Microcomputer-aided insulin dose determination in intensified conventional insulin therapy

1988 ◽  
Vol 35 (2) ◽  
pp. 167-171 ◽  
Author(s):  
T. Shimauchi ◽  
N. Kugai ◽  
N. Nagata ◽  
O. Takatani
Keyword(s):  
Insulin Therapy ◽  
Insulin Dose ◽  
Conventional Insulin Therapy ◽  
Dose Determination

Insulin Dosage Adjustments After Initiation of GLP-1 Receptor Agonists in Patients With Type 2 Diabetes

2021 ◽  
pp. 089719002199362
Author(s):  
Mandy Chen ◽  
Etty Vider ◽  
Roda Plakogiannis
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Insulin Therapy ◽  
Basal Insulin ◽  
Insulin Dose ◽  
Retrospective Chart Review ◽  
Insulin Dosage ◽  
History Of ◽  
Bolus Insulin

Background: Combination of insulin and GLP-1RAs have shown reductions in the HbA1c, body weight, and the risk of hypoglycemia. To date, there are conflicting data regarding the effect of GLP-1RAs on insulin dosage(s). Objective: The objective of this study was to evaluate adjustments of insulin doses upon initiation of GLP-1RAs. Methods: This was a retrospective chart review of patients on insulin therapy initiated on GLP-1RAs at NYU Langone Health. Patients were included in the study if they were at least 18 years of age, history of type 2 diabetes, and were on concurrent basal or mixed insulin therapy. 45 patients met inclusion criteria and were included in the study analysis. The primary endpoint was the median change in overall basal insulin doses. Secondary endpoints included median changes in total basal, mixed, and bolus insulin doses, oral antidiabetic medications and GLP-1RA doses, HbA1c, body weight, fasting glucose, and creatinine clearance. Safety results included any adverse reactions to insulin and/or GLP-1RA. Results: In the per-protocol analysis, there was a significant reduction in overall total basal insulin doses from baseline to week 24 (50 units vs. 44 units, p < 0.05). There was a median reduction in patients receiving glargine (50 units vs. 44 units) and detemir (29 units vs. 21.5 units). Conclusions: Use of GLP-1RAs after 24 weeks resulted in a statistically significant reduction in overall total basal insulin dosages from baseline. The median HbA1C in our patient population was >8%. Consider a ≥10% reduction in the overall basal insulin dose upon initiation of GLP-1RA in patients with a HbA1C >8%.

Observations on Control of Glycemia with Conventional Insulin Therapy or Continuous Subcutaneous Insulin Infusion

Diabetes ◽  
1985 ◽  
Vol 34 (Supplement_3) ◽  
pp. 22-26 ◽  
Author(s):  
W. V. Tamborlane ◽  
M. C. Champion ◽  
R. A. Rizza ◽  
F. J. Service ◽  
R. M. Bergenstal ◽  
...  
Keyword(s):  
Insulin Therapy ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Subcutaneous Insulin ◽  
Conventional Insulin Therapy

scholarly journals Model-Based Tool for Personalized Adjustment of Basal Insulin Supply in Patients With Intensified Conventional Insulin Therapy

2019 ◽  
Vol 13 (5) ◽  
pp. 928-934
Author(s):  
Lutz Vogt ◽  
Andreas Thomas ◽  
Gert Fritzsche ◽  
Peter Heinke ◽  
Klaus-Dieter Kohnert ◽  
...  
Keyword(s):  
Insulin Therapy ◽  
Basal Insulin ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Insulin Dosage ◽  
Treatment Team ◽  
Pump Therapy ◽  
Modeling Tool ◽  
Conventional Insulin Therapy ◽  
Model Based

