Review of Insulin Therapy

2004 ◽  
Vol 17 (1) ◽  
pp. 10-19 ◽  
Author(s):  
Kimberly K. Daugherty

The objective of this article is to review the different types of insulin and to explain some of the different dosing regimens that are used. Articles were obtained via a MEDLINE search and product package inserts. There is no one insulin therapy that is best for all patients. Type 1 diabetes patients require insulin therapy tomaintain life. Studies support intensive insulin dosing in these patients to obtain an A1C of less than 7.0%. Insulin therapy for type 2 diabetes patients may be a little less clear. Long-acting insulin in combination with an oral agentmay be just as effective as insulin alone, and in patients who fail oral therapy, a simple insulin regimen is preferred over a complex one.

Author(s):  
Ariel Florenţiu ◽  
Ioana Dima

Abstract Background and aims: The epidemic of diabetes mellitus has made the effective treatment of hyperglycemia a top priority. Maintaining near-normal glycemic levels has been demonstrated to have a beneficial effect on diabetes-specific complications. Insulin can decrease any level of elevated glycated hemoglobin. Insulin glargine (Lantus®) is a long-acting insulin analog with a favorable 24-h time-action profile, once daily administration and low risk of hypoglycemia used in type 1 and 2 diabetes. In Romania, real-life data about glycaemic control is lacking. Material and methods: We present results from a retrospective, open-label, non-randomised, registry trial in 2946 Romanian diabetes patients. The objective of the study was to assess the proportion of patients with appropriate glycaemic control after 3 to 6 months of glargine treatment. Results and conclusions: A little over one third of the patients had reached target glycated hemoglobin after 3-6 months of glargine treatment in both types of diabetes. In type 2 diabetes patients the glargine dose used was not high (0.33 UI/kg). Inadequate insulin titration is a possible cause for not reaching glycemic targets.


2011 ◽  
Vol 33 (9) ◽  
pp. 1258-1267 ◽  
Author(s):  
Andrew Lloyd ◽  
Beenish Nafees ◽  
Anthony H. Barnett ◽  
Simon Heller ◽  
Uffe J. Ploug ◽  
...  

Author(s):  
A.M. Satarkulova

The assessment and dynamic control over students’ status is a very important task. It allows timely detection of prenosological status prior to pathology and health maintenance in students. The objective of the paper is to assess the adaptive abilities of the body, to analyze changes in heart rate variability indicators in students with various types of autonomic regulation, to identify prenosological status and precursory pathological symptoms. Materials and Methods. The study enrolled 302 students from India, aged 21.54±1.43. Programming complex «Psychophysiologist» was used to register the main HRV parameters within 5 minutes. Health status was evaluated according to the index of functional changes and the scale of functional states. Results. N.I. Shlyk (2009) distinguished two groups of students with different types of autonomic regulation: type 1 (53 %) with moderate and type 2 (5 %) with marked characteristics of central regulation profile, type 3 (35 %) with moderate and type 4 (7 %) with marked characteristics of autonomous regulation profile. Main parameters of HRV and adaptation potential were defined for each student.All the parameters characterized functional and health status. Conclusions. It was shown that 82 % of trial subjects (type 1), 53 % (type 2), 94 % (type 3) and 95 % (type 4) demonstrated satisfactory adaptation and their physiological processes were at an optimal level. 18 % of students (type 1) demonstrated reduced adaptive abilities of the body. Moreover, they were under moderate stress. 47 % of subjects (type 2) were also under a significant stress, which was proven by excessively high SI, low SDNN and TP, and an increased index of functional changes. 5 % of students (type 4) revealed dysfunctional characteristics in the heart rhythm, peculiar to pathology. Keywords: foreign students, heart rate variability, types of autonomic regulation, adaptation potential, functional status. Оценка состояния студентов и динамический контроль за ним является важной задачей, поскольку позволяет своевременно выявлять у студентов донозологические состояния, предшествующие патологии, и способствовать сохранению здоровья. Цель. Оценка адаптивных возможностей организма, анализ изменений показателей вариабельности сердечного ритма у студентов с различными типами вегетативной регуляции, выявление донозологических состояний и ранних признаков патологии. Материалы и методы. В исследовании участвовало 302 студента в возрасте 21,54+1,43 года из Индии. Регистрировались основные параметры ВСР в течение 5 мин с использованием программно-аппаратного комплекса «Психофизиолог». Состояние и уровень здоровья оценивались по индексу функциональных изменений и шкале функциональных состояний. Результаты. По способу, предложенному Н.И. Шлык, выделены группы студентов с различными типами вегетативной регуляции: I (53 %) и II типы (5 %) – с умеренным и выраженным преобладанием центрального контура регуляции соответственно, III (35 %) и IV типы (7 %) – с умеренным и выраженным преобладанием автономного контура регуляции соответственно. У каждого из студентов определены основные параметры ВСР и адаптационного потенциала, характеризующие функциональное состояние и уровень здоровья. Выводы. Показано, что для 82 % обследуемых с I типом, 53 % со II типом, 94 % c III типом и 95 % с IV типом регуляции характерно состояние удовлетворительной адаптации, физиологические процессы сохраняются на оптимальном уровне. В группе студентов I типа у 18 % студентов адаптивные возможности организма снижены, выявлено состояние умеренного напряжения. У 47 % обследуемых II типа также зафиксировано состояние резко выраженного напряжения, индикатором которого является чрезмерно высокое значение SI, низкие величины SDNN и ТP, повышенное значение индекса функциональных изменений. В группе студентов с IV типом у 5 % учащихсяв регуляции ритма сердца выявлены дисфункциональные признаки, характерные для патологии. Ключевые слова: иностранные студенты, вариабельность сердечного ритма, типы вегетативной регуляции, адаптационный потенциал, функциональное состояние.


