Journal articles on the topic 'Insulin Analysis'
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Du, Xinli, Rihua Zhang, Yi Xue, Dong Li, Jinmei Cai, Suming Zhou, Zhengkai Huang, Rongbin Yu, and Yun Liu. "Insulin Glargine and Risk of Cancer: A Meta-Analysis." International Journal of Biological Markers 27, no. 3 (July 2012): 241–46. http://dx.doi.org/10.5301/jbm.2012.9349.
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Aims Recently, more and more attention has been drawn on the long-term effects of insulin glargine. Here we strived to estimate the association of cancer occurrence with the use of insulin glargine. Methods We searched all the publications regarding the association between cancer occurrence and the use of insulin glargine using the US National Library of Medicine's PubMed database. Data were independently extracted and analyzed using random or fixed effects meta-analysis depending upon the degree of heterogeneity. Results Seven cohort studies were included in the meta-analysis. Cancer occurrence had no significant difference in glargine-treated patients compared to patients treated with other insulins (RR=0.86, 95% CI=0.69–1.07, p=0.17, Pheterogeneity <0.00001). In our subgroup analysis, glargine, compared to other insulins, did not increase the risk of breast cancer (RR=1.14, 95% CI=0.65–2.02, p=0.65, Pheterogeneity=0.002), prostate cancer (RR=1.00, 95% CI=0.79–1.26, p=0.99, Pheterogeneity=0.78), pancreatic cancer (RR=0.57, 95% CI=0.14–2.35, p=0.44, Pheterogeneity=0.0002) and gastrointestinal cancer (RR=0.80, heterogeneity 95% CI=0.62–1.02, p=0.07, Pheterogeneity=0.86). Conclusions This meta-analysis of open-label studies does not support an increased cancer risk in patients treated with insulin glargine. The result provides confidence for the development of insulin glargine, but needs confirmation by further clinical studies.
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Whitmore, T. J., N. J. Trengove, D. F. Graham, and P. E. Hartmann. "Analysis of Insulin in Human Breast Milk in Mothers with Type 1 and Type 2 Diabetes Mellitus." International Journal of Endocrinology 2012 (2012): 1–9. http://dx.doi.org/10.1155/2012/296368.
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Despite the important role that insulin plays in the human body, very little is known about its presence in human milk. Levels rapidly decrease during the first few days of lactation and then, unlike other serum proteins of similar size, achieve comparable levels to those in serum. Despite this, current guides for medical treatment suggest that insulin does not pass into milk, raising the question of where the insulin in milk originates. Five mothers without diabetes, 4 mothers with type 1, and 5 mothers with type 2 diabetes collected milk samples over a 24-hour period. Samples were analysed for total and endogenous insulin content and for c-peptide content. All of the insulin present in the milk of type 1 mothers was artificial, and c-peptide levels were 100x lower than in serum. This demonstrates that insulin is transported into human milk at comparable concentration to serum, suggesting an active transport mechanism. The role of insulin in milk is yet to be determined; however, there are a number of potential implications for the infant of the presence of artificial insulins in milk.
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Kim, Christian C. K., Thomas G. Rosano, Erin E. Chambers, Manjunath P. Pai, and James Desemone. "Insulin Glargine and Insulin Aspart Overdose With Pharmacokinetic Analysis." AACE Clinical Case Reports 2, no. 2 (April 2016): e122-e128. http://dx.doi.org/10.4158/ep15689.cr.
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Couchman, Lewis, David R. Taylor, and Cajetan F. Moniz. "Analysis of insulin and insulin analogues by mass spectrometry." Annals of Clinical Biochemistry 53, no. 2 (March 2016): 302–3. http://dx.doi.org/10.1177/0004563215597011.
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Silva, Thales B. C., Paulo H. R. F. Almeida, Vania E. Araújo, Francisco de Assis Acurcio, Augusto A. Guerra Júnior, Brian Godman, and Juliana Alvares. "Effectiveness and safety of insulin glargine versus detemir analysis in patients with type 1 diabetes: systematic review and meta-analysis." Therapeutic Advances in Endocrinology and Metabolism 9, no. 8 (June 22, 2018): 241–54. http://dx.doi.org/10.1177/2042018818781414.