Background: The decisive factor in successful intensive insulin therapy is the ability to deliver need-based-adjusted nutrition-independent insulin dosages at the closest possible approximation to the physiological insulin level. Because this basal insulin requirement is strongly influenced by the patient’s lifestyle, its subtlety is of great importance. This challenge is very different between patients with type 1 diabetes and those with insulin-dependent type 2 diabetes. Furthermore, it is more difficult to finetune a basal insulin dosage with intensified conventional insulin therapy (ICT), due to delayed insulin delivery, compared to insulin pump therapy, which provides continuous delivery of small doses of exclusively short-acting insulin. In all cases, the goal is to achieve an optimal basal delivery rate. Method: We hypothesized that this goal could be achieved with a modeling tool that determined the optimal basal insulin supply based on the patient’s anamnestic data and monitored glucose values. This type of modeling tool has been used in health insurance programs in Germany to improve insulin control in patients that receive ICT. Results: Our retrospective data analysis showed that this modeling tool provided a significant improvement in metabolic control, significant reductions in HbA1c and Q scores, and improved time-in-range values, with reduced daily insulin levels. Conclusion: The model-based basal rate test could provide additional data of the actual effect of the basal insulin adjustment in intensified insulin treated diabetes to the physician or treatment team.

Principles of self-adjustment of insulin dose in people with diabetes type 2 and flexible insulin therapy

2016 ◽  
Vol 116 ◽  
pp. 165-170 ◽  
Author(s):  
G. Kramer ◽  
N. Kuniss ◽  
C. Kloos ◽  
T. Lehmann ◽  
N. Müller ◽  
...  
Keyword(s):  
Insulin Therapy ◽  
Insulin Dose ◽  
Diabetes Type 2 ◽  
Diabetes Type

Intensive Conventional Insulin Therapy for Type II Diabetes: Metabolic effects during a 6-mo outpatient trial

Diabetes Care ◽  
1993 ◽  
Vol 16 (1) ◽  
pp. 21-31 ◽  
Author(s):  
R. R. Henry ◽  
B. Gumbiner ◽  
T. Ditzler ◽  
P. Wallace ◽  
R. Lyon ◽  
...  
Keyword(s):  
Insulin Therapy ◽  
Type Ii Diabetes ◽  
Metabolic Effects ◽  
Type Ii ◽  
Conventional Insulin Therapy

Metformin and Insulin: Is There a Role for Combination Therapy?

1997 ◽  
Vol 31 (4) ◽  
pp. 474-480 ◽  
Author(s):  
Jacqueline R Daniel ◽  
Kathleen O Hagmeyer
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Combination Therapy ◽  
Insulin Therapy ◽  
Insulin Dose ◽  
Insulin Requirements ◽  
Study Selection ◽  
Combined Use ◽  
Bibliographic Search

Objective To review the literature on concomitant insulin and metformin therapy in patients with type 1 diabetes to determine the potential for combination therapy. Data Sources A MEDLINE and bibliographic search (1966–1996) of the literature pertaining to metformin and phenformin and their combined use with insulin in the treatment of patients with type 1 diabetes mellitus was performed. Study Selection All human studies using metformin with insulin were included in the analysis. Studies using phenformin with insulin were also included due to its similarities to metformin. Data Synthesis The recent availability of metformin provides some new options for treating diabetes mellitus. One possibility is the use of this medication in conjunction with insulin in patients with type 1 diabetes. Although this seems like a potentially beneficial combination, there is currently no recommendation for use in this manner. Experience with combination metformin and insulin therapy has consistently demonstrated a reduction in insulin requirements. Studies have not been of necessary size or duration to definitively prove the benefits of this insulin dose reduction or any other benefits of combination therapy. Conclusions When metformin is added to insulin therapy, insulin requirements are likely to decrease. Although one would anticipate benefits from reduction in circulating insulin concentrations, the studies do not provide data to determine if benefits of combination therapy outweigh risks. Further studies of larger size and longer duration are needed before the use of metformin with insulin can be routinely recommended in patients with type 1 diabetes.

Sign in / Sign up

Export Citation Format

Share Document