2014 ◽  
Vol 8 (5) ◽  
pp. 1058-1059 ◽  
Author(s):  
Robin S. Wagner ◽  
Walter Koehler ◽  
Christopher G. Parkin

Author(s):  
Elisabeth Mönnig ◽  
Erik Spaepen ◽  
Beatrice Osumili ◽  
Beth D. Mitchell ◽  
Frank Snoek ◽  
...  

Abstract Background A global cross-sectional survey (CRASH) was designed to provide information about the experiences of people with diabetes (PWD) and their caregivers in relation to severe hypoglycaemic events. Methods Adults with type 1 diabetes or insulin-treated type 2 diabetes who had experienced one or more severe hypoglycaemic events within the past 3 years, and adult caregivers for such people, were recruited from medical research panels using purposive sampling. We present here results from Germany. Results Approximately 100 individuals in each of the four participant groups completed a 30-minute online survey. Survey results indicated that the most recent severe hypoglycaemic event made many participants feel scared (80.4%), unprepared (70.4%), and/or helpless (66.5%). Severe hypoglycaemia was discussed by healthcare professionals at every visit with only 20.2% of participants who had ever had this conversation, and 53.5% of participants indicated that their insulin regimen had not changed following their most recent event. 37.1% of PWD/people with diabetes cared for by caregivers owned a glucagon kit at the time of survey completion. Conclusions The survey identified areas for improvement in the prevention and management of severe hypoglycaemic events. For healthcare professionals, these include enquiring more frequently about severe hypoglycaemia and adjusting blood glucose-lowering medication after a severe hypoglycaemic event. For individuals with diabetes and their caregivers, potential improvements include ensuring availability of glucagon at all times. Changes in these areas could lead not only to improved patient wellbeing but also to reduced use of emergency services/hospitalisation and, consequently, lower healthcare costs.


Palaios ◽  
2021 ◽  
Vol 36 (3) ◽  
pp. 115-121
Author(s):  
EDUARDO MAYORAL ◽  
JORGE F. GENISE ◽  
FRANCISCO J. RODRÍGUEZ-TOVAR ◽  
ANA SANTOS

ABSTRACT Plio?-Pleistocene outcrops located at the southwestern edge of the Guadalquivir Basin in the area of Lepe (Huelva, Spain) provide an interesting example for studying the contemporaneity of traces with the rocks that contain them. Two different types of cells compatible with the ichnogenera Celliforma (Type 1) and Palmiraichnus (Type 2) were found in these outcrops. Their walls were constructed with the same material as the matrix and our first research in the area showed no extant bees producing them suggesting that they were coeval with the trace-bearing rocks. The case of the “Palmiraichnus-like” Type 2 cells was misleading because of its similarity with Palmiraichnus described from the region in the Canary Islands and Balearic Archipelago (Spain). Two determining features were vital in clarifying this first appearance. In the Palmiraichnus-like cells we found remains of a larval cocoon in one cell that could be dated by C14, giving a modern age. In the Celliforma-like cells more field research in the area allow us to observe extant bees nesting in these rocks in autumn. Ichnological literature show a few cases of asynchronies involving extant traces found mostly in Paleozoic and Mesozoic rocks. In contrast, the case presented herein indicates the time gap between the bearing rocks and the Lepe traces was shorter (ca. 12 ky–2.6 My), enhancing the similarity of traces and rocks and thus their potential coevalness. This case may serve as a warning about other potential examples in the fossil record in which relatively short asynchronies between traces and paleosols exist.


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