Journal articles: 'Insuline – Administration'

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CARLBORG., J. TILLGREN et UNO. "Le traitement diabétique par insuline de dépôt (I.P.Z.) et par administration d'insuline (I. O.)tràs matinale." Acta Medica Scandinavica 95, S90 (April 24, 2009): 73–79. http://dx.doi.org/10.1111/j.0954-6820.1938.tb09017.x.

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Petrukhin, Aleksey. "Pump Insulin Therapy and Continuous Glycemic Monitoring." Spravočnik vrača obŝej praktiki (Journal of Family Medicine), no. 6 (June 1, 2020): 26–32. http://dx.doi.org/10.33920/med-10-2006-03.

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Diabetes mellitus is a chronic disease, which is based on insufficient insulin production, which ultimately leads to the development of hyperglycemia. As a result of the continuous increase in blood sugar levels, many organs and systems suffer, and diabetes is one of the common causes of disability. After the discovery of the true nature of the disease, the main method of treatment is the administration of insulin. The dose and frequency of administration of this drug are selected individually and can be adjusted during treatment. The insulins used at the present stage are represented by ultra-short, short-acting, mediumduration and slow-acting drugs. Ultrashort and short-acting insulins begin to work literally in a few minutes after administration, but the effect persists for a short time. This type of insulin is indicated for subcutaneous administration before meals or immediately after it. Medium and slow-acting insulins are meant to maintain insulin at a certain level for a long time, they are administered at the same time, usually twice a day. Short and ultrashort insulins should be injected into the subcutaneous tissue of the abdomen, while taking into account that the greater the thickness of the subcutaneous fat layer, the slower the absorption. Slow-acting insulins are recommended to be administered to the outer surface of the thigh or buttocks. Insulin is administered using insulin syringes or pen injectors. At present, the use of insulin pumps, which provide continuous supply of insulin using a special device, has become an alternative to the syringe administration of short-acting and ultra-short insulins. Often, such devices are equipped with glucose level sensors, which allows continuous monitoring of blood sugar levels.

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Jayagopal, Vijay, Russell Drummond, and Dinesh Nagi. "Association of British Clinical Diabetologists (ABCD) position statement on the use of biosimilar insulin." British Journal of Diabetes 18, no. 4 (December 12, 2018): 171–74. http://dx.doi.org/10.15277/bjd.2018.190.

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Biosimilar insulins have the potential to offer the NHS a considerable cost saving. The acceptability and use of biosimilar insulin by clinicians and patients may, however, be limited by lack of experience, understanding and concerns about safety and tolerability. This article summarises information on the advantages and disadvantages of using biosimilar insulins and an overview of the published evidence in relation to efficacy, tolerability and safety of current and expected Biosimilar Insulins. The position of the ABCD on the use of Biosimilar Insulin is stated along with the key practical considerations for healthcare staff involved in insulin prescription and administration.

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Andrade, Pedro, Luísa Barros, and Margarida Gonçalo. "Type 1 Ig-E mediated allergy to human insulin, insulin analogues and beta-lactam antibiotics." Anais Brasileiros de Dermatologia 87, no. 6 (December 2012): 917–19. http://dx.doi.org/10.1590/s0365-05962012000600018.

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Insulin, a crucial therapeutic agent for diabetes mellitus, has been rarely associated with hypersensitivity events. We present a 69-year-old type-2 diabetic patient with urticariform lesions on the sites of subcutaneous injection of insulin. The patient denied any known allergies, except for an unspecific cutaneous reaction after intramuscular penicillin administration in childhood. Prick tests revealed positive reactions to all tested human insulins and insulin analogues. Serum IgE levels were above normal range and RAST tests were positive for human, bovine and porcine insulins, as well as beta-lactams. Type 1 IgEmediated allergy to insulin analogues demands a prompt diagnosis and represents a significant therapeutic challenge in diabetic patients.

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Kirchner, K. A. "Insulin increases loop segment chloride reabsorption in the euglycemic rat." American Journal of Physiology-Renal Physiology 255, no. 6 (December 1, 1988): F1206—F1213. http://dx.doi.org/10.1152/ajprenal.1988.255.6.f1206.

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To elucidate the nephron segment(s) responsible for insulin's antinatriuretic effect in the mammalian kidney, late proximal, early distal, and late distal tubule micropuncture was performed during base-line and intravenous insulin infusion in glucose-clamped, volume-expanded rats. During insulin infusion, urinary sodium chloride excretion fell. Blood glucose, arterial pressure, whole kidney and single-nephron inulin clearance, fluid, and chloride delivery out of the proximal convoluted tubule remained unchanged. Early distal chloride delivery decreased (P less than 0.001) during insulin administration. Insulin infusion increased calculated loop chloride reabsorption compared with both base-line values and values for time-control rats. Distal convoluted tubule chloride reabsorption was unchanged during insulin administration. We conclude that 1) euglycemic insulin administration reduces urinary chloride excretion in volume-expanded rats by tubular mechanisms; 2) in superficial nephrons, insulin has no effect on proximal tubule fluid or chloride reabsorption but markedly stimulates chloride reabsorption in the loop; and 3) chloride reabsorption in the distal convoluted tubule was unaltered by insulin administration.

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Taylor, M. Joan, Krishan P. Chauhan, and Tarsem S. Sahota. "Glucose lowering strategies with insulin." British Journal of Diabetes 19, no. 2 (December 17, 2019): 124–30. http://dx.doi.org/10.15277/bjd.2019.228.

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People with type 1 diabetes must use insulin and a large fraction of those with type 2 condition also do so. Many therefore struggle with the unpredictable balancing of insulin dose with calorie intake and utility. A healthy pancreas makes meticulous adjustment on a continuous basis that present therapeutic insulin administration cannot match. However, much progress has been made to make it simpler to inject both background and fast-acting boost insulins with a view to better mimicking normal pancreatic output. The present fast insulins are reviewed with accent on the primary amino acid structures of the biosynthetic types that diffuse more quickly than regular insulin that associates in hexamers. This makes boost doses kinetically and clinically more effective, allowing people to inject better estimated boost and corrective doses. Formulation advances are discussed for their present and potential contributions. The newer slow-acting insulins are also described and compared, their advantage also being kinetic with a lower likelihood of inducing overnight hypoglycaemia when used optimally. Finally, the appreciation of the advantages of alternative routes of administration such as oral and peritoneal are included in this review because of the possibility of altering the hepatic to peripheral ratio, the reasons for which are more effective but less obesogenic insulin activity. The logistics of oral insulin are summarised in terms of the risks to the insulin structure, the facilitation of paracellular uptake at the apical surface and the paradoxically advantageous hepatic first pass. Other non-invasive routes are also included in the review.

