scholarly journals NPH insulin. Effective mixing - effective dose regimen

2011 ◽  
Vol 57 (4) ◽  
pp. 56-60
Author(s):  
T V Nikonova
Keyword(s):  
Diabetes Mellitus ◽  
High Performance ◽  
Insulin Dose ◽  
Nph Insulin ◽  
Marked Variability ◽  
Wide Availability ◽  
Treatment Of Diabetes ◽  
Attending Physician

Insulin therapy, a corner stone of the treatment of diabetes mellitus, both type 1 and type 2, has undergone substantial modification since the manufacture of the first insulin preparations 90 years ago up to the present time. Human insulins, such as neutral protamin Hagedorn (NPH) insulins, remain a major instrument of therapy of diabetes mellitus despite rapid developments in this field of knowledge and the wide availability of insulin analogs. When prescribing these preparations, the attending physician should be absolutely confident that the patient has a minimum background of knowledge and skills indispensable for efficacious and safe treatment. Such skills include the habit of mixing NPH insulin suspensions by 20-fold turning the vial or the cartridge upside-down or rolling them between the palms in order to ensure the uniform distribution of insulin in the suspension and its accurate dosing. The manufactures place from one to three glass or metal bullets inside the vials and cartridges for more homogeneous mixing of their contents. P. Kaiser et al. undertook the study of several pharmaceutical forms of NPH insulin manufactured by different companies to estimate the accuracy of dosing (variability of the insulin dose depending on the number of turns of the cartridge for homogeneous mixing). The insulin concentration in a single dose was measured by high-performance liquid chromatography. Marked variability of the insulin dose after less than ten (three or six) turns was documented for all cartridges with the exception of Insuman Basal insulin cartridges ("Sanofi"). It may be expected that the accuracy of dosing will not deteriorate using these cartridges owing to the presence in them of three heavy metal bullets even if the patient does not perform the necessary mixing procedure for one or another reason.

Insulin Dose Adjustment Following Bariatric Surgery, a Review of Available Literature

2021 ◽  
pp. 193229682110288
Author(s):  
Lynn E. Kassel ◽  
Jessica J. Berei ◽  
Jamie M. Pitlick ◽  
Joel E. Rand
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Type 2 Diabetes Mellitus ◽  
Dose Adjustment ◽  
Insulin Dose ◽  
Appraisal Tool

Bariatric surgery is a known and effective treatment for type 2 diabetes mellitus. Patients with type 1 diabetes mellitus and exogenous insulin-requiring type 2 diabetes mellitus require adjusted insulin dosing after surgery to avoid hypoglycemia. This review describes insulin dose adjustments following a variety of bariatric procedures. After searching the available literature and assessing for eligibility, 8 articles were included. The Johns Hopkins Research Evidence Appraisal Tool for literature appraisal was used. The results of this review reveal insulin dose adjustment varies based upon surgical procedure type and time of follow-up from the procedure.

scholarly journals Gut microbiota imbalances in Tunisian participants with type 1 and type 2 diabetes mellitus

2019 ◽  
Vol 39 (6) ◽  
Author(s):  
Meriem Fassatoui ◽  
Mireia Lopez-Siles ◽  
Diana A. Díaz-Rizzolo ◽  
Haifa Jmel ◽  
Chokri Naouali ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Multivariate Analysis ◽  
Gut Microbiota ◽  
Glycated Hemoglobin ◽  
Statistical Tests ◽  
Treatment Of Diabetes

Abstract Gut microbiota plays an important role in the regulation of the immune system and host’s metabolism. We aimed to characterize the gut microbiota of Tunisian participants with and without diabetes. We enrolled ten participants with type 1 diabetes mellitus (T1DM), ten patients with type 2 diabetes mellitus (T2DM), and 11 subjects without diabetes. Bacteria was quantified in fecal samples by quantitative PCR (qPCR). Statistical tests and multivariate analysis were performed using RStudio program. Results showed that the proportions of Firmicutes, Akkermansia muciniphila, and Faecalibacterium prausnitzii (P≤0.041), as well as, the ratio Firmicutes/Bacteroidetes decreased in participants with T1DM compared with those without diabetes (p = 0.036). Participants with T2DM presented a reduction in the amounts of A. muciniphila and F. prausnitzii compared with those without diabetes (P≤0.036). Furthermore, A muciniphila is negatively correlated with glucose level (P=0.022) and glycated hemoglobin (HbA1c) (P=0.035). Multivariate analysis revealed that participants with diabetes formed a cluster apart compared with those without diabetes. In conclusion the gut bacteria of Tunisian participants with diabetes was altered. The gut bacterial profile, especially the distribution of A muciniphila in participants with diabetes was affected by glycemic dysregulation. The investigation of the gut microbiota may help clinicians to improve diagnosis and treatment of diabetes and its complications.