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Background: Diabetes mellitus type 1 (DM1) is an autoimmune disease characterized by metabolic destruction of pancreatic cells responsible for insulin production, with treatment based on replacing insulin. Long-acting insulin analogs are indicated for patients with DM1 who exhibit important oscillations of their daily glycemia, despite its higher cost. Our study objective was to evaluate the effectiveness and safety of two long-acting insulins, insulin glargine and detemir, in treating patients with DM1. Methods: We undertook a systematic review with meta-analysis of observational studies (cohort and registry) available in the databases and the gray literature, and a complementary search in the Diabetes Care journal. Outcomes assessed were: glycated hemoglobin concentration; fasting plasma or capillary glucose; occurrence of episodes of severe hypoglycemia and occurrence of nocturnal hypoglycemia. The assessment of methodological quality was performed using the Newcastle score. The meta-analyses were performed on software Review Manager® 5.2. Results: Out of 705 publications, 8 cohort studies were included. The quality of these studies was classified as high. In the meta-analysis, results regarding episodes of severe hypoglycemia ( p = 0.02) and fasting glucose ( p = 0.01) were in favor of detemir. The glycated hemoglobin ( p = 0.49; I2 = 89) showed high heterogeneity and no statistically significant difference between the two. The meta-analysis of total insulin dose favored glargine ( p = 0.006; I2 = 75). The rates of nocturnal hypoglycemia (NH) were evaluated only for one study and showed a significant reduction of NH after therapy with detemir, ( p < 0.0001). Conclusion: Although some outcomes were favorable to detemir insulin analog, it has not been possible to identify important differences of effectiveness and safety between the two analogs. These results can help in the current debate on the inclusion of long-acting analogs on the list of reimbursed medicines in Brazil, especially with the recent introduction of an insulin glargine biosimilar at a considerably lower price.
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Kinsella, Hannah M., Laura D. Hostnik, Hailey A. Snyder, Sarah E. Mazur, Ahmed M. Kamr, Teresa A. Burns, John C. Mossbarger, and Ramiro E. Toribio. "Comparison of insulin sensitivity between healthy neonatal foals and horses using minimal model analysis." PLOS ONE 17, no. 1 (January 14, 2022): e0262584. http://dx.doi.org/10.1371/journal.pone.0262584.
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The equine neonate is considered to have impaired glucose tolerance due to delayed maturation of the pancreatic endocrine system. Few studies have investigated insulin sensitivity in newborn foals using dynamic testing methods. The objective of this study was to assess insulin sensitivity by comparing the insulin-modified frequently sampled intravenous glucose tolerance test (I-FSIGTT) between neonatal foals and adult horses. This study was performed on healthy neonatal foals (n = 12), 24 to 60 hours of age, and horses (n = 8), 3 to 14 years of age using dextrose (300 mg/kg IV) and insulin (0.02 IU/kg IV). Insulin sensitivity (SI), acute insulin response to glucose (AIRg), glucose effectiveness (Sg), and disposition index (DI) were calculated using minimal model analysis. Proxy measurements were calculated using fasting insulin and glucose concentrations. Nonparametric statistical methods were used for analysis and reported as median and interquartile range (IQR). SI was significantly higher in foals (18.3 L·min-1· μIU-1 [13.4–28.4]) compared to horses (0.9 L·min-1· μIU-1 [0.5–1.1]); (p < 0.0001). DI was higher in foals (12 × 103 [8 × 103−14 × 103]) compared to horses (4 × 102 [2 × 102−7 × 102]); (p < 0.0001). AIRg and Sg were not different between foals and horses. The modified insulin to glucose ratio (MIRG) was lower in foals (1.72 μIUinsulin2/10·L·mgglucose [1.43–2.68]) compared to horses (3.91 μIU insulin2/10·L·mgglucose [2.57–7.89]); (p = 0.009). The homeostasis model assessment of beta cell function (HOMA-BC%) was higher in horses (78.4% [43–116]) compared to foals (23.2% [17.8–42.2]); (p = 0.0096). Our results suggest that healthy neonatal foals are insulin sensitive in the first days of life, which contradicts current literature regarding the equine neonate. Newborn foals may be more insulin sensitive immediately after birth as an evolutionary adaptation to conserve energy during the transition to extrauterine life.
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Koechlin, Alice, Mathieu Boniol, Chris Robertson, Geremia Bolli, Julio Rosenstock, and Peter Boyle. "Meta-analysis of cancer risk among users of insulin glargine." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 1510. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.1510.
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1510 Background: The association between diabetes, its risk factors and treatments, and cancer risk and death is now high on the clinical and research agenda. Methods: All data regarding cancer risk and use of insulin glargine has been assembled and meta-analyses performed using state-of-the-art statistical methodology. Glargine is the most studied insulin in this regard. A random effects model was employed with tests for heterogeneity (I2) and publication bias. These meta-analyses are based on reports from epidemiological studies involving a total of 907,008 diabetic subjects and 2,597,602 person-years of observation. Results: Based on independent estimates from 14 studies, the Summary Relative Risk (SRR) for all forms of cancer was (SRR=0.90, 95% CI (0.82, 0.98)) and for breast cancer SRR=1.14 (95% CI (1.00, 1.29)). For new users of glargine, from 7 studies, the SRR for breast cancer was SRR=1.20 (95% CI (0.90, 1.58)). Based on independent estimates for 9 studies, for colorectal cancer the SRR was 0.73 (95% CI (0.59, 0.91)) and for prostate cancer SRR=1.16 (95% CI (1.03, 1.30)). Overall, the risk of developing cancer among users of insulin glargine is reduced compared to the risk of users of other insulins. Similarly, the risk of colorectal cancer is reduced among users of glargine. While above unity, the risks of breast cancer and prostate cancer are increased marginally. Potential limitations to this meta-analysis include that the comparison group was not the same in all studies but this could also be seen as a strength. This is not likely to invalidate the findings of this analysis nor would the fact that different adjustments were made in the individual studies. Conclusions: The current evidence gives no support to the hypothesis that insulin glargine is associated with an increased risk of cancer as compared to other insulins and should give reassurance to physicians and their patients. Given the short exposure time possible to glargine (less than 5 years maximum), it is not biologically plausible to have a causal link to common forms of cancer.
