scholarly journals Critical Low Catastrophe: A Case Report of Treatment-Refractory Hypoglycemia following Overdose of Long-Acting Insulin

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Rashi Sandooja ◽  
John M. Moorman ◽  
Monisha Priyadarshini Kumar ◽  
Karla Detoya
Keyword(s):  
Case Report ◽  
Volume Overload ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Clinical Challenge ◽  
Acting Insulin ◽  
Treatment Refractory ◽  
Long Acting ◽  
Stress Dose ◽  
Subsequent Improvement

Overdose of long-acting insulin can cause unpredictable hypoglycemia for prolonged periods of time. The initial treatment of hypoglycemia includes oral carbohydrate intake as able and/or parenteral dextrose infusion. Refractory hypoglycemia following these interventions presents a clinical challenge in the absence of clear guidelines for management. Octreotide has sometimes been used, but its use is generally limited to sulfonylurea overdose. In this case report, we present a case of refractory hypoglycemia following an overdose of 900 units of long-acting insulin glargine that failed to respond to usual modes of therapy mentioned above. Stress-dose corticosteroids were then initiated, followed by subsequent improvement in IV dextrose and glucagon requirements and blood glucose levels. Hence, corticosteroids may serve as an adjunctive therapy in managing hypoglycemia and can be considered earlier in the course of treatment in patients with refractory hypoglycemia to prevent volume overload, especially when large volumes of dextrose infusions are required.

scholarly journals Impact of the Type of Continuous Insulin Administration on Metabolism in a Diabetic Rat Model

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
A. Schaschkow ◽  
C. Mura ◽  
S. Dal ◽  
A. Langlois ◽  
E. Seyfritz ◽  
...  
Keyword(s):  
Diabetic Rat ◽  
Diabetic Patients ◽  
Insulin Administration ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Acting Insulin ◽  
Short Period ◽  
Insulin Pens ◽  
Long Acting ◽  
Type 1 Diabetic Patients

Exogenous insulin is the only treatment available for type 1 diabetic patients and is mostly administered by subcutaneous (SC) injection in a basal and bolus scheme using insulin pens (injection) or pumps (preimplanted SC catheter). Some divergence exists between these two modes of administration, since pumps provide better glycaemic control compared to injections in humans. The aim of this study was to compare the impacts of two modes of insulin administration (single injections of long-acting insulin or pump delivery of rapid-acting insulin) at the same dosage (4 IU/200 g/day) on rat metabolism and tissues. The rat weight and blood glucose levels were measured periodically after treatment. Immunostaining for signs of oxidative stress and for macrophages was performed on the liver and omental tissues. The continuous insulin delivery by pumps restored normoglycaemia, which induced the reduction of both reactive oxygen species and macrophage infiltration into the liver and omentum. Injections controlled the glucose levels for only a short period of time and therefore tissue stress and inflammation were elevated. In conclusion, the insulin administration mode has a crucial impact on rat metabolic parameters, which has to be taken into account when studies are designed.

A Review of Type 1 Diabetes (T1D)

2020 ◽  
pp. 13-49
Author(s):  
Eileen O'Donnell ◽  
Liam O'Donnell
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Acting Insulin ◽  
Short Period ◽  
Sporting Activities ◽  
To Come

The diagnosis of Type 1 Diabetes (T1D) will come as an unwelcome surprise to most people. Within a short period of time, the person will have to come to understand and manage this chronic illness. The terminology associated with the T1D condition will also be totally new to the person: diabetes mellitus, pancreas, hyperglycaemia (hyper), hypoglycaemia (hypo), bolus (fast acting insulin), basal (slow acting insulin), ketones and blood glucose levels. The purpose of this article is to assist newly diagnosed patients' understanding of T1D, people who are already living with T1D, carers of people with T1D, partners and family members of someone with T1D, work colleagues, and friends who participate in the same sporting activities or go on holiday with a person who has T1D. In addition, this article reviews how people living with T1D can still enjoy exercise and maintain the best quality of life possible; whilst controlling the blood glucose levels in their body for the rest of their lives to prevent the onset of complications associated with diabetes.

scholarly journals Preventive Effect of Salicylate and Pyridoxamine on Diabetic Nephropathy

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Tarek Kamal Abouzed ◽  
Seiichi Munesue ◽  
Ai Harashima ◽  
Yusuke Masuo ◽  
Yukio Kato ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Blood Glucose ◽  
Macrophage Infiltration ◽  
Gene Expressions ◽  
Beneficial Effects ◽  
Glucose Levels ◽  
Developmental Factors ◽  
Blood Glucose Levels ◽  
Patients With Diabetes ◽  
Long Acting