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De Meyts, Pierre. "Le récepteur de l’insuline a 50 ans – Revue des progrès accomplis." Biologie Aujourd’hui 216, no. 1-2 (2022): 7–28. http://dx.doi.org/10.1051/jbio/2022007.

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L’isolement de l’insuline du pancréas et sa purification à un degré suffisant pour permettre son administration à des patients atteints de diabète de type 1 furent accomplis il y a 100 ans à l’Université de Toronto par Banting, Best, Collip et McLeod et représentent sans conteste une des plus grandes révolutions thérapeutiques en médecine, reconnue par l’attribution du Prix Nobel de Physiologie ou Médecine en 1923 à Banting et McLeod. Les retombées cliniques furent rapides ainsi que l’internationalisation de sa production commerciale. Les retombées en matière de recherche fondamentale furent beaucoup plus lentes, en particulier en ce qui concerne les mécanismes moléculaires d’action de l’insuline sur ses cellules cibles. Presque un demi-siècle s’écoula avant la détermination de la structure tri-dimensionnelle de l’insuline en 1969 et la caractérisation de son récepteur cellulaire en 1970–1971. Le fait que le récepteur de l’insuline soit une enzyme appelée tyrosine kinase ne fut démontré que dans les années 1982–1985, et la structure cristallographique du domaine kinase intracellulaire fut déterminée dix ans plus tard. La structure cristallographique du premier substrat intracellulaire de la kinase (IRS-1) en 1991 ouvrira la voie à l’élucidation des voies de signalisation intracellulaires. Il faudra 15 ans de plus avant l’obtention de la structure cristallographique du domaine extracellulaire du récepteur (en l’absence d’insuline) en 2006. Depuis, la détermination de la structure du complexe insuline-récepteur dans les états inactif et activé a fait d’énormes progrès, en particulier grâce aux améliorations récentes dans les pouvoirs de résolution de la cryo-microscopie électronique. Je passerai ici en revue les étapes du développement du concept de récepteur hormonal, et de nos connaissances sur la structure et le mécanisme moléculaire d’activation du récepteur de l’insuline.

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Zac-Varghese, Sagen, Bev Summerhayes, and Peter Winocour. "Managing type 1 diabetes in frailty." BMJ Case Reports 15, no. 12 (December 2022): e253779. http://dx.doi.org/10.1136/bcr-2022-253779.

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Managing type 1 diabetes in frail elderly people can be logistically challenging, particularly for those living alone. District nurse visits are unpredictable and coincide poorly with meal time insulin regimes. Elderly people, particularly those with dementia, have variable oral intake and activity. For some, poor glycaemic control leads to frequent and prolonged inpatient admissions. The use of technology, such as flash glucose monitoring, and the use of analogue insulins can be helpful in this setting. Increased monitoring enables more accurate titration of insulin doses and the information can be accessed by healthcare professionals and carers remotely. Longer lasting analogue insulins allow for a greater margin of error in the timing of insulin administration.

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Heinemann, Lutz, and Christopher G. Parkin. "Rethinking the Viability and Utility of Inhaled Insulin in Clinical Practice." Journal of Diabetes Research 2018 (2018): 1–9. http://dx.doi.org/10.1155/2018/4568903.

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Despite considerable advances in pharmacotherapy and self-monitoring technologies in the last decades, a large percentage of adults with diabetes remain unsuccessful in achieving optimal glucose due to suboptimal medication adherence. Contributors to suboptimal adherence to insulin treatment include pain, inconvenience, and regimen complexity; however, a key driver is hypoglycemia. Improvements in the PK/PD characteristics of today’s SC insulins provide more physiologic coverage of basal and prandial insulin requirements than regular human insulin; however, they do not achieve the rapid on/rapid off characteristics of endogenously secreted insulin seen in healthy, nondiabetic individuals. Pulmonary administration of prandial insulin represents an attractive option that overcomes limitations of SC insulin by providing more a rapid onset of action and a faster return of action to baseline levels than SC administration of rapid-acting insulin analogs. This article reviews the unique PK/PD properties of a novel inhaled formulation that support its use in patient populations with T1D or T2D.

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Garcia, Joshua, Megan Pintens, Amanda Morris, Paul Takamoto, Laura Baumgartner, and Chelsea L. Tasaka. "Reduced Versus Conventional Dose Insulin for Hyperkalemia Treatment." Journal of Pharmacy Practice 33, no. 3 (September 6, 2018): 262–66. http://dx.doi.org/10.1177/0897190018799220.

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Background: Using a reduced dose of 5 units of regular insulin has been proposed as a strategy to mitigate the risk of hypoglycemia when treating hyperkalemia. The comparative efficacy and safety of this strategy to conventional 10 units is not well established. Objective: To compare the effectiveness of reduced and conventional dosed insulin for hyperkalemia treatment. Methods: Electronic medication administration reports of conventional or reduced doses of insulin given for hyperkalemia treatment were reviewed from July 2013 to September 2015. The primary outcome was reduction in serum potassium. Results: Ninety-two administrations of reduced dose insulin and 309 administrations of conventional dose insulin were included. No significant difference was found in potassium reduction between the groups (−0.096 mmol/L, P value = .2210). Post hoc subgroup analysis of patients with serum potassium > 6 mmol/L revealed a lower reduction in potassium in the reduced dose group compared to the conventional dose group (difference: −0.238 mmol/L, P value = .018). Conclusions Conventional dose insulin may be more effective than reduced dose regular insulin at baseline serum potassium levels >6 mmol/L in the treatment of hyperkalemia. Frequent monitoring of serum potassium and glucose after administration of insulin is necessary to confirm adequate response and avoidance of hypoglycemia.

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Rasmussen, Jack T., and Heather J. Ipema. "Formulary Considerations for Insulins Approved Through the 505(b)(2) “Follow-on” Pathway." Annals of Pharmacotherapy 53, no. 2 (August 20, 2018): 204–10. http://dx.doi.org/10.1177/1060028018795834.

