No abstract available.
Biphasic Insulins

No abstract available.
Biphasic Insulins

The elderly population has recently increased significantly, and therefore the number of elderly patients with diabetes is also rapidly increasing. There are many physical, mental, and societal differences among elderly diabetic patients. Therefore, before initiating any form of glucose-lowering therapy in the elderly, it is necessary to assess overall patient health status, coexisting illnesses, the social environment, and degree of cognitive function. The elderly may also be at increased risk of adverse events, particularly hypoglycemia, during drug therapy for glucose control. Glucose control should remain an individualized target while minimizing the risk of hypoglycemia in elderly diabetic patients. This article summarizes treatment options with respect to oral glucose-lowering agents and insulins that are effective in elderly patients.
Aged ; Diabetes Mellitus ; Glucose ; Humans ; Hypoglycemia ; Insulin ; Insulins ; Social Environment

Chronic hyperglycemia is the primary risk factor for the development of complications in diabetes mellitus (DM); however, it is believed that frequent or large glucose fluctuations may independently contribute to diabetes-related complications. Postprandial spikes in blood glucose, as well as hypoglycemic events, are blamed for increased cardiovascular events in DM. Glycemic variability (GV) includes both of these events; hence, minimizing GV can prevent future cardiovascular events. Correcting GV emerges as a target to be pursued in clinical practice to safely reduce the mean blood glucose and to determine its direct effects on vascular complications in diabetes. Modern diabetes management modalities, including glucagon-related peptide-1-based therapy, newer insulins, modern insulin pumps and bariatric surgery, significantly reduce GV. However, defining GV remains a challenge primarily due to the difficulty of measuring it and the lack of consensus regarding the optimal approach for its management. The purpose of this manuscript was not only to review the most recent evidence on GV but also to help readers better understand the available measurement options and how the various definitions relate differently to the development of diabetic complications.
Bariatric Surgery ; Blood Glucose ; Consensus ; Diabetes Complications ; Diabetes Mellitus ; Glucose ; Hyperglycemia ; Insulin ; Insulins ; Risk Factors

The worldwide prevalence of type 2 diabetes increases with age and almost 40% of men and more than 50% of women in Korean diabetic patients are over the age of 65. Recent clinical trials suggest that early intensive glycemic control reduces chronic complications associated with morbidity and mortality in type 2 diabetic patients. The principles of management of type 2 diabetes in the elderly are not different from those in middle-aged patients. However, before initiating any form of glucose-lowering therapy in the elderly it is necessary to assess the patient overall health status, coexisting illnesses, social environment, psychological well-being and degree of cognitive function. Furthermore, it should be considered to keep glucose control on individualized target without the risk of hypoglycemia in elderly diabetic patients due to the more deleterious and serious conditions. The old and more recent oral glucose-lowering agents and insulins are effective in the elderly patient. The characteristics and side effects of diabetic agents should be carefully reviewed by clinician before starting any form of medication in the elderly.
Aged ; Diabetes Mellitus ; Female ; Glucose ; Humans ; Hypoglycemia ; Insulin ; Insulins ; Male ; Prevalence ; Social Environment

Adult ; Aged ; Autoimmune Diseases ; diagnosis ; metabolism ; Female ; Humans ; Insulins ; metabolism ; Male ; Middle Aged

A 2.4 kg baby boy born via Caesarian section at 35 weeks had the first onset of hypoglycemia at 2 hours of life. The infant required a glucose load of 30 mg/kg/min. Insulin level was 19.6 pmol/L (normal value 17.8-173.0) in the absence of ketosis. He was resistant to oral diazoxide but responded to octreotide infusion. The boy was found to be heterozygous for an ABCC8 nonsense mutation, p.R934*. We present our experience on the use of subcutaneous octreotide for 2 years for the treatment of diazoxide resistant congenital hyperinsulinism (CHI).

Male ; Infant ; Codon, Nonsense ; Congenital Hyperinsulinism ; Diazoxide ; Glucose ; Infant ; Insulins ; Ketosis ; Octreotide ; Parturition ; Pregnancy ; Mutation

Insulin plays an important role in the treatment of diabetes. Since it was discovered in the early 1920s, major advances have been made in the medical use of insulin. However, certain insulin associated challenges remain, such as hypoglycemia, weight gain, complex management, and injection site pain. Novel insulins and delivery systems are being developed that can address these limitations. Insulin degludec is a novel basal insulin with a long half-life (25 hours) and action duration (> 42 hours). Glargine U300 is a concentrated formulation of insulin glargine. For improvement in postprandial glucose control, ultrarapid-acting insulins are being investigated. New insulin delivery systems including inhaled insulin and insulin patches are also being developed to overcome the inconvenience associated with subcutaneous injection. In this review, clinical studies of new insulins and new insulin delivery systems are summarized.
Diabetes Mellitus ; Glucose ; Half-Life ; Hypoglycemia ; Injections, Subcutaneous ; Insulin* ; Insulins* ; Weight Gain ; Insulin Glargine

OBJECTIVE: To study the clinical effect of continuous subcutaneous insulin infusion (CSⅡ) versus multiple daily injection (MDI) on blood glucose control in children with type 1 diabetes mellitus (T1DM). METHODS: A retrospective analysis was performed on the medical data of 91 children with T1DM who were treated with CSⅡ for more than 1 year and 75 children with T1DM who were treated with MDI. The two groups were compared in terms of glycosylated hemoglobin (HbA1C) and the recurrence of diabetic ketoacidosis (DKA) to evaluate the difference in the efficacy during the 3-year follow-up. A survey was conducted for the children in the CSⅡ group and their family members to investigate the degree of satisfaction with insulin pump. RESULTS: There was no significant difference in age, sex, and course of diabetes between the CSⅡ and MDI groups at disease onset and in the first year, the second year, and the third year of follow-up ( CONCLUSIONS Children with T1DM treated with CSⅡ have a better control of blood glucose than those treated with MDI, and children and their family members are satisfied with CSⅡ treatment. Therefore, it holds promise for clinical application.
Child ; Diabetes Mellitus, Type 1/drug therapy* ; Diabetic Ketoacidosis ; Follow-Up Studies ; Humans ; Insulins ; Retrospective Studies

Humans ; Neutrophils ; Retrospective Studies ; Leukocyte Count ; Hyperglycemia/drug therapy* ; Insulins ; Insulin/therapeutic use*