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1

United States. Food and Drug Administration. Office of Women's Health. Insulin. Washington, D.C.]: Dept. of Health and Human Services, FDA, Office of Women's Health, 2010.

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2

Human insulin: Clinical pharmacological studies in normal man. Lancaster: MTP Press, 1986.

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3

Tattersall, Robert. Diabetes, a practical guide for patients on insulin. 2nd ed. Edinburgh: Churchill Livingstone, 1985.

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4

Fisher, Simon Jeremy. Use of the matched step tracer infusion procedure to evaluate the effects of different routes of insulin administration and to compare the effects of insulin and insulin-like growth factor I. Ottawa: National Library of Canada = Bibliothèque nationale du Canada, 1992.

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5

Registered Nurses' Association of Ontario., ed. Best practice guideline for the subcutaneous administration of insulin in adults with type 2 diabetes. Toronto: Registered Nurses Association of Ontario = L'association des infirmières et infirmiers autorisés de l'Ontario, 2004.

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6

Havas, Stephen. Self-control: A physician's guide to blood glucose monitoring in the management of diabetes. Leawood, KS: American Academy of Family Physicians, 2004.

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7

Page, Brackenridge Betty. Diabetes 101: A pure and simple guide for people who use insulin. 3rd ed. Minneapolis, MN: Chronimed Pub., 1998.

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8

Heller, Richard F. The carbohydrate addict's healthy heart program: Break your carbo-insulin connection to heart disease. New York: Ballantine Pub. Group, 1999.

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9

Page, Brackenridge Betty. Diabetes 101: Candy apples, log cabins & you : a pure and simple guide for people who use insulin. 2nd ed. Minneapolis, MN: Chronimed Pub., 1993.

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10

Melvin, Wiedman, ed. Diabetes: Current research and future directions in management and cure. Jefferson, N.C: McFarland, 1988.

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11

Association, American Diabetes, ed. Intensive diabetes management. 5th ed. Alexandria [Va.]: American Diabetes Association, 2012.

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12

E, Kowalski Robert, ed. The type 2 diabetes diet book: The insulin control diet : your fat can make you thin. 3rd ed. Los Angeles: Lowell House, 1999.

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13

J, Klingensmith Georgeanna, and American Diabetes Association, eds. Intensive diabetes management. 3rd ed. Alexandria, Va: American Diabetes Association, 2003.

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14

Association, American Diabetes, ed. Intensive diabetes management. 2nd ed. Alexandria, Va: American Diabetes Association, 1998.

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15

I, Stearns Eugene, ed. Microcomputers in health care management: Strategies and applications for the 1990s. 2nd ed. Rockville, MD: Aspen Publishers, 1990.

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16

Ezrin, Calvin. The endocrine control diet: How to beat the metabolic trap and lose weight permanently. New York: Harper & Row, 1990.

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17

I, Wolfsdorf Joseph, and American Diabetes Association, eds. Intensive diabetes management. 4th ed. Alexandria: American Diabetes Association, 2009.

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18

Campbell, R. Keith. Medications for the treatment of diabetes. Alexandria, Va: American Diabetes Association, 2000.

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19

Using Insulin, Everything You Need for Success With Insulin. Torrey Pines Press, 2003.

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20

Novak, Richard J. Insulin Overdose. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0096.

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The most significant risk of hypoglycemia is damage to the central nervous system. Iatrogenic insulin overdose by healthcare professionals as well as self-administered overdoses are known to occur. Of particular concern to anesthesia care team members is that hypoglycemia under general anesthesia may be difficult to diagnose clinically, because general anesthesia masks the neuroglycopenic symptoms of stupor and coma. In fact, anesthesiologists are the physicians most at risk for administrating an insulin medication error. A structured system of monitoring and administering insulin promotes patient safety. This chapter will review the appropriate assessment and management of patients suffering from insulin overdose, with particular focus on perioperative challenges.
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21

Owens, D. R. Human Insulin: Clinical Pharmacological Studies in Normal Man. Springer, 2012.

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22

Owens, D. R. Human Insulin: Clinical Pharmacological Studies in Normal Man. Springer Netherlands, 2011.