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Objective: To summarize formulary-relevant issues for follow-on insulins approved through the Food and Drug Administration (FDA) 505(b)(2) approval pathway (Basaglar and Admelog). Data Sources: A search of the MEDLINE database was performed for articles pertaining to clinical and formulary considerations for follow-on insulin products through July 2018. Study Selection and Data Extraction: All clinical trials used in the 505(b)(2) approval process for follow-on insulin glargine and insulin lispro products were included and summarized. Data Synthesis: Follow-on insulin glargine and insulin lispro products have been recently approved as the first lower-cost alternatives to innovator insulin products. The follow-on insulins were approved via the 505(b)(2) pathway, making them neither generics nor biosimilars. Current data do not suggest any clinically relevant differences between the follow-on insulins and their respective innovator products. Clinicians should be aware that follow-on insulins will be reclassified as biologic products in the year 2020. Relevance to Patient Care and Clinical Practice: This article provides information about currently available follow-on insulin products that were approved through the 505(b)(2) pathway, including product characteristics and efficacy and safety data. These products will likely be considered for both clinical use and formulary placement because of their potentially lower cost compared with innovator products. Conclusions: Follow-on insulin products approved through the 505(b)(2) pathway are supported by robust efficacy and safety data. As new follow-on insulins are approved and the regulatory change that will occur with these products in 2020 approaches, formulary decisions and clinical policies (eg, substitution) will continue to be revisited.

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Dedov, I. I., and M. V. Shestakova. "On the centenary of the insulin discovery." Diabetes mellitus 24, no. 1 (February 14, 2021): 11–16. http://dx.doi.org/10.14341/dm12733.

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The discovery of insulin and the beginning of its use in 1921–1922 made a revolution in endocrinology and in medicine in general. This significant event gave millions of patients with diabetes not only the opportunity to live, but also the hope that their life with this disease would be full.The article examines the history of insulin discovery, as well as the evolution of several generations of insulin preparations and the advantages of each of the generations that have radically changed not only life expectancy, but also its quality.The first generation — insulins of animal origin and the solution of the first tasks of their sufficient production and purification. The next generation is human insulins, the purification of which was also a problem. The third generation is insulin analogues, the action of which became closer to the action profile of natural insulin. And the last generation — insulin analogues, most closely mimicking the action of endogenous insulin.Along with the development of insulin preparations, the article traces the evolution of the devices of its administration.

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Heinemann, Lutz, Robert Baughman, Anders Boss, and Marcus Hompesch. "Pharmacokinetic and Pharmacodynamic Properties of a Novel Inhaled Insulin." Journal of Diabetes Science and Technology 11, no. 1 (July 9, 2016): 148–56. http://dx.doi.org/10.1177/1932296816658055.

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Advances in insulin treatment options over recent decades have markedly improved the management of diabetes. Despite this, glycemic control remains suboptimal in many people with diabetes. Although postprandial glucose control has been improved with the development of subcutaneously injected rapid-acting insulin analogs, currently available insulins are not able to fully mimic the physiological time–action profile of endogenously secreted insulin after a meal. The delayed onset of metabolic action and prolonged period of effect induce the risk of postprandial hyperglycemia and late postprandial hypoglycemia. A number of alternative routes of insulin administration have been investigated over time in an attempt to overcome the limitations associated with subcutaneous administration and to provide an improved time–action insulin profile more closely simulating physiological prandial insulin release. Among these, pulmonary insulin delivery has shown the most promise. Technosphere® Inhaled Insulin (TI) is a rapid-acting inhaled human insulin recently approved by the FDA for prandial insulin therapy. In this article we discuss the pharmacokinetic and pharmacodynamic properties of TI, and, based on key studies performed during its clinical development, the implications for improved postprandial glucose control.

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HAHN, KAREN. "ABOUT INSULIN ADMINISTRATION." Nursing 19, no. 4 (April 1989): 66–73. http://dx.doi.org/10.1097/00152193-198904000-00027.

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ossi, Wilma. "Surreptitious Insulin Administration." Archives of Pediatrics & Adolescent Medicine 141, no. 6 (June 1, 1987): 604. http://dx.doi.org/10.1001/archpedi.1987.04460060022015.

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Brouhard, Ben H. "Surreptitious Insulin Administration." Archives of Pediatrics & Adolescent Medicine 141, no. 1 (January 1, 1987): 28. http://dx.doi.org/10.1001/archpedi.1987.04460010028016.

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Harned, Leighton Kahle, and Edward Chin. "PSUN278 Factitious hypoglycemia, diagnostic delay due to insulin assay failure to detect insulin analogues." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A403. http://dx.doi.org/10.1210/jendso/bvac150.838.

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Abstract Factitious hypoglycemia may be difficult to diagnose clinically. Hypoglycemia due to insulin self-administration is established by the presence of a low c-peptide and elevated plasma insulin levels. Commercial insulin assays often fail to detect insulin analogs and can create confusion among providers investigating causes of hypoglycemia. A 20 year old female with no significant past medical history presented to an Emergency Room (ER) with hypoglycemia. She was treated with a single dose of octreotide 150 mcg, dexamethasone 10 mg PO and started on a D10W drip at 100ml/hr prior to transfer. Laboratory studies on transfer reported plasma glucose 52ng/dL (RR: 70-100), low C-peptide 0.02 (RR: 0.78-5.19), low insulin level <0.087 uIU/mL, normal IGF-I level 122 ng/mL (RR: 85-370). Normal IGF-II level 401 ng/mL (RR: 333-967), and low Pro-insulin level 1.8 pmol/L (RR: 3.6-22 pmol/L). Sulfonylurea Screen was negative. The patient and her mother both denied exogenous insulin use. The patient and her mother both work in healthcare. The patient's boyfriend has type 1 diabetes mellitus and the patient stated she keeps insulin in her purse for him. The patient was admitted for a 72 hour fast and remained normoglycemic. An aliquot of the admission ER insulin blood sample was sent to second laboratory utilizing an assay able to detect analog insulins. The patient's sample previously reporting an undetectable insulin level (<0.087 uIU/mL) now reported an insulin level 8 uIU/mL. Factitious hypoglycemia is a challenging clinical diagnosis. The term factitious implies an attempt to deceive and creates mistrust between the physician and patient. However, hypoglycemia may be the result of medication errors or administered by a second party with the intent to harm. Analog insulins (glargine, aspart, lispro, glulisine, etc) are genetically modified insulins developed to mimic the physiologic pattern of pancreatic beta cell insulin secretion. The amino acid modifications in analog insulins result in structural variations which alters the ability of highly specific commercial automated immunoassays to accurately quantitate these analog insulins. The variation in lab assay detection may cause confusion when interpreting the results. The DiaSorin Liaison XL platform in our hospital utilizes a chemiluminescence immunoassay which does not detect insulin analogs, but detects regular and NPH insulin as they are structurally identical to endogenous human insulin. The second laboratory uses the Siemens Advia Centaur platform, an immunoassay which reacts with insulin analogs "on a nearly equimolar basis with the analogs insulin aspart, insulin glargine, and insulin lispro. Insulin detemir exhibits approximately 50 percent cross-reactivity. Test reactivity with insulin glulisine is negligible (< 3 percent)". Many commercial insulin assays do not detect analog insulins and none qualitatively distinguish between different insulins. Failure to recognize this detection flaw may result in misdiagnosis, patient safety issues and costly unneeded additional studies Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

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Andrianova, E. A. "The use of ultra-short acting insulin preparations for insulin pumps." Problems of Endocrinology 58, no. 3 (June 15, 2012): 46–50. http://dx.doi.org/10.14341/probl201258346-50.