Insights into the Role of DNA Methylation and Protein Misfolding in Diabetes Mellitus

2019 ◽  
Vol 19 (6) ◽  
pp. 744-753 ◽  
Author(s):  
Sara M. Ahmed ◽  
Dina Johar ◽  
Mohamed Medhat Ali ◽  
Nagwa El-Badri
Keyword(s):  
Diabetes Mellitus ◽  
Dna Methylation ◽  
Protein Function ◽  
Protein Misfolding ◽  
Gene Sequence ◽  
Metabolic Memory ◽  
Treatment Of Diabetes

Background: Diabetes mellitus is a metabolic disorder that is characterized by impaired glucose tolerance resulting from defects in insulin secretion, insulin action, or both. Epigenetic modifications, which are defined as inherited changes in gene expression that occur without changes in gene sequence, are involved in the etiology of diabetes. Methods: In this review, we focused on the role of DNA methylation and protein misfolding and their contribution to the development of both type 1 and type 2 diabetes mellitus. Results: Changes in DNA methylation in particular are highly associated with the development of diabetes. Protein function is dependent on their proper folding in the endoplasmic reticulum. Defective protein folding and consequently their functions have also been reported to play a role. Early treatment of diabetes has proven to be of great benefit, as even transient hyperglycemia may lead to pathological effects and complications later on. This has been explained by the theory of the development of a metabolic memory in diabetes. The basis for this metabolic memory was attributed to oxidative stress, chronic inflammation, non-enzymatic glycation of proteins and importantly, epigenetic changes. This highlights the importance of linking new therapeutics targeting epigenetic mechanisms with traditional antidiabetic drugs. Conclusion: Although new data is evolving on the relation between DNA methylation, protein misfolding, and the etiology of diabetes, more studies are required for developing new relevant diagnostics and therapeutics.

scholarly journals Metforminium Decavanadate as a Potential Metallopharmaceutical Drug for the Treatment of Diabetes Mellitus

2016 ◽  
Vol 2016 ◽  
pp. 1-14 ◽  
Author(s):  
Samuel Treviño ◽  
Denisse Velázquez-Vázquez ◽  
Eduardo Sánchez-Lara ◽  
Alfonso Diaz-Fonseca ◽  
José Ángel Flores-Hernandez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Pancreatic Beta Cells ◽  
Insulin Mimetic ◽  
Male Wistar Rats ◽  
Liver And Kidney ◽  
Treatment Of Diabetes ◽  
Hypercaloric Diet ◽  
Better Than

New potential drugs based on vanadium are being developed as possible treatments for diabetes mellitus (DM) and its complications. In this regard, our working group developed metforminium decavanadate (MetfDeca), a compound with hypoglycemic and hypolipidemic properties. MetfDeca was evaluated in models of type 1 and type 2 diabetes mellitus, on male Wistar rats. Alloxan-induction was employed to produce DM1 model, while a hypercaloric-diet was employed to generate DM2 model. Two-month treatments with 3.7 μg (2.5 μM)/300 g/twice a week for DM2 and 7.18 μg (4.8 μM)/300 g/twice a week for DM1 of MetfDeca, respectively, were administered. The resulting pharmacological data showed nontoxicological effects on liver and kidney. At the same time, MetfDeca showed an improvement of carbohydrates and lipids in tissues and serum. MetfDeca treatment was better than the monotherapies with metformin for DM2 and insulin for DM1. Additionally, MetfDeca showed a protective effect on pancreatic beta cells of DM1 rats, suggesting a possible regeneration of these cells, since they recovered their insulin levels. Therefore, MetfDeca could be considered not only as an insulin-mimetic agent, but also as an insulin-enhancing agent. Efforts to elucidate the mechanism of action of this compound are now in progress.

scholarly journals HPTLC Fingerprint Profile and Identification of Antidiabetic and Antioxidant Leads from Bauhinia rufescens L

2020 ◽  
Vol 2020 ◽  
pp. 1-18
Author(s):  
Wadah Osman ◽  
Mona S Mohammed ◽  
Hassan S Khalid ◽  
Abdelkhalig Muddathir ◽  
Shaza W. Shantier ◽  
...  
Keyword(s):  
High Performance ◽  
Mass Spectrometric ◽  
Spectrometric Analysis ◽  
Antioxidant Compounds ◽  
Major Health ◽  
Treatment Of Diabetes ◽  
Layer Chromatography

Diabetes is one of the world’s major health problems, and many reports have supported the role of oxidative stress in the pathogenesis of both type 1 and type 2 diabetes. The present study aims to evaluate the antidiabetic and antioxidant activity of Bauhinia rufescens, a plant used in Sudanese folkloric medicine for the treatment of diabetes. It was also aimed to identify isolates and characterize the bioactive antidiabetic and antioxidant compounds using bioactivity-guided fractionation followed by high-performance thin-layer chromatography (HPTLC) autobiography, liquid chromatography-mass spectrometric analysis, and nuclear magnetic resonance (NMR). Two potential compounds were successfully isolated and identified which may provide new leads for more potent analogues in drug discovery.