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23

Effects of leg exercise and insulin injection sites on blood glucose in persons with insulin dependent diabetes mellitus (IDDM). 1992.

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24

Effects of leg exercise and insulin injection sites on blood glucose in persons with insulin dependent diabetes mellitus (IDDM). 1992.

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25

Effects of leg exercise and insulin injection sites on blood glucose in persons with insulin dependent diabetes mellitus (IDDM). 1992.

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26

Lameire, Norbert. Prevention of acute kidney injury. Edited by Norbert Lameire. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0226_update_001.

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This chapter summarizes the pharmacological interventions that can be used in the prevention of acute kidney injury (AKI). These following interventions are discussed: the use and selection of vasopressors; the administration of loop diuretics and mannitol; vasodilating drugs including dopamine, atrial natriuretic peptide, nesiritide, fenoldopam, and adenosine antagonists. The role of N-acetylcysteine in the prevention of contrast-induced AKI and cardiac surgery is discussed. The chapter concludes with a summary of the potential role of insulin-like growth factor and erythropoietin in the prevention of AKI.
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27

Diabetes 101: A Pure and Simple Guide for People Who Use Insulin. Wiley & Sons, Incorporated, John, 1998.

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28

Mesotten, Dieter, and Sophie Van Cromphaut. Management of diabetic emergencies in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0260.

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The three major diabetic emergencies comprise diabetic ketoacidosis (DKA), hyperglycaemic hyperosmolar state (HHS), and prolonged hypoglycaemia. These complications are preventable, treatable, and rather infrequently lead to prolonged intensive care (ICU) admission. Hyperglycaemic crises, whether DKA in type 1 diabetics, or HHS in type 2 diabetics, are characterized by moderate to severe hypovolaemia, electrolyte disturbances and a potentially life-threatening trigger. Hence, airway–breathing–circulation securement, diagnosis, and treatment of the underlying condition, as well as fluid resuscitation are the cornerstones of the acute management of DKA and HHS. Currently, a continuous, low (physiological) dose insulin scheme intravenously with omission of the priming bolus is advocated to avoid hypoglycaemia. An evidence-based treatment protocol, and reliable blood glucose and electrolyte measurements are compulsory to safely manage these crises until resolution of ketoacidosis or the hyperosmolar state. Profound hypoglycaemia should be suspected in every coma patient with an indistinct history or on a known regimen of insulin or sulphonylurea/meglitinide. This condition warrants immediate and sufficiently long administration of glucose orally or intravenously, as well as repeated monitoring of blood glucose levels. Alternatively, the counter-regulatory hormone glucagon may be injected intramuscularly in the emergency setting.
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29

Cropsey, Christopher L., and Patrick B. Knight. Beta Blocker/Calcium Channel Blocker Overdose. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0088.

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Beta blocker and calcium channel blocker overdose is a rare perioperative complication that manifests with symptoms of altered mental status, hypotension, bradycardia, and cardiovascular collapse. Although the clinical presentation is often similar, the underlying pathophysiology can differ between either cardiogenic or vasodilatory shock. Standard therapies such as calcium administration or beta-adrenergic agonists may be effective but often require much higher doses than normal. The evidence for targeted therapies, such as high-dose insulin infusion and glucagon, is mixed, but these should be considered. Refractory toxicity may require advanced lifesaving measures such as intra-arterial balloon counterpulsation or extracorporeal membrane oxygenation. If prompt cardiovascular support can be achieved, patient outcomes are generally very positive.
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30

Debaveye, Yves, Dieter Mesotten, and Greet Van den Berghe. Hyperglycaemia, diabetes, and other endocrine emergencies. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0069.