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The data on the efficacy of using ultra-short acting insulin preparations in insulin pumps for children and adolescents presenting with diabetes mellitus. Insulin pump therapy in the patients of these age groups is finding an increasingly wider application as being more convenient for the users and leading to the improvement of glycemic control. One of the main advantages of modern insulin pump therapy is the possibility to maximally imitate the physiological profile of insulin secretion. The flexibility of both basal and bolus dosing regimens of insulin administration can be further increased by using ultra-short acting insulin preparations in insulin pumps. The choice of any of the three currently available analogs of ultra-short acting insulin guarantees their identical efficacy and safety in the children and adolescents with type 1 diabetes mellitus. They can be recommended as insulins of choice for the use in pump therapy

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J, Fövényi, Pánczél P, and Thaisz E. "Healthy Pregnancy and Birth during Unusually Long-Lasting Remission of Type-1 Diabetes: Case Report." Asploro Journal of Biomedical and Clinical Case Reports 3, no. 1 (January 2, 2020): 1–5. http://dx.doi.org/10.36502/2019/asjbccr.6175.

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The 26-year-old woman was diagnosed with type 1 diabetes in 2014. The diagnosis was confirmed while there was a slight increase in blood glucose and HbA1c levels using oral glucose tolerance test, determination of insulin levels and GADA testing. This was followed by a 2-year period with complete remissions and partial remissions of 2-8 U daily basal insulin glargine. Thereafter, the patient became pregnant. The minimal basal insulin used to date has been switched to human rapid-acting and NPH insulins five times daily, which had to be increased to 11 times the initial dose in the third trimester of pregnancy. After a successful spontaneous birth of a healthy baby girl, our patient wished to return to one-tenth of the maximum insulin dose that was used during pregnancy, to once daily insulin glargine. After three months, her blood glucose levels began to rise, with oral glucose challenge test showing a marked increase in blood glucose and a drastic reduction in C-peptide levels. This was when we switched to multiple daily insulin administration using glargine basal- and glulisine analogue insulins. Later, glargine was switched to insulin degludec, and with a 30-33 U total daily insulin dose and CGM for the past two years, the patient was in a satisfactory metabolic state.

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Gorrell, Jennifer Justice, Jennifer Schoelles Williams, and Paula Powell. "Review and Update of Insulin Dependent Diabetes Mellitus." Journal of Pediatric Pharmacology and Therapeutics 8, no. 4 (October 1, 2003): 252–65. http://dx.doi.org/10.5863/1551-6776-8.4.252.

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The purpose of this article is to provide the health care practitioner with a comprehensive review of the pathophysiology and treatment of Type 1 Diabetes Mellitus. Traditionally, insulin has been administered via an insulin syringe. In the recent past, diabetes research has focused on developing more convenient insulin delivery devices and longer acting insulin's in hopes of increasing compliance with insulin therapy and improving the management of Type 1 diabetes in both children and adults. Rapidly developing approaches to insulin delivery for Type 1 diabetes continue to be developed at a rapid rate, including administration via continuous subcutaneous insulin infusion in addition to other new approaches. With these advances in therapy, pediatric patients with Type 1 diabetes have been able to achieve strict glycemic control, although the treatment of hypoglycemia remains a burden. The objectives of this article are to the following: to review the epidemiology, risk factors, pathophysiology, clinical manifestations, and diagnostic criteria of Type 1 diabetes mellitus in children,; to discuss the management of these patients, including, insulin therapy, monitoring, diet and exercise, carbohydrate counting and treatment of hypoglycemia,; and to review insulin administration devices, including insulin pens, insulin jet injectors, insulin pumps, and novel insulin delivery systems.

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Tashima, Toshihiko. "Shortcut Approaches to Substance Delivery into the Brain Based on Intranasal Administration Using Nanodelivery Strategies for Insulin." Molecules 25, no. 21 (November 7, 2020): 5188. http://dx.doi.org/10.3390/molecules25215188.

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The direct delivery of central nervous system (CNS) drugs into the brain after administration is an ideal concept due to its effectiveness and non-toxicity. However, the blood–brain barrier (BBB) prevents drugs from penetrating the capillary endothelial cells, blocking their entry into the brain. Thus, alternative approaches must be developed. The nasal cavity directly leads from the olfactory epithelium to the brain through the cribriform plate of the skull bone. Nose-to-brain drug delivery could solve the BBB-related repulsion problem. Recently, it has been revealed that insulin improved Alzheimer’s disease (AD)-related dementia. Several ongoing AD clinical trials investigate the use of intranasal insulin delivery. Related to the real trajectory, intranasal labeled-insulins demonstrated distribution into the brain not only along the olfactory nerve but also the trigeminal nerve. Nonetheless, intranasally administered insulin was delivered into the brain. Therefore, insulin conjugates with covalent or non-covalent cargos, such as AD or other CNS drugs, could potentially contribute to a promising strategy to cure CNS-related diseases. In this review, I will introduce the CNS drug delivery approach into the brain using nanodelivery strategies for insulin through transcellular routes based on receptor-mediated transcytosis or through paracellular routes based on escaping the tight junction at the olfactory epithelium.

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Hummel, Julia, Charlotte Benkendorff, Louise Fritsche, Katsiaryna Prystupa, Andreas Vosseler, Sofiya Gancheva, Sandra Trenkamp, et al. "Brain insulin action on peripheral insulin sensitivity in women depends on menstrual cycle phase." Nature Metabolism 5, no. 9 (September 21, 2023): 1475–82. http://dx.doi.org/10.1038/s42255-023-00869-w.

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AbstractInsulin action in the human brain modulates eating behaviour, whole-body metabolism and body fat distribution1,2. In particular, brain insulin action increases whole-body insulin sensitivity, but these studies were mainly performed in lean men3,4. Here we investigate metabolic and hypothalamic effects of brain insulin action in women with a focus on the impact of menstrual cycle (ClinicalTrials.gov registration: NCT03929419).Eleven women underwent four hyperinsulinemic–euglycemic clamps, two in the follicular phase and two in the luteal phase. Brain insulin action was introduced using nasal insulin spray5–7 and compared to placebo spray in a fourfold crossover design with change in glucose infusion rate as the primary endpoint. Here we show that during the follicular phase, more glucose has to be infused after administration of nasal insulin than after administration of placebo. This remains significant after adjustment for blood glucose and insulin. During the luteal phase, no significant influence of brain insulin action on glucose infusion rate is detected after adjustment for blood glucose and insulin (secondary endpoint). In 15 other women, hypothalamic insulin sensitivity was assessed in a within-subject design by functional magnetic resonance imaging with intranasal insulin administration8. Hypothalamus responsivity is influenced by insulin in the follicular phase but not the luteal phase.Our study therefore highlights that brain insulin action improves peripheral insulin sensitivity also in women but only during the follicular phase. Thus, brain insulin resistance could contribute to whole-body insulin resistance in the luteal phase of the menstrual cycle.

