in insulin the Europeans experienced 7.3% more increase in IMT at 5 years than the Aboriginals. In the plaque area and total area models, there were significant glucose-ethnicity interactions (p = 0.009 and p=0.016 respectively), with the slope showing a 101% and 121% increase for plaque area and total area, respectively, in Europeans, at 5 years per percent change in glucose at baseline. Logistic regression found a significant glucose-ethn Continue reading >>

The Relationship Between Glucose Tolerance, Plasma Insulin And Corticosteroid Therapy In Patients With Rheumatoid Arthritis☆

The Relationship Between Glucose Tolerance, Plasma Insulin And Corticosteroid Therapy In Patients With Rheumatoid Arthritis☆

Abstract Oral glucose tolerance tests (GTT) and Cortisone GTT were performed in 36 patients with Rheumatoid Arthritis of whom 20 were receiving long-term corticosteroid therapy. Sixteen who had never had corticosteroid therapy formed the control group. During both tests plasma insulin levels were measured by immunoassay. Acute stressing with cortisone produced a significant rise in blood sugar and plasma insulin levels in both groups of patients. In contrast, long-term corticosteroid therapy appeared to have no overall effect, no significant difference being found in blood sugar or plasma insulin levels in either the Standard or Cortisone GTT between these on long-term corticosteroid therapy and the control group. Of the 16 control patients, one had an abnormal Standard GTT, and 8 of the remaining 15 had an abnormal cortisone GTT. Seven of the 20 corticosteroid-treated patients had an abnormal Standard GTT, and 3 of the remaining 10 had an abnormal Cortisone GTT. The proportion of patients in each group with some abnormality of glucose tolerance was therefore the same in each group (50%:56%), although significantly more of the corticosteroid-treated patients had an abnormal Standard GTT. The results suggest that long-term corticosteroid therapy produces abnormal glucose tolerance only in those with a diabetic trait. Continue reading >>

Relationship Between Glucose And Insulin Levels In A Non-diabetic

Relationship Between Glucose And Insulin Levels In A Non-diabetic

Insulin, made by the pancreas, is an important hormone for blood sugar regulation. After consuming food, glucose (sugar) is extracted from the consumed carbohydrates and released into the bloodstream. In a healthy (non-diabetic) person, this increase in blood glucose levels triggers the pancreas to release insulin. The insulin works to shuttle glucose into the cells of the body; here, organelles called *mitochondria use the glucose to make energy (ATP). Excess glucose not used by cells is converted to glycogen, which is stored in the liver. Figure 1 demonstrates the interplay between glucose and insulin levels. Superimposed on the graph, the red and blue dotted and solid lines represent what happens during a meal rich in either simple (sucrose) or more complex (starchy) carbohydrates. Humans have a set amount of glucose in the blood (the fasting glucose level), and the body monitors the levels to keep it at the correct set point. Having a certain amount of sugar in the bloodstream is necessary. Otherwise, cells would have no fuel. If blood glucose levels fall too low, another hormone, glucagon, works to increase blood sugar levels. Glucagon, also made by the pancreas, causes the liver to break down glycogen stores. Breakdown of glycogen results in glucose, which is added to the bloodstream to help bring blood glucose levels back to normal. The interplay between blood sugar, insulin, and glycogen is diagrammed in Figure 2. People with diabetes mellitus have difficulty regulating their blood glucose levels. People with Type 1 diabetes (also known as juvenile diabetes) have a condition in which their pancreatic tissue makes minimal insulin, if any. This often occurs because the person’s own immune system attacks and destroys the pancreatic tissue. If someone with Type 1 Continue reading >>

Thyroid And Blood Sugar Relationship

Thyroid And Blood Sugar Relationship

Both controlled by the endocrine system, the thyroid gland and your blood sugar levels (controlled by the pancreas) go hand in hand. As such, a problem with one can lead to a problem with the other. If you are suffering from a thyroid problem – or diabetes – then read on to learn more about the relationship between your thyroid and your blood sugar – and how it can affect your health in the long run. The Endocrine System The endocrine system is a group of cells and glands that produce hormones, molecules that regulate the activities of various organs and tissues in the body. Included in this system is the thyroid gland, pituitary gland, adrenal gland, pancreas, testicles, and ovaries. However, only those that will be discussed in detail are the glands relevant to this topic. The Thyroid Gland Located at the front of your neck, the thyroid gland is proof that great things come in small packages. Shaped like a butterfly, this gland controls many vital functions in the body, such as your respiration, heart rate, body temperature, and digestion. If your thyroid is inactive, it is not able to make the hormones that the body needs. This condition is called hypothyroidism. Symptoms include weight gain, cold intolerance, lower heart rate, fatigue, and muscle pain, to name a few. On the other hand, if your thyroid is too active, it will produce more hormones than the body requires. This condition, called hyperthyroidism, is characterized by heat intolerance, sleeping problems, mood swings, weight loss, and faster heart rate, among many others. Pancreas Located behind the stomach’s lower part is the pancreas, a gland responsible for making digestive enzymes as well as insulin, a hormone which regulates the body’s blood sugar levels. Insulin is produced in the islets of Continue reading >>

The Relationship Between Glucose And Insulin

The Relationship Between Glucose And Insulin

Glucose meet insulin, insulin meet glucose. The Relationship Between Glucose and Insulin What exactly is glucose? Or insulin? Glucose is basically a sugar found in food. Its job is to provide energy to the cell. Glucose gets into the body through digestion. It goes through the mouth, into the stomach, and then finally into the small intestine. So how exactly does this "glucose" get into the cell? Now, glucose is absorbed and then released into the bloodstream by the small intestine and the stomach. Now, the glucose has finally made it into the body! The glucose tries to get into the cells but the cell membrane won't let them. The glucose is too thick. It can't get in on its own. Left Out Since the glucose can't get in, it roams around in the bloodstream. Until... Insulin to The Rescue! Beta cells, which are sensitive to glucose levels, begin making insulin. They order the pancreas to speed up or slow down the amount of insulin produced, depending on the amount of excessive glucose found in the blood stream. Insulin to The Rescue Continued! Now, the insulin attaches itself to the receptor cell wall. This allows an opening to be made. The opening,or the channel, is big enough for the glucose to finally enter. Now, the cell can finally receive the energy it needs to function properly. By: Autumn Shomo, Jaydon Nance, Maria Barrera, and Justin Lorenz Sources Jagoda, R. (March 7, 2011). How Does Insulin Signal a Cell to Take in Glucose from the Blood. In Livestrong. Retrieved October 15, 2012, from Freudenrich, C. (2012). Diabetes Overview. In Discovery Fit and Health. Retrieved October 15, 2012, from BD. (2012). How Insulin Works to Regulate Blood Glucose. In BD Diabetes. Retrieved October 15, 2012, from Citations: If our presentation did not help, here's a little demonstrat Continue reading >>

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