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Although endocrine pathology is usually treated in outpatient clinic, intensive care may be required when endocrinopathies are associated with other medical illnesses or reach a state of decompensation. Although endocrine emergencies are quite rare, they are potentially life-threatening, if not recognized promptly and managed effectively. Therefore, every clinician should always be attentive to a possible diagnosis of these complex disorders. The three major diabetic emergencies comprise diabetic ketoacidosis, hyperglycaemic hyperosmolar state, and prolonged hypoglycaemia. Hyperglycaemic crises are characterized by hypovolaemia, electrolyte disturbances, and potentially life-threatening triggers. Hence, airway-breathing-circulation securement, diagnosis and treatment of the underlying condition, and fluid resuscitation are the cornerstones of acute diabetic ketoacidosis/hyperglycaemic hyperosmolar state management. Subsequently, monitoring and correction of electrolyte disturbances and insulin treatment are initiated. Profound hypoglycaemia should be suspected in every coma patient with an indistinct history or treated with insulin or sulfonylurea/meglitinide. This condition warrants an immediate and a sufficiently long administration of glucose, under blood glucose monitoring. Alternatively, glucagon may be injected subcutaneously, or preferably intramuscularly. Hyperglycaemia in intensive care unit patients is associated with adverse outcome which can be prevented via the implementation of glucose control with intravenous insulin. One should hereby target glucose levels to be as close to normal as possible, without evoking unacceptable glucose fluctuations and hypoglycaemia. The classical non-diabetic endocrine emergencies comprise thyroid storm, myxoedema coma, acute adrenal crisis, and phaeochromocytoma. They all pose diagnostic and therapeutic challenges and require specific treatment such as endocrine replacement or blockage therapy. It is important to note that they are occasionally the presenting manifestation in undiagnosed patients. This chapter also briefly discusses amiodarone-induced thyroid dysfunction.
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31

Neligan, Patrick J., and Clifford S. Deutschman. Pathophysiology and causes of metabolic acidosis in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0255.

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Critical illness is typically characterized by changes in the balance of water and electrolytes in the extracellular space, resulting in the accumulation of anionic compounds that manifests as metabolic acidosis. Metabolic acidosis manifests with tachypnoea, tachycardia, vasodilatation, headache and a variety of other non-specific symptoms and signs. It is caused by a reduction in the strong ion difference (SID) or an increase in weak acid concentration (albumin or phosphate). Increased SID results from hyperchloraemia, haemodilution or accumulation of metabolic by-products. A reduction in SID results in a corresponding reduction is serum bicarbonate. There is a corresponding increase in alveolar ventilation and reduced PaCO2. Lactic acidosis results from increased lactate production or reduced clearance. Ketoacidosis is associated with reduced intracellular glucose availability for metabolism, and is associated with insulin deficiency and starvation. Hyperchloraemic acidosis is associated with excessive administration of isotonic saline solution, renal tubular acidosis and ureteric re-implantation. Renal acidosis is associated with hyperchloraemia, hyperphosphataemia, and the accumulation of medley nitrogenous waste products.
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32

Llewellyn, Matthew P., and John Gleaves. The Amateur Apostle and the Cold War Games. University of Illinois Press, 2017. http://dx.doi.org/10.5406/illinois/9780252040351.003.0006.

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This chapter focuses on International Olympic Committee (IOC) president Avery Brundage, who defended amateurism seemingly with religious conviction throughout his bureaucratic career. His deeply conservative views and passionate defense of the amateur ideal set the tone for the IOC in the Cold War years, helping insulate the movement from the radical currents that were transforming postwar societies and global affairs. Both in his lifetime and in the years since, portrayals of Brundage depict a Quixote-esque idealist providing the Olympic Movement's only firm line of defense against professional and commercial encroachments. However, the orthodox view of Brundage as an unwavering apostle of amateurism overlooks the finer, more nuanced realities of his administration. Despite his anticommercial rhetoric and investigatory crusades, Brundage also appeased, compromised, and even spearheaded initiatives that broke with the Olympic Movement's amateur traditions.
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33

Covelli, Pasquale, and Melvin Wiedman. Diabetes: Current Research and Future Directions in Management and Cure. McFarland & Company, 1988.

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34

Brackenridge, Betty, and Richard O. Dolinar. Diabetes 101: Candy Apples, Log Cabins and You. Chronimed Publishing, 1989.

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35

Nuevos productos para tratar la diabetes: La FDA ayuda a combatir una amenaza mayor a salud pública. Rockville, MD: Dept. of Health and Human Services, Food and Drug Administration, Office of Public Affairs, 2002.

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36

Nuevos productos para tratar la diabetes: La FDA ayuda a combatir una amenaza mayor a salud pública. Rockville, MD: Dept. of Health and Human Services, Food and Drug Administration, Office of Public Affairs, 2002.