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Kim Jun, Jeany. "Focus on New Diabetes Treatment Options with Cardiovascular Benefits." Journal of Contemporary Pharmacy Practice 66, no. 3 (September 1, 2019): 34–40. http://dx.doi.org/10.37901/jcphp18-00029.

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The landscape of diabetes treatment options has changed due to new diabetes drug approvals, changes in the Food and Drug Administration indications based on cardiovascular (CV) outcomes studies, as well as the approval of follow-on biologic insulins. Two new drugs were approved for type 2 diabetes mellitus including ertugliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, and semaglutide, a glucagon-like peptide-1 (GLP1) receptor agonist joining a number of other drugs in these classes. In addition, follow-on biologic insulins, such as long-acting Basaglar (insulin glargine), and rapid-acting insulins Admelog (insulin lispro) and Fiasp (insulin aspart), were also approved. Furthermore, the CV outcome trial for dapagliflozin was published in November 2018 showing CV benefits. Finally, the 2018 joint American Diabetes Association (ADA) and European Association for the Study of Diabetes statement on the management of type 2 diabetes and the 2019 ADA Standards of Care for Diabetes made several recommendations. They encourage the use of agents with CV benefit in those with established atherosclerotic cardiovascular disease (ASCVD) or heart failure and to consider GLP1 receptor agonists as the first injectable agent, even before basal insulin, in certain patients. The purpose of this review is to discuss recently approved agents for type 2 diabetes comparing the available cardiovascular findings of SGLT2 inhibitors and GLP1 receptor agonists and outline key take-home points when recommending additional treatment for patients with type 2 diabetes after metformin.

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Orlovskii, M. A., Yu M. Kolesnik, and A. V. Abramov. "The effect of multiple injections of cholecystokinin 26-33 on a - and p-cells of islets of Langerhans normal and in experimental type 1 diabetes mellitus." Problems of Endocrinology 50, no. 3 (June 15, 2004): 37–41. http://dx.doi.org/10.14341/probl11424.

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The impact of multiple peripheral (intraperitoneal) and central (intracerebroventricular) administrations of cholecystokinin 26-33 (CCK-8) octapeptide on the function of a- and /3- cells of the islets of Langerhans was studied in investigations made on normal rats and rats with experimental streptosotocine-induced type 1 diabetes mellitus. Insulin in /З-cells and glucagon in а-cells were found by indirect immunofluorescence. Both routes of administration to normal animals were shown to lead to the suppressed secretion of insulin with decreased food intake. At the same time the central administration of CCK-8, unlike the peripheral one, caused a significant (p < 0.05) rise in the level of glycemia and enhanced glucagon production in а-cells, while the administrations of the peptide to diabetic animals resulted a significant increase in the blood concentration of insulin (p < 0.05), to the lower level of glycemia (p < 0.05) and to suppressed polyphagia (p < 0.01), which is associated with the activation of /З-cell function and with the suppression of the pathologically high activity of а-cells. The established facts suggest that neuroendocrine interactions are impaired in diabetes mellitus and confirm the previously made suggestions that cholecystokinin plays an important role in the pathogenesis of this disease.

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Spangler, R. S. "Insulin Administration via Liposomes." Diabetes Care 13, no. 9 (September 1, 1990): 911–22. http://dx.doi.org/10.2337/diacare.13.9.911.

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Selam, J. L., and M. A. Charles. "Devices for Insulin Administration." Diabetes Care 13, no. 9 (September 1, 1990): 955–79. http://dx.doi.org/10.2337/diacare.13.9.955.

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Twaddell, M. "Devices for Insulin Administration." Diabetes Care 14, no. 4 (April 1, 1991): 353. http://dx.doi.org/10.2337/diacare.14.4.353a.

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Karch, Amy M., and Fred E. Karch. "Troubleshooting Insulin Self-Administration." American Journal of Nursing 100, no. 7 (July 2000): 24. http://dx.doi.org/10.1097/00000446-200007000-00022.

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Haibach, Helmut, Jay D. Dix, and Jayendra H. Shah. "Homicide by Insulin Administration." Journal of Forensic Sciences 32, no. 1 (January 1, 1987): 12344J. http://dx.doi.org/10.1520/jfs12344j.

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O'Brien, Laura. "Insulin Administration at School." AJN, American Journal of Nursing 111, no. 11 (November 2011): 12. http://dx.doi.org/10.1097/01.naj.0000407283.17255.e0.

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Rushakoff, Robert J., and Heidemarie W. Macmaster. "Improving Emergency Insulin Administration." JAMA 319, no. 18 (May 8, 2018): 1937. http://dx.doi.org/10.1001/jama.2018.2106.

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Değim, I. Tuncer, Bülent Gümüşel, Zelihagül Değim, Tanju Özçelikay, Aydin Tay, and Şahika Güner. "Oral Administration of Liposomal Insulin." Journal of Nanoscience and Nanotechnology 6, no. 9 (September 1, 2006): 2945–49. http://dx.doi.org/10.1166/jnn.2006.416.

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There have been several attempts published in the literature related with orally effective insulin formulations, which are increasing in popularity. Some of the results indicate that it is possible to reduce blood glucose level by orally administered liposomal insulin formulations, but there is general need to understand the mechanism and effective components of the liposome formulations. In our study, liposomal insulin formulations were prepared using insulin (Humulin R) or protaminecontaining insulin (Humulin N) with cholesterol, dipalmitoyl phosphatidylcholine (egg) (DPPC)-cholesterol mixture, and mucoadhesive agent (methyl cellulose, MC)-added DPPC-cholesterol mixture. A tablet formulation of insulin was also prepared. Formulations of liposomal insulin were introduced to mice and rats orally and reduced blood glucose levels were observed. The composition of phospholipid (DPPC, cholesterol and MC mixture) was found to be quite effective in reducing blood glucose levels. The pH of the solution and the presence of the protamine sulfate were found to be important. The application site was also found to be important because liposomal insulin formulations administered through the mouth or esophagus resulted in reduced blood glucose levels. Reduced blood glucose levels were also observed when tablet formulations of insulin were administered to rats orally.