Objective. Diabetic nephropathy is a life-threatening complication in patients with long-standing diabetes. Hemodynamic, inflammatory, and metabolic factors are considered as developmental factors for diabetic nephropathy. In this study, we evaluated whether pharmacological interventions with salicylate, compared to pyridoxamine, could prevent diabetic nephropathy in mice. Methods. Male mice overexpressing inducible nitric oxide synthase in pancreatic β-cells were employed as a diabetic model. Salicylate (3 g/kg diet) or pyridoxamine (1 g/L drinking water; ~200 mg/kg/day) was given for 16 weeks to assess the development of diabetic nephropathy. Treatment with long-acting insulin (Levemir 2 units/kg twice a day) was used as a control. Results. Although higher blood glucose levels were not significantly affected by pyridoxamine, early to late stage indices of nephropathy were attenuated, including kidney enlargement, albuminuria, and increased serum creatinine, glomerulosclerosis, and inflammatory and profibrotic gene expressions. Salicylate showed beneficial effects on diabetic nephropathy similar to those of pyridoxamine, which include lowering blood glucose levels and inhibiting macrophage infiltration into the kidneys. Attenuation of macrophage infiltration into the kidneys and upregulation of antiglycating enzyme glyoxalase 1 gene expression were found only in the salicylate treatment group. Conclusions. Treatment with salicylate and pyridoxamine could prevent the development of diabetic nephropathy in mice and, therefore, would be a potentially useful therapeutic strategy against kidney problems in patients with diabetes.

A Review of Type 1 Diabetes (T1D)

2018 ◽  
Vol 8 (2) ◽  
pp. 14-45
Author(s):  
Eileen O'Donnell ◽  
Liam O'Donnell
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Acting Insulin ◽  
Short Period ◽  
Sporting Activities ◽  
To Come

The diagnosis of Type 1 Diabetes (T1D) will come as an unwelcome surprise to most people. Within a short period of time, the person will have to come to understand and manage this chronic illness. The terminology associated with the T1D condition will also be totally new to the person: diabetes mellitus, pancreas, hyperglycaemia (hyper), hypoglycaemia (hypo), bolus (fast acting insulin), basal (slow acting insulin), ketones and blood glucose levels. The purpose of this article is to assist newly diagnosed patients' understanding of T1D, people who are already living with T1D, carers of people with T1D, partners and family members of someone with T1D, work colleagues, and friends who participate in the same sporting activities or go on holiday with a person who has T1D. In addition, this article reviews how people living with T1D can still enjoy exercise and maintain the best quality of life possible; whilst controlling the blood glucose levels in their body for the rest of their lives to prevent the onset of complications associated with diabetes.

scholarly journals Circadian rhythm and gestational diabetes: working conditions, sleeping habits and lifestyle influence insulin dependency during pregnancy

2021 ◽  
Author(s):  
Friederike Weschenfelder ◽  
Karolin Lohse ◽  
Thomas Lehmann ◽  
Ekkehard Schleußner ◽  
Tanja Groten
Keyword(s):  
Circadian Rhythm ◽  
Gestational Diabetes ◽  
Sleep Quality ◽  
Multivariate Regression ◽  
Fasting Glucose ◽  
Work Conditions ◽  
Work Condition ◽  
Glucose Levels ◽  
Acting Insulin ◽  
Long Acting

Abstract Objective Management of gestational diabetes (GDM) is currently changing toward a more personalized approach. There  is a growing number of GDM patients requiring only a single dose of basal insulin at night to achieve glucose control. Well-known risk factors like obesity, parity and family history have been associated with GDM treatment requirements. Sleep quality and lifestyle factors interfering with the circadian rhythm are known to affect glucose metabolism. The aim of this study was to investigate the impact of such lifestyle factors on insulin requirement in GDM patients, in particular on long-acting insulin to control fasting glucose levels. Research design and methods A total of 805 patients treated for GDM between 2012 and 2016 received a study questionnaire on lifestyle conditions. Sleep quality and work condition categories were used for subgroup analysis. Independent effects on treatment approaches were evaluated using multivariate regression. Results In total, 235 (29.2%) questionnaires returned. Women reporting poor sleep conditions had higher pre-pregnancy weight and BMI, heavier newborns, more large for gestational age newborns and higher rates of hyperbilirubinemia. Treatment requirements were related to sleep and work condition categories. Multivariate regression for ‘Basal’ insulin-only treatment revealed an adjOR 3.4 (CI 1.23–9.40, p  <  0.05) for unfavorable work conditions and adjOR 4.3 (CI 1.28–14.50, p  <  0.05) for living with children. Conclusions Our findings suggest that external stressors like unfavorable work conditions and living with children are independently associated with the necessity of long-acting insulin at night in GDM patients. Thus, fasting glucose levels of pregnant women presenting with such lifestyle conditions may be subject to close monitoring.

scholarly journals THE EFFECT OF DIFFERENT TYPES OF FOOD CONSUMED ON INTERSTITIAL BLOOD GLUCOSE LEVELS – A CASE REPORT

2020 ◽  
Vol 06 (04) ◽  
pp. 180-184
Author(s):  
Uma Mageshwari ◽  
Patricia Trueman ◽  
Dharini Krishnan ◽  
Vijay Viswanathan
Keyword(s):  
Case Report ◽  
Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Different Types ◽  
Food Consumed
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