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37

Jörres, Achim, Dietrich Hasper, and Michael Oppert. Non-dialytic management of the patient with acute kidney injury. Edited by Norbert Lameire. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0228.

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The main focus in the non-dialytic management of patients with acute kidney injury (AKI) is the prevention and treatment of complications.Nutritional support is an important aspect as many patients tend to be hypercatabolic, thus requiring adequate caloric intake, yet without administration of excessive fluid volumes. Inadequate nutrition in AKI may lead to enhanced production of urea nitrogen and azotaemia. However, hyperglycaemia is a frequent complication in these patients, often requiring continuous insulin therapy to achieve the recommended blood glucose target range of 110–150 mg/dL (6.11–8.33 mmol/L).Patients with AKI are prone to infections which are a common cause of death in this population. Careful search for and intensive treatment of infections is therefore of utmost importance, and antimicrobial chemotherapy must be initiated as early as possible, especially in patients with sepsis and AKI.Drug dosing in patients with AKI is complex and difficult. Residual kidney function can be highly variable and drug disposition may be altered due to changes in distribution volume, protein binding, and metabolism. Moreover, many drugs can be removed by renal replacement therapy (RRT). Therefore, adequate dosing must take into account the patient’s individual clinical characteristics, the specific pharmacokinetic/pharmacodynamic properties of the drug, and the mode and intensity of renal replacement therapy.
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38

Farkas-Hirsch, Ruth, and Laurie Guffey. Intensive Diabetes Management (Clinical Education Series) (Clinical Education Series). 2nd ed. McGraw-Hill/Contemporary, 2003.

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39

Ezrin, Calvin, and Robert E. Kowalski. The Endocrine Control Diet: How to Beat the Metabolic Trap and Lose Weight Permanently. HarperCollins, 1989.

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40

Clowes, Alexander W., John Lechleiter, and A. Ian Fraser. Doc and the Duchess: The Life and Legacy of George H. A. Clowes. Indiana University Press, 2016.

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41

Doc and the Duchess: The Life and Legacy of George H. A. Clowes. Indiana University Press, 2016.

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42

Zimmerman, Jonathan. Campus Politics. Oxford University Press, 2016. http://dx.doi.org/10.1093/wentk/9780190627393.001.0001.

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Universities are usually considered bastions of the free exchange of ideas, but a recent tide of demonstrations across college campuses has called this belief into question, and with serious consequences. Such a wave of protests hasn't been seen since the campus free speech demonstrations of the 1960s, yet this time it is the political Left, rather than the political Right, calling for restrictions on campus speech and freedom. And, as Jonathan Zimmerman suggests, recent campus controversies have pitted free speech against social justice ideals. The language of trauma--and, more generally, of psychology--has come to dominate campus politics, marking another important departure from prior eras. This trend reflects an increased awareness of mental health in American society writ large. But it has also tended to dampen exchange and discussion on our campuses, where faculty and students self-censor for fear of insulting or offending someone else. Or they attack each other in periodic bursts of invective, which run counter to the “civility” promised by new speech and conduct codes. In Campus Politics: What Everyone Needs to Know®, Jonathan Zimmerman breaks down the dynamics of what is actually driving this recent wave of discontent. After setting recent events in the context of the last half-century of free speech campus movements, Zimmerman looks at the political beliefs of the US professorate and students. He follows this with chapters on political correctness; debates over the contested curriculum; admissions, faculty hires, and affirmative action; policing students; academic freedom and censorship; in loco parentis administration; and the psychology behind demands for "trigger warnings" and "safe spaces." He concludes with the question of how to best balance the goals of social and racial justice with the commitment to free speech.
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43

Ezrin, Calvin, and Robert E. Kowalski. The Endocrine Control Diet: How to Beat the Metabolic Trap and Lose Weight Permanently. HarperCollins, 1989.

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44

Ezrin, Calvin, and Robert E. Kowalski. The Type II Diabetes Diet Book. 3rd ed. McGraw-Hill, 1999.

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45

White, John, and R. Keith Campbell. Medications for the Treatment of Diabetes. American Diabetes Association, 2003.

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