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Sinay, I., S. Schlimovich, S. Damilano, Ana Cagide, M. Faingold, Elisa Facco, Mirta Gurfinkiel, and P. Arias. "Intranasal Insulin Administration in Insulin Dependent Diabetes:." Hormone and Metabolic Research 22, no. 05 (May 1990): 307–8. http://dx.doi.org/10.1055/s-2007-1004908.

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Engström, Lars H. K. "Insulin pen for administration of isophane insulin." Practical Diabetes International 7, no. 4 (July 1990): 162–64. http://dx.doi.org/10.1002/pdi.1960070408.

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Barros, Alexandra Ezoraide, and Emiliane Nogueira de Souza. "Self-injection of insulin: attitudes of a group of individuals with diabetes." Revista de Enfermagem UFPE on line 5, no. 3 (April 22, 2011): 593. http://dx.doi.org/10.5205/reuol.1262-12560-1-le.0503201106.

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ABSTRACTObjective: to verify the preparation of diabetic users for self administration of insulin. Method: this is a cross-sectional study carried out with diabetic users of insulin registered at two Basic Health Units (BHU) one with Family Health Strategy the other without. A questionnaire with open and closed questions was used. Data were analyzed using descriptive and analytical statistic. The study was approved by the committee of ethical in investigation of the Associação Cultural e Científica Nossa Senhora de Fátima under the protocol nº 020/09. Results: women (67,5%), average age 61,40±11,99. Most were suffering from type 2 diabetes (95%), and were under treatment with insulin for an average time of about 6,33±6,92 years. Signs and symptoms of decompensated diabetes were recognized by 62,5% of users, 67,5% perform self administration of insulin. Most have some type of questions regarding site rotation for the injection. Alcohol swabs are used as an antiseptic in preparation of the skin prior to insulin injection by most respondents (73,7%). Regarding the reuse of syringes and needles, most users carry out this practice. Conclusion: the results suggest that users need professional monitoring, aiming to reinforce guidance on diabetes and insulin therapy. Descriptors: diabetes mellitus; primary health care; insulin; community health nursing.RESUMOObjetivo: verificar o preparo do usuário diabético para a autoaplicação de insulina. Método: estudo transversal, realizado com usuários diabéticos, cadastrados em duas unidades básicas de saúde (UBS), uma com Estratégia da Saúde da Família e, a outra, sem. Utilizou-se um questionário com perguntas abertas e fechadas, os dados foram analisados por meio de estatística descritiva e analítica. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Associação Cultural e Científica Nossa Senhora de Fátima, sob o número 020/09. Resultados: mulheres (67,5%), idade média de 61,40±11,99 anos. A maioria era portadora de diabetes tipo 2 (95%), com uma média de tempo de tratamento com insulina de 6,33±6,92 anos. Os sinais e sintomas de descompensação da diabetes são reconhecidos por 62,5% dos usuários, e 67,5% realizam a autoaplicação de insulina. A maioria apresenta algum tipo de dúvida em relação ao rodízio e locais de aplicação de insulina. A antissepsia é realizada com algodão e álcool para a limpeza local (73,7%). Em relação à reutilização de seringas e agulhas, grande parte dos usuários realiza essa prática. Conclusão: os resultados evidenciam a necessidade de acompanhamento profissional dos usuários, com o intuito de reforçar as orientações acerca da DM e da insulinoterapia. Descritores: diabetes mellitus; atenção primária à saúde; insulina; enfermagem em saúde comunitária. RESUMENObjetivo: verificar el preparo del usuario diabético para la autoaplicación de insulina. Método: estudio transversal, realizado con usuarios diabéticos registrados en dos unidades básicas de salud (UBS), una de ellas con Estrategia de Salud de la Familia. Se utilizo un cuestionario con preguntas abiertas y cerradas. Los datos fueron analizados utilizando estadística descriptiva y analítica. El estudio fue aprobado por el comité de ética en investigación de la Associação Cultural e Científica Nossa Senhora de Fátima bajo el protocolo nº 020/09. Resultados: media de edad de 61,4±11,99 años, 67% mujeres. La mayoría portador de diabetes tipo 2 (95%), con media de tiempo de tratamiento con insulina de 6,33±6,92 años. Las señales y síntomas de descompensación de diabetes son reconocidos por 62,5% de los usuarios, 67,5% realiza autoaplicación de insulina. La mayoría de los entrevistados (73,7%) realiza la desinfección local con algodón con alcohol. En relación a la reutilización de jeringas y agujas, gran parte de los usuarios realiza esta práctica. Conclusión: los resultados ponen en evidencia la necesidad de asesoramiento profesional de los usuarios, reforzando las orientaciones acerca de Diabetes Mellitus e insulinoterapia. Descriptores: diabetes mellitus; atención primaria de la salud, insulina; enfermería en salud comunitaria.

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Helms, Kristen L., and Kristi W. Kelley. "Insulin Glulisine: An Evaluation of Its Pharmacodynamic Properties and Clinical Application." Annals of Pharmacotherapy 43, no. 4 (March 31, 2009): 658–68. http://dx.doi.org/10.1345/aph.1e662.

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Objective: To evaluate the pharmacodynamic properties, efficacy, safety, and clinical application of insulin glulisine, a rapid-acting insulin analog, in the treatment of diabetes mellitus in ambulatory and hospitalized patients. Data Sources: Searches were performed with the headings glulisine, insulin analog, [LysB3, GluB29] insulin, insulin glulisine, rDNA insulin, rapid-acting insulin, SoloStar, safety, efficacy, pharmacodynamics, and cost analysts within MEDLINE and PubMed, American Diabetes Association (ADA), the Food and Drug Administration (FDA), and Sanofi-aventis Pharmaceuticals (1990–August 2008). Study Selection and Data Extraction: Phase 1, Phase 2, Phase 3, and postmarketing trials examining the efficacy and safety of glulisine in type 1 or type 2 diabetes were reviewed. Studies published as abstracts and the manufacturer's product information supplemented data absent from clinical trials. Data Synthesis: Insulin glulisine is a rapid-acting insulin with relative equivalence in efficacy and safety to other short- and rapid-acting insulins. Glulisine's onset of action of 20 minutes and 4-hour duration of action allow for bolus administration 15–20 minutes prior to or up to 20 minutes after meals. Clinical trials have demonstrated the safety and efficacy in adults with type 1 or type 2 diabetes. Several studies indicated a statistically significant decrease of hemoglobin A1C (A1C) with glulisine compared with regular insulin (0.10 decrease); however, no difference in A1C control was found compared with insulin aspart or lispro, Significant adverse effects appear to be limited to localized and systemic allergic reactions and hypoglycemia. Conclusions: Insulin glulisine is a safe and effective rapid-acting insulin analog for the treatment of adults with diabetes. Clinical benefit over other short- and rapid-acting insulin products is not established. Addition of insulin glulisine to a formulary should be based on institution-specific availability and cost differences between glulisine, lispro, and aspart in the absence of superiority of clinical efficacy or safety and data beyond 26 weeks.