Cost-effectiveness of insulin detemir compared to NPH insulin for type 1 and type 2 diabetes mellitus in the Canadian payer setting: modeling analysis

2009 ◽  
Vol 25 (5) ◽  
pp. 1273-1284 ◽  
Author(s):  
Sandra L. Tunis ◽  
Michael E. Minshall ◽  
Christopher Conner ◽  
John I. McCormick ◽  
Jovana Kapor ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cost Effectiveness ◽  
Insulin Detemir ◽  
Nph Insulin ◽  
Modeling Analysis

scholarly journals New Frontier in the Treatment of Diabetes

2019 ◽  
Vol 9 (5-s) ◽  
pp. 178-187
Author(s):  
Abhishek Jayesh Bhatt ◽  
Arya Sudhanshu Vyas ◽  
Devarshi Priyesh Shah
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Metabolic Diseases ◽  
Diabetes Type 2 ◽  
Secondary Diabetes ◽  
Novel Technologies ◽  
Chronic Hyperglycemia ◽  
Treatment Of Diabetes

Diabetes mellitus is a group of metabolic diseases recognized by chronic hyperglycemia resulting from defects in secretion in insulin, insulin action or both. There are different types of diabetes like Type 1, type 2, gestational diabetes, secondary diabetes, wolfram syndrome and autoimmune polyglandular syndrome. Type 1 and type 2 diabetes are most common type of diabetes. Polydipsia, polyuria, polyphagia, weight loss slow wound healing, etc. are common symptoms of Diabetes. Diabetes can be genetic; autoimmune, medical related or even diet related. In this article causes and treatment of diabetes is discussed in detail. It includes glimpse of novel technologies like patches, pump and pens, etc. It also includes momentary of other treatment like oral and Injectable hypoglycemic drug and surgical treatments. A glance of latest innovation for measuring glucose level in body with help of sweat, breath and saliva are explained. Keywords: Diabetes; Type 2 Diabetes Mellitus (TY2DM), Polydipsia, polyuria, polyphagia, clicksoft microinjection, insulin pen, v-go

scholarly journals Evaluation of Cinnamon (Cinnamomum Verum) Effects on Liver CYP450 2D1 Activity and Hepatic Clearance in Diabetic Rats

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Navid Neyshaburinezhad ◽  
Mohammadreza Rouini ◽  
Hoda Lavasani ◽  
Yalda H. Ardakani
Keyword(s):  
Diabetes Mellitus ◽  
Enzyme Activity ◽  
High Performance ◽  
Liver Perfusion ◽  
Hepatic Clearance ◽  
Diabetic Rats ◽  
Control Group ◽  
Male Wistar Rats

Objectives: The present study assessed the effects of cinnamon on the activity of the liver CYP2D1 enzyme and hepatic clearance in the rat model of type 1 and 2 diabetes mellitus. Methods: Male Wistar rats were randomly categorized into 8 groups. Fourteen days after induction of diabetes type 1 and 2, type 1 groups received cinnamon and insulin plus cinnamon and type 2 groups received cinnamon and metformin plus cinnamon daily for 14 days. On day 28, rats were subjected to liver perfusion by buffer containing dextromethorphan as the CYP2D1 enzyme activity probe. Perfused samples were analyzed by high-performance liquid chromatography (HPLC) with fluorescence (FL) detection to evaluate the CYP2D1 activity and hepatic clearance. Results: In the control group, enzyme activity and hepatic clearance changed from 0.0081 ± 0.00009 and 6.09 ± 0.2 mL/min to 0.0059 ± 0.0001 and 3.71 ± 0.07 mL/min in the untreated type 1 diabetic rats and to 0.0006 ± 0.0001 and 5.19 ± 0.02 mL/min in untreated type 2 ones. These pharmacokinetic (PK) parameters changed to 0.0069 ± 0.0005 and 6.27 ± 0.06 mL/min in treated type 1 and 0.0115 ± 0.0003 and 5.79 ± 0.11 mL/min in the treated type 2 rats with only cinnamon administration. Treatment with cinnamon plus insulin or metformin modulated these PK parameters to 0.0039 ± 0.00006 and 4.88 ± 0.13 mL/min in type 1 and 0.0092 ± 0.0005 and 6.13 ± 0.01 mL/min in type 2 diabetic rats. Conclusions: Cinnamon can act as an effective complementary medicine in order to normalize the metabolism and clearance processes in diabetes mellitus.

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