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Bajaj, M., T. L. Blundell, R. Horuk, J. E. Pitts, S. P. Wood, L. K. Gowan, C. Schwabe, A. Wollmer, J. Gliemann, and S. Gammeltoft. "Coypu insulin. Primary structure, conformation and biological properties of a hystricomorph rodent insulin." Biochemical Journal 238, no. 2 (September 1, 1986): 345–51. http://dx.doi.org/10.1042/bj2380345.
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Insulin from a hystricomorph rodent, coypu (Myocaster coypus), was isolated and purified to near homogeneity. Like the other insulins that have been characterized in this Suborder of Rodentia, coypu insulin also exhibits a very low (3%) biological potency, relative to pig insulin, on lipogenesis in isolated rat fat-cells. The receptor-binding affinity is significantly higher (5-8%) in rat fat-cells, in rat liver plasma membranes and in pig liver cells, indicating that the efficacy of coypu insulin on receptors is about 2-fold lower than that of pig insulin. The primary structures of the oxidized A- and B-chains were determined, and our sequence analysis confirms a previous report [Smith (1972) Diabetes 21, Suppl. 2, 457-460] that the C-terminus of the A-chain is extended by a single residue (i.e. aspartate-A22), in contrast with most other insulin sequences, which terminate at residue A21. In spite of a large number of amino acid substitutions (relative to mammalian insulins), computer-graphics model-building studies suggest a similar spatial arrangement for coypu insulin to that for pig insulin. The substitution of the zinc-co-ordinating site (B10-His----Gln) along with various substitutions on the intermolecular surfaces involved in the formation of higher aggregates are consistent with the observation that this insulin is predominantly ‘monomeric’ in nature. The c.d. spectrum of coypu insulin is relatively similar to those of casiragua insulin and of bovine insulin at low concentration.
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Mao, Xuhua, Hucheng Chen, Junmin Tang, Liangliang Wang, and Tingting Shu. "Hepcidin links gluco-toxicity to pancreatic beta cell dysfunction by inhibiting Pdx-1 expression." Endocrine Connections 6, no. 3 (April 2017): 121–28. http://dx.doi.org/10.1530/ec-16-0115.
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Objective Gluco-toxicity is a term used to convey the detrimental effect of hyperglycemia on β-cell function through impaired insulin synthesis. Although it is known that the expression and activity of several key insulin transcription regulators is inhibited, other molecular mechanisms that mediate gluco-toxicity are poorly defined. Our objective was to explore the role of hepcidin in β-cell gluco-toxicity. Design We first confirmed that high glucose levels inhibited hepcidin expression in the mouse insulinoma cell line, MIN6. The downregulation of hepcidin decreased Pdx-1 expression, which reduced insulin synthesis. Methods MIN6 cells were exposed to high glucose concentrations (33.3 mmol/L). Glucose-stimulated insulin secretion (GSIS) and serum hepcidin levels were measured by ELISA. The mRNA levels of insulin1, insulin2, Pdx-1 and hepcidin were measured by real-time polymerase chain reaction. Western blot analysis was used to detect the changes in PDX-1 expression. Transient overexpression with hepcidin was used to reverse the downregulation of Pdx-1 and insulin synthesis induced by gluco-toxicity. Results Exposure of MIN6 cells to high glucose significantly decreased GSIS and inhibited insulin synthesis as well as Pdx-1 transcriptional activity and expression at both the mRNA and protein levels. High glucose also decreased hepcidin expression and secretion. Hepcidin overexpression in MIN6 cells partially reversed the gluco-toxicity-induced downregulation of Pdx-1 and insulin expression and improved GSIS. The restoration of insulin synthesis by transfection of a hepcidin overexpression plasmid confirmed the role of hepcidin in mediating the gluco-toxic inhibition of insulin synthesis. Conclusions Our observations suggest that hepcidin is associated with gluco-toxicity-reduced pancreatic β-cell insulin synthesis in type 2 diabetes by inhibiting Pdx-1 expression.
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Savoy, L. A., R. M. L. Jones, S. Pochon, J. G. Davies, A. V. Muir, R. E. Offord, and K. Rose. "Identification by fast atom bombardment mass spectrometry of insulin fragments produced by insulin proteinase." Biochemical Journal 249, no. 1 (January 1, 1988): 215–22. http://dx.doi.org/10.1042/bj2490215.