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Wang, Nasui, Weidong Chai, Lina Zhao, Lijian Tao, Wenhong Cao, and Zhenqi Liu. "Losartan increases muscle insulin delivery and rescues insulin's metabolic action during lipid infusion via microvascular recruitment." American Journal of Physiology-Endocrinology and Metabolism 304, no. 5 (March 1, 2013): E538—E545. http://dx.doi.org/10.1152/ajpendo.00537.2012.

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Insulin delivery and transendothelial insulin transport are two discrete steps that limit muscle insulin action. Angiotensin II type 1 receptor (AT1R) blockade recruits microvasculature and increases glucose use in muscle. Increased muscle microvascular perfusion is associated with increased muscle delivery and action of insulin. To examine the effect of acute AT1R blockade on muscle insulin uptake and action, rats were studied after an overnight fast to examine the effects of losartan on muscle insulin uptake ( protocol 1), microvascular perfusion ( protocol 2), and insulin's microvascular and metabolic actions in the state of insulin resistance ( protocol 3). Endothelial cell insulin uptake was assessed, using 125I-insulin as tracer. Systemic lipid infusion was used to induce insulin resistance. Losartan significantly increased muscle insulin uptake (∼60%, P < 0.03), which was associated with a two- to threefold increase in muscle microvascular blood volume (MBV; P = 0.002) and flow (MBF; P = 0.002). Losartan ± angiotensin II had no effect on insulin internalization in cultured endothelial cells. Lipid infusion abolished insulin-mediated increases in muscle MBV and MBF and lowered insulin-stimulated whole body glucose disposal ( P = 0.0001), which were reversed by losartan administration. Inhibition of nitric oxide synthase abolished losartan-induced muscle insulin uptake and reversal of lipid-induced metabolic insulin resistance. We conclude that AT1R blockade increases muscle insulin uptake mainly via microvascular recruitment and rescues insulin's metabolic action in the insulin-resistant state. This may contribute to the clinical findings of decreased cardiovascular events and new onset of diabetes in patients receiving AT1R blockers.

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Loput, Charity M., Connie L. Saltsman, Risa C. Rahm, Wm Dan Roberts, Sanya Sharma, Cindy Borum, and Jennifer A. Casey. "Evaluation of medication administration timing variance using information from a large health system’s clinical data warehouse." American Journal of Health-System Pharmacy 79, Supplement_1 (October 15, 2021): S1—S7. http://dx.doi.org/10.1093/ajhp/zxab378.

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Abstract Purpose An analysis to determine the frequency of medication administration timing variances for specific therapeutic classes of high-risk medications using data extracted from a health-system clinical data warehouse (CDW) is presented. Methods This multicenter retrospective, observational analysis of medication administration data from 14 hospitals over 1 year was conducted using a large enterprise health-system CDW. The primary objective was to assess medication administration timing variance for focused therapeutic classes using medication orders and electronic medication administration records data extracted from the electronic health record (EHR). Administration timing variance patterns between standard hospital staffing shifts, within therapeutic drug classes, and for as-needed (PRN) medications were also studied. To assess medication administration timing variance, calculated variables were created for time intervals of 30-59, 60-120, and greater than 120 minutes. Scheduled medications were assessed for delayed administration and PRN medications for early administration. Results A total of 5,690,770 medication administrations (3,418,275 scheduled and 2,272,495 PRN) were included in the normalized data set. Scheduled medications were frequently subject to delays of ≥60 minutes (15% of administrations, n = 275,257) when scheduled for administration between 9-10 AM and between 9-10 PM. By therapeutic drug class, scheduled administrations of insulins, heparin products, and platelet aggregation inhibitors were the most commonly delayed. For PRN medications, medications in the anticoagulant and antiplatelet agent class (most commonly heparin flushes and line-management preparations) were most likely to be administered early, defined as more than 60 minutes from the scheduled time of first administration. Conclusion The findings of this study assist in understanding patterns of delayed medication administration. Medication class, time of day of scheduled administration, and frequency were factors that influenced medication administration timing variance.

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Trautvetter, Ulrike, and Gerhard Jahreis. "Effect of supplementary calcium phosphate on plasma gastrointestinal hormones in a double-blind, placebo-controlled, cross-over human study." British Journal of Nutrition 111, no. 2 (July 22, 2013): 287–93. http://dx.doi.org/10.1017/s0007114513002341.

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Gastrointestinal hormones and Ca are associated with bone metabolism. The objective of the present human study was to determine the effect of calcium phosphate on the postprandial circulation of gastrointestinal hormones. A total of ten men participated in the present double-blind, placebo-controlled, cross-over study. The participants were divided into two groups. Of these, one group consumed bread enriched with 1 g Ca (pentacalcium hydroxy-triphosphate, CaP) daily for 3 weeks. The other group consumed placebo bread. After 2 weeks of washout, the intervention was changed between the groups for another 3 weeks. The subjects consumed a defined diet at the beginning (single administration) and at the end (repeated administration) of the intervention periods, and blood samples were drawn at 0, 30, 60, 120, 180 and 240 min. Between 0 and 30 min, the participants consumed a test meal, with or without CaP. The concentrations of gastrointestinal hormones (glucose-dependent insulinotropic polypeptide, glucagon-like peptide (GLP) 1 and GLP2), insulin and glucose were determined. The AUC of GLP1 (total and active) and GLP2 increased significantly after the repeated CaP administrations compared with that after placebo administration. The AUC of insulin and glucose showed no differences between the CaP and placebo administrations. CaP affects the postprandial plasma concentrations of gastrointestinal hormones through the modulation of the intestinal environment, e.g. bile acids and microbiota.

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Finelli, Carmine. "Is Co-Administration Curcumin and Piperine a Benefit in Preventing Metabolic Syndrome?" Archives of Medical Case Reports and Case Study 5, no. 1 (January 5, 2022): 01–03. http://dx.doi.org/10.31579/2692-9392/099.

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The metabolic syndrome, which includes obesity, insulin resistance, dyslipidemia, and hypertension, has gained importance due to its link to the development of cardiovascular disease and type 2 diabetes.

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Lotfi, A., H. Aghdam-Shahryar, J. Ghiasi-Ghalehkandi, H. Kaiya, and N. Maheri-Sis. "Effect of in ovo ghrelin administration on subsequent serum insulin and glucose levels in newly-hatched chicks." Czech Journal of Animal Science 56, No. 8 (August 18, 2011): 377–80. http://dx.doi.org/10.17221/2396-cjas.

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Ghrelin is a regulatory peptide in glucose homeostasis in animal species. Its effect in the avian embryo is unclear. The aim of this study was to investigate the effects of in ovo ghrelin administration on serum glucose and insulin levels of hatched chicks. A total of 250 fertilized eggs were divided into 5 groups; group T1 as control (without injection), group T2 (in ovo injected with 50 ng/egg ghrelin on day 5), group T3 (in ovo injected with 100 ng/egg ghrelin on day 5), group T4 (in ovo injected with 50 ng/egg ghrelin on day 10) and group T5 (in ovo injected with 100 ng/egg ghrelin on day 10). After hatching, serum insulin and glucose concentrations were determined. Group T4 and T5 showed significantly higher serum insulin levels (0.43 and 0.60 ng/ml, respectively) compared with T1, T2 and T3 (0.09, 0.10, and 0.23 ng/ml, respectively) in hatched chicks. Glucose concentrations have not been affected by in ovo administered ghrelin in all injected groups. It seems that embryonic β-cells were stimulated to secrete a considerable level of insulin in response to in ovo ghrelin in the late embryonic life. The observed stability of glucose rate suggests the incidence of insulin resistance at hatching time or in newly hatched chicks from in ovo ghrelin administered eggs on day 10.

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Shitov, L. N., Yu A. Dzhurko, R. V. Drai, I. E. Makarenko, A. L. Khokhlov, L. A. Khozova, O. V. Afonkina, Yu A. Sevastyanova, N. A. Vasilenko, and A. A. Abramova. "Enzyme-Linked Immunosorbent Assay Method Application in the Study of Comparative Pharmacokinetics of Insulin Glargin Preparations." Acta Biomedica Scientifica 4, no. 1 (April 4, 2019): 93–101. http://dx.doi.org/10.29413/abs.2019-4.1.14.

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Aims:adaptation and validation of the ELISA method insulin glargine determination for the pharmacokinetic study, practical approval in the biosimilars clinical trial.Materials and methods.Serum insulin glargine determination was measured using a commercial ELISA kit. All tests were run on a Personal LAB machine (Adaltis S.r.l., Rome, Italy) with test systems for measuring the concentration of insulin glargine (Invitron Ltd., United Kingdom); human insulin concentrations were measured in the samples from the study for correction of cross-reactivity. Clinical part of this study included 42 male patients aged 18–65 with diabetes mellitus type 1. This was a double-blind, randomized, crossover clamp study with wash-out period of 7–14 days. Comparisons drugs: Insulin Glargine (glargine) solution for subcutaneous administration, 100 U/ml (GEROPHARM, Russia) and Lantus® (glargine) solution for subcutaneous administration, 100 U/ml (Sanofi-Aventis Deutschland GmbH, Germany).Results.At the stage of the method adaptation the modification of original manufacturer’s method was performed; the full validation of modified analytical method for all parameters (selectivity, specificity, precision of calibration curves, intra- and inter-batch precision and accuracy, carry-over, dilution integrity, stability of solutions, stability in biologic matrix, parallelism) in accordance with regulatory authorities requirements has been done. The primary endpoint for long-acting insulins – AUCins.0-τ was calculated. Insulin Glargine and Lantus® are equivalent based on AUCins.0-τ data (point estimation for ratio of geometric means was 99 %, the confidence intervals for the ratio of the geometric mean for AUCins.0-τ was 81.02–120.62 %, that correspond to acceptance range 80.00–125.00 %).

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&NA;. "Insulin pens can completely replace syringe insulin administration." Inpharma Weekly &NA;, no. 784 (April 1991): 8. http://dx.doi.org/10.2165/00128413-199107840-00024.

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Ginsberg, B., Joan Parkes, and C. Sparacino. "The Kinetics of Insulin Administration by Insulin Pens." Hormone and Metabolic Research 26, no. 12 (December 1994): 584–87. http://dx.doi.org/10.1055/s-2007-1001764.

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Jaffe, Craig A., Bryan W. Huffman, and Roberta Demott-Friberg. "Insulin hypoglycemia and growth hormone secretion in sheep: a paradox revisited." American Journal of Physiology-Endocrinology and Metabolism 277, no. 2 (August 1, 1999): E253—E258. http://dx.doi.org/10.1152/ajpendo.1999.277.2.e253.

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Although insulin-induced hypoglycemia is a potent stimulus for growth hormone (GH) secretion in humans, hypoglycemia was reported to suppress GH in sheep. We investigated whether GH suppression in sheep during insulin hypoglycemia resulted from the dose of insulin administered or the fed state of the animal. Saline or insulin (0.05, 0.2, 1.0, or 5.0 U/kg) intravenous boluses were administered to eight fasted ewes in a crossover experiment. In another experiment, four sheep were fed 2 h before intravenous administrations of either 0.2 or 5 U/kg of insulin. All doses of insulin resulted in comparable hypoglycemia, although the duration of hypoglycemia increased directly with insulin dose. Hypoglycemia in fasted animals stimulated GH secretion. The GH rise above baseline was inversely related to the insulin dose, and the insulin doses of 1 and 5 U/kg resulted in late suppression of GH below baseline concentrations. Insulin administration to fed animals caused an identical degree of hypoglycemia but no increase in GH. Insulin-hypoglycemia stimulates GH secretion in sheep in a manner similar to humans, and the response is dependent on both fed state and insulin dose.

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GWINUP, GRANT. "New Modes of Insulin Administration." Annals of Internal Medicine 105, no. 4 (October 1, 1986): 633. http://dx.doi.org/10.7326/0003-4819-105-4-633_2.

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Cernea, S., and I. Raz. "Noninjectable methods of insulin administration." Drugs of Today 42, no. 6 (2006): 405. http://dx.doi.org/10.1358/dot.2006.42.6.985632.

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Yasmeen, BH Nazma. "Insulin administration Devices–an update." Northern International Medical College Journal 9, no. 2 (November 23, 2018): 283–85. http://dx.doi.org/10.3329/nimcj.v9i2.38907.

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Kal, J. E., E. E. W. Vlassak, E. R. Bulder, and E. J. F. Franssen. "Inadvertent epidural administration of insulin." Anaesthesia 62, no. 6 (June 2007): 621–23. http://dx.doi.org/10.1111/j.1365-2044.2007.04996.x.

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SANAI, L. "Administration of insulin during surgery." British Journal of Anaesthesia 72, no. 6 (June 1994): 735. http://dx.doi.org/10.1093/bja/72.6.735.

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Journal articles on the topic 'Insuline – Administration'

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