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We describe the isolation by reversed-phase h.p.l.c. of a number of products of the degradation of insulin by insulin proteinase and their direct analysis by fast atom bombardment mass spectrometry (f.a.b.-m.s.). Various semisynthetically labelled insulins were used, including [[2H2]GlyA1]insulin and [18O]LysB29]insulin. The results obtained confirm and extend the results obtained by non-mass-spectrometric methods [Davies, Muir, Rose & Offord (1988) Biochem. J. 249, 209-214, and papers cited therein]. Cleavage sites were identified between positions A13-A14, A14-A15, B9-B10, B13-B14, B24-B25 and B25-B26. The advantages and disadvantages of the application of f.a.b.-m.s. to such studies are discussed.
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Власенко, І. О., and І. В. Ніженковська. "Biosimilar insulins in international and domestic practice of pharmacist." Farmatsevtychnyi zhurnal, no. 1 (February 23, 2022): 50–62. http://dx.doi.org/10.32352/0367-3057.1.22.05.
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In Ukraine, people with diabetes receive insulin, including insulin biosimilars in pharmacies, so pharmacists should increase their knowledge about biosimilar because they become more available in the coming years.
The aim of the work was to summarize current information on insulin biosimilars.
Research materials ‒ regulatory database information and scientific publications on biosimilars. Content analysis, bibliosemantic, analytical, generalizing analyzes were used.
The terminology related to reproducible biological drugs (biosimilars) is difference and it depend on the regulatory agency or the country that controls the approve of drugs. Insulin was the first biopharmaceutical drug which was developed. For approving biosimilars, it is necessary to establish similarity with the reference drug in terms of safety, purity and efficacy. Regulatory of biosimilars and requirements for demonstration the biosimilarity are specified in regulatory of the EMA and WHO. The regulatory of the approving of biosimilar in Ukraine is harmonized with European regulatory. The rules on interchangeability are not determined by all regulatory agency. The International Diabetes Federation emphasizes the role of the pharmacist, stating that they should be well informed about the forms of insulin, includes biosimilars. In Ukraine, pharmacists must dispense insulin, including biosimilars, exactly in accordance to the prescription in which the trade name of insulin (or biosimilars) is indicated. Insulin biosimilars can be an alternative to original insulins that have lost patent protection by increasing the availability of drugs, which can lead to increased market competition and access insulin for patients.
Based on the analysis of current information on biosimilars, generalizations about their terminology, aspects of manufecture, regulatory, interchangeability, prospects in the treatment of diabetes and their replacement of referens insulins are presented. The potential impact of biosimilar insulins to patients and the health care system was determinated. The importance of awareness of these drugs by pharmacists as part of the diabetic team are highlighted.
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Arrais, Elkletícia Carvalho, and Bruna Fernanda da Silva Oliveira. "Acondicionamento da insulina no domicílio por diabéticos." Revista Recien - Revista Científica de Enfermagem, no. 16 (April 25, 2016): 21. http://dx.doi.org/10.24276/2358-3088.2016.6.16.21-31.
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Este estudo objetivou descrever como os diabéticos acondicionam a insulina em seu domicílio e identificar o responsável pela orientação sobre o acondicionamento da insulina. Trata-se de um estudo exploratório-descritivo, que percorreu a trajetória metodológica qualitativa. A análise dos dados foi realizada por meio da técnica de análise de conteúdo temática. Os sujeitos da pesquisa foram 14 pacientes diabéticos assistidos pela Estratégia Saúde da Família. Os dados foram coletados através de um roteiro de entrevista semiestruturada e para sua análise utilizou-se a técnica de análise de conteúdo de Minayo. Frente aos resultados considera-se que os usuários de insulina entrevistados têm um conhecimento superficial do local adequado para o acondicionamento da insulina e como transportá-lo e tem a segurança que o enfermeiro é responsável pelas orientações do acondicionamento da insulina e nos remete a uma reflexão sobre a qualidade das informações prestadas em visto que muitos têm um baixo nível de escolaridade.Descritores: Enfermagem; Diabetes Mellitus, Insulina. Insulin of packaging at home diabeticAbstract: This study aimed to describe the pack diabetic insulin in your home and identify the person responsible for guidance on the packaging of insulin. This is an exploratory-descriptive study, which covered the qualitative methodological approach. Data analysis was performed using thematic content analysis technique. The study subjects were 14 diabetic patients assisted by the Family Health Strategy. Data were collected through a semi-structured interviews and their analysis was used to Minayo content analysis technique. Based on the results it is considered that the respondents insulin users have a superficial knowledge of the appropriate place for the packaging of insulin and how to transport it and have the security that the nurse is responsible for insulin packaging guidelines and leads us to a reflection on the quality of information provided in as many have a low level of education.Descriptors: Nursing. Diabetes Mellitus. Insulin. Insulina de envasado en casa diabetesResumen: Este estudio tuvo como objetivo describir la insulina para diabéticos acondicionar en su casa e identificar a la persona responsable de la orientación en el envase de la insulina. Este es un estudio exploratorio-descriptivo, que cubría el enfoque metodológico cualitativo. Se realizó el análisis de datos utilizando la técnica de análisis de contenido temático. Los sujetos del estudio fueron 14 pacientes diabéticos con la asistencia de la Estrategia Salud de la Familia. Los datos fueron recolectados a través de una entrevista semi-estructurada y se utilizó el análisis de Minayo técnica de análisis de contenido. Con base en los resultados se considera que los usuarios encuestados insulina tienen un conocimiento superficial del lugar apropiado para el envasado de la insulina y cómo transportarlo y tener la seguridad de que la enfermera es responsable de las directrices de embalaje de insulina y nos lleva a una reflexión en la calidad de la información proporcionada en hasta tener un bajo nivel de educación.Descriptores: Enfermería; Diabetes Mellitus; La insulina.
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Arrais, Elkletícia Carvalho, and Bruna Fernanda da Silva Oliveira. "Acondicionamento da insulina no domicílio por diabéticos." Revista Recien - Revista Científica de Enfermagem 6, no. 16 (April 5, 2016): 21. http://dx.doi.org/10.24276/rrecien2358-3088.2016.6.16.21-31.
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Este estudo objetivou descrever como os diabéticos acondicionam a insulina em seu domicílio e identificar o responsável pela orientação sobre o acondicionamento da insulina. Trata-se de um estudo exploratório-descritivo, que percorreu a trajetória metodológica qualitativa. A análise dos dados foi realizada por meio da técnica de análise de conteúdo temática. Os sujeitos da pesquisa foram 14 pacientes diabéticos assistidos pela Estratégia Saúde da Família. Os dados foram coletados através de um roteiro de entrevista semiestruturada e para sua análise utilizou-se a técnica de análise de conteúdo de Minayo. Frente aos resultados considera-se que os usuários de insulina entrevistados têm um conhecimento superficial do local adequado para o acondicionamento da insulina e como transportá-lo e tem a segurança que o enfermeiro é responsável pelas orientações do acondicionamento da insulina e nos remete a uma reflexão sobre a qualidade das informações prestadas em visto que muitos têm um baixo nível de escolaridade.Descritores: Enfermagem; Diabetes Mellitus, Insulina. Insulin of packaging at home diabeticAbstract: This study aimed to describe the pack diabetic insulin in your home and identify the person responsible for guidance on the packaging of insulin. This is an exploratory-descriptive study, which covered the qualitative methodological approach. Data analysis was performed using thematic content analysis technique. The study subjects were 14 diabetic patients assisted by the Family Health Strategy. Data were collected through a semi-structured interviews and their analysis was used to Minayo content analysis technique. Based on the results it is considered that the respondents insulin users have a superficial knowledge of the appropriate place for the packaging of insulin and how to transport it and have the security that the nurse is responsible for insulin packaging guidelines and leads us to a reflection on the quality of information provided in as many have a low level of education.Descriptors: Nursing. Diabetes Mellitus. Insulin. Insulina de envasado en casa diabetesResumen: Este estudio tuvo como objetivo describir la insulina para diabéticos acondicionar en su casa e identificar a la persona responsable de la orientación en el envase de la insulina. Este es un estudio exploratorio-descriptivo, que cubría el enfoque metodológico cualitativo. Se realizó el análisis de datos utilizando la técnica de análisis de contenido temático. Los sujetos del estudio fueron 14 pacientes diabéticos con la asistencia de la Estrategia Salud de la Familia. Los datos fueron recolectados a través de una entrevista semi-estructurada y se utilizó el análisis de Minayo técnica de análisis de contenido. Con base en los resultados se considera que los usuarios encuestados insulina tienen un conocimiento superficial del lugar apropiado para el envasado de la insulina y cómo transportarlo y tener la seguridad de que la enfermera es responsable de las directrices de embalaje de insulina y nos lleva a una reflexión en la calidad de la información proporcionada en hasta tener un bajo nivel de educación.Descriptores: Enfermería; Diabetes Mellitus; La insulina.
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Ader, M., and R. N. Bergman. "Peripheral effects of insulin dominate suppression of fasting hepatic glucose production." American Journal of Physiology-Endocrinology and Metabolism 258, no. 6 (June 1, 1990): E1020—E1032. http://dx.doi.org/10.1152/ajpendo.1990.258.6.e1020.
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Insulin may suppress hepatic glucose production directly, or indirectly via suppression of release of gluconeogenic substrates from extrasplanchnic tissues. To compare these mechanisms, we performed insulin dose-response experiments in conscious dogs at euglycemia, during somatostatin infusion, and intraportal glucagon replacement. Insulin was sequentially infused either intraportally (0.05, 0.20, 0.40, 1.0, 1.4, and/or 3.0; protocol I) or systemically at half the intraportal rate (0.025, 0.10, 0.20, 0.50, 0.70, and/or 1.5 mU.min-1.kg-1; protocol II). Exogenous glucose infused during clamps was labeled with 3-[3H]glucose (2 microCi/g) to prevent a fall in plasma specific activity (P greater than 0.2) that may have contributed to previous underestimations of hepatic glucose output (HGO). Portal insulins were up to threefold higher during intraportal infusion, but peripheral insulin levels were not different between the intraportal and systemic protocols [7 +/- 5 vs. 9 +/- 1, 12 +/- 4 vs. 13 +/- 6, 16 +/- 3 vs. 27 +/- 5, 70 +/- 23 vs. 48 +/- 8, 83 +/- 3 vs. 86 +/- 21, and 128 vs. 120 +/- 14 microU/ml for paired insulin doses; P greater than 0.06 by analysis of variance (ANOVA)]. Despite higher portal insulin levels in protocol I, HGO suppression was equivalent in the two protocols when systemic insulin was matched, from 3.3 +/- 0.1 to near-total suppression at 0.3 mg.min-1.kg-1 at the highest insulin infusion rate (3.0 mU.min-1.kg-1; P less than 0.0001) with intraportal insulin, from 2.9 +/- 0.8 to -0.8 +/- 0.2 mg.min-1.kg-1 in protocol II (P less than 0.001). Suppression of HGO was similar at matched systemic insulin, regardless of portal insulin, suggesting the primacy of insulin's action on the periphery in its restraint of hepatic glucose production.
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Bertuzzi, Alessandro, Federica Conte, Geltrude Mingrone, Federico Papa, Serenella Salinari, and Carmela Sinisgalli. "Insulin Signaling in Insulin Resistance States and Cancer: A Modeling Analysis." PLOS ONE 11, no. 5 (May 5, 2016): e0154415. http://dx.doi.org/10.1371/journal.pone.0154415.
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Youn, J. H., J. K. Kim, and G. M. Steil. "Assessment of extracellular glucose distribution and glucose transport activity in conscious rats." American Journal of Physiology-Endocrinology and Metabolism 268, no. 4 (April 1, 1995): E712—E721. http://dx.doi.org/10.1152/ajpendo.1995.268.4.e712.
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The effects of insulin on extracellular glucose distribution and cellular glucose transport activity were studied by simultaneously analyzing the plasma kinetics of L-[1-14C]glucose and 3-O-[3H]methylglucose after an intravenous injection during saline or insulin infusion (euglycemic glucose clamp) in conscious rats (n = 7 for each). The time profiles of plasma L-glucose were almost superimposable in the two protocols, and compartmental analysis showed that neither distribution volumes nor distribution rate constants were affected with insulin (P > 0.05 for all), suggesting that glucose distribution within the extracellular space was not influenced with insulin. In contrast, the time profile of plasma 3-O-methylglucose (3-MG) was markedly altered with insulin; the initial decrease was much faster during insulin infusion than during saline infusion, indicating stimulation of 3-MG transport into intracellular spaces with insulin. The 3-MG data were analyzed using a comprehensive model separately describing extracellular distribution and cellular transport of 3-MG by incorporating information on extracellular distribution kinetics obtained from L-glucose data. The combined L-glucose and 3-MG kinetic analysis precisely estimated insulin's effect in vivo to stimulate glucose transport into and out of intracellular spaces. We conclude that 1) insulin does not affect extracellular glucose distribution kinetics or volumes in conscious rats and 2) insulin's effects on cellular glucose transport in vivo can be assessed by simultaneous analysis of plasma L-glucose and 3-MG kinetics.
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Brunner, Yannick, Yohann Couté, Mariella Iezzi, Michelangelo Foti, Mitsonuri Fukuda, Denis F. Hochstrasser, Claes B. Wollheim, and Jean-Charles Sanchez. "Proteomics Analysis of Insulin Secretory Granules." Molecular & Cellular Proteomics 6, no. 6 (February 22, 2007): 1007–17. http://dx.doi.org/10.1074/mcp.m600443-mcp200.
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Weissberg-Benchell, J., J. Antisdel-Lomaglio, and R. Seshadri. "Insulin Pump Therapy: A meta-analysis." Diabetes Care 26, no. 4 (April 1, 2003): 1079–87. http://dx.doi.org/10.2337/diacare.26.4.1079.
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Grau, U. "Fingerprint Analysis of Insulin and Proinsulins." Diabetes 34, no. 11 (November 1, 1985): 1174–80. http://dx.doi.org/10.2337/diab.34.11.1174.
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FABRY, Marlies, and Dietrich BRANDENBURG. "Analysis of the Human Insulin Receptor." Biological Chemistry Hoppe-Seyler 373, no. 2 (January 1992): 915–24. http://dx.doi.org/10.1515/bchm3.1992.373.2.915.
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Tavaré, Jeremy M., and Kenneth Siddle. "Mutational analysis of insulin receptor function." Biochimica et Biophysica Acta (BBA) - Molecular Cell Research 1178, no. 1 (July 1993): 21–39. http://dx.doi.org/10.1016/0167-4889(93)90106-y.
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Grau, U. "Fingerprint analysis of insulin and proinsulins." Diabetes 34, no. 11 (November 1, 1985): 1174–80. http://dx.doi.org/10.2337/diabetes.34.11.1174.
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Rosenzweig, James L. "Analysis: The Use of Diluted Insulin." Diabetes Technology & Therapeutics 2, no. 1 (May 2000): 67–68. http://dx.doi.org/10.1089/152091599316766.
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Kitamura, Tadahiro, Yukari Kitamura, Jun Nakae, Antonio Giordano, Saverio Cinti, C. Ronald Kahn, Argiris Efstratiadis, and Domenico Accili. "Mosaic analysis of insulin receptor function." Journal of Clinical Investigation 113, no. 2 (January 15, 2004): 209–19. http://dx.doi.org/10.1172/jci17810.
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Kitamura, T. "Mosaic analysis of insulin receptor function." Journal of Clinical Investigation 113, no. 2 (January 15, 2004): 209–19. http://dx.doi.org/10.1172/jci200417810.
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Honeychurch, Michael J., and Michael J. Ridd. "Derivative chronopotentiometric stripping analysis of insulin." Electroanalysis 8, no. 1 (January 1996): 49–54. http://dx.doi.org/10.1002/elan.1140080111.
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Sanches, Andréia Cristina Conegero, Cassyano Januário Correr, Rafael Venson, Patrícia Rodrigues Gonçalves, Mariana Martins Garcia, Mário Sérgio Piantavini, and Roberto Pontarolo. "Insulin analogues versus human insulin in type 1 diabetes: direct and indirect meta-analyses of efficacy and safety." Brazilian Journal of Pharmaceutical Sciences 49, no. 3 (September 2013): 501–9. http://dx.doi.org/10.1590/s1984-82502013000300011.
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All patients with Diabetes Mellitus (DM) receive insulin therapy. In this study, we evaluated the efficacy, safety and tolerability of human insulin and insulin analogues. We performed a systematic review of the literature and a meta-analysis according to the Cochrane Collaboration methodology. In the absence of clinical studies comparing insulins, we performed a mixed treatment comparison to establish the differences between the active treatments. We included studies published from 1995 to 2010. HbA1c results, episodes of hypoglycemia and nocturnal hypoglycemia data were extracted and analyzed. Thirty-five randomized clinical trials were selected after examining the abstract and a full text review. These studies included 4,206 patients who received long-acting insulin analogues and 5,733 patients who received short-acting insulin analogues. Pooled data regarding efficacy indicated no significant differences in HbA1c values between glargine or detemir (once daily) and NPH insulin. However, a twice-daily dose of detemir produced differences in HbA1c values that favored detemir (-0.14% [95% CI: -0.21 to -0.08]; p<0.0001; I²=0%). Direct and indirect comparisons are consistent and show that there were no significant differences between human insulin and insulin analogues in efficacy or safety. Our results indicate that long- and short-acting insulin analogues offer few clinical advantages over conventional human insulin.
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Kolbin, A. S., A. A. Kurilev, Y. E. Balikina, and M. A. Proskurin. "The clinical-economic characteristic of current basis-bolus insulin therapy schemes in diabetes mellitus type 1 in adults." Kachestvennaya Klinicheskaya Praktika = Good Clinical Practice, no. 1 (April 28, 2022): 4–16. http://dx.doi.org/10.37489/2588-0519-2022-1-4-16.
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Basis-bolus insulin therapy is a cornerstone of Diabetes Mellitus type 1 (DM1T) control. Basal insulin analogs — glargine 300 U/ml (iGla 300), glargine 100 U/ml (iGla 100), detemir (iDet) degludec (iDeg), — as well as prandial insulins — glulisine (iGlu), aspart (iAsp) and lispro — are used widely during last 10–15 years. Aim. Evaluation of a comparative economic efficacy of the different basis-bolus schemes of insulin therapy in DM1T in adults. Materials and methods. Analysis has been performed for the following schemes: iGla 300 + iGlu, iGla 100 + iGlu, iDet+iAsp, iDeg+iAsp from Govt position based on modelling of the efficacy for 5 years. Data regarding probability of complications based on glycated hemoglobin (HbA1c) reduction for human insulin treatment and insulin analogs were taken into modelling. Direct medical costs were calculated for insulins, complications, hypoglycemic including severe events. Sensitivity analysis has been performed for validation of the received results. Results: Insulin analogs have economic advantages in compare with human insulins for DM1T control for 6.5 years. They could reduce expenditures in 1.89 times. iGla 300 + iGlu and iDeg+iGlu reduced HbA1c more effective among analogs and hypo events were more rare also (35.0 episodes/patient/year), including severe (0.57 and 0.70 episodes/patient/ year accordingly) vs iGla 100 + iGlu and iDet+iAsp (37.8 and 39.9 episodes/patient/year and 1.10 and 1.21 episodes/patient/ year for severe accordingly). Calculated direct medical costs were less for iGla 300 + iGlu, after that were following iGla 100 + iGlu, iDet+iAsp and last (highest) were expenditures for iDeg+iAsp. Conclusion. Created model prognoses complications of DM1T depending on schemes of insulin therapy and calculates of direct costs. iGla 300 + iGlu has economic advantages vs iGla100 + iGlu, iDet+iAsp and iDeg+iAsp in DM1T control during 5 years horizon.
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Moon, Shinje, Hye-Soo Chung, Yoon-Jung Kim, Jae-Myung Yu, Woo-Ju Jeong, Jiwon Park, and Chang-Myung Oh. "Efficacy and Safety of Insulin Degludec/Insulin Aspart Compared with a Conventional Premixed Insulin or Basal Insulin: A Meta-Analysis." Metabolites 11, no. 9 (September 18, 2021): 639. http://dx.doi.org/10.3390/metabo11090639.
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Insulin degludec/insulin aspart (IDegAsp) is a novel co-formulation of 70% insulin degludec and 30% insulin aspart. The present meta-analysis was conducted to assess the efficacy and safety of IDegAsp compared with a conventional premixed insulin or basal insulin. We extracted data from citation databases, including PubMed, EMBASE, and the Cochrane Library, since inception to 2021. We calculated the mean differences for hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), self-measured mean glucose, and postprandial glucose (PPG) and odds ratios for confirmed hypoglycemia events. Compared with twice-daily conventional premixed insulin, twice-daily IDegAsp showed a similar effect on changes in HbA1c, but it significantly reduced FPG and self-measured mean glucose levels. Furthermore, compared to once-daily basal insulin, once-daily IDegAsp had a similar effect on changes in HbA1c, but it significantly reduced self-measured mean glucose and PPG levels. The risk of overall confirmed hypoglycemia was similar between treatments; however, the risk of nocturnal hypoglycemia events was significantly lower with IDegAsp than with conventional premixed insulin and basal insulin. Thus, IDegAsp was more effective than conventional premixed insulin and basal insulin at reducing blood glucose with fewer nocturnal hypoglycemia events.
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Müller, MJ, CA Reynard, AG Burger, G. Toffolo, C. Cobelli, and E. Ferrannini. "Kinetic analysis of thyroid hormone action on glucose metabolism in man." European Journal of Endocrinology 132, no. 4 (April 1995): 413–18. http://dx.doi.org/10.1530/eje.0.1320413.
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Müller MJ, Reynard CA, Burger AG, Toffolo G, Cobelli C, Ferrannini E. Kinetic analysis of thyroid hormone action on glucose metabolism in man. Eur J Endocrinol 1995;132:413–18. ISSN 0804–4643 Thyroid hormone action on insulin's effect on glucose kinetics was investigated with the use of a physiological three compartment model. In six healthy volunteers before and after 14 days of thyroxine treatment (300 μg/day), a bolus of [3-H3]glucose was injected and the time course of plasma radioactivity was followed closely for 150 min. Then a hyperinsulinemic (1 mU · min−1 · kg−1) and euglycemic clamp was started, and euglycemia was maintained for another 250 min. A second bolus of the tracer was then given at 240 min, and the plasma radioactivity was followed for 160 min. Insulin stimulated basal plasma glucose clearance fourfold (p < 0.001) and completely suppressed basal hepatic glucose production (p < 0.001). Concomitantly, the total distribution volume of glucose was increased by 19% (p < 0.05); this change was accompanied by about 50% expansion of the slowly exchanging glucose pool (putatively representing the insulin-dependent compartment). Thyroxine treatment increased plasma triiodothyronine by about 20% (0.1 > p > 0.05) but did not affect basal glucose turnover, insulin-stimulated plasma glucose clearance or the insulin-induced suppression of endogenous glucose output. However, thyroxine treatment blunted the insulin-induced increases in total distribution volume and the slowly exchanging pool of glucose (p = NS vs the basal state). We conclude that minor changes in plasma triiodothyronine (such as occur during overfeeding) do not interfere with the ability of insulin to stimulate the rate of disappearance of glucose or suppress endogenous glucose release; however, our data suggest that they induce finer changes in glucose kinetics, possibly reflecting acceleration or intracellular glucose degradation. Manfred J Müller, Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Düsternbrooker Weg 17, D-24105 Kiel, Germany
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Suplotova, L. A., A. S. Sudnitsyna, and N. V. Romanova. "Analysis of the quality of life of patients with type 1 diabetes mellitus in real clinical practice who received insulin degludec." Meditsinskiy sovet = Medical Council, no. 14 (October 18, 2021): 96–103. http://dx.doi.org/10.21518/2079-701x-2021-14-96-103.
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Introduction. Long-term and high-quality glycemic control prevents the development of vascular complications of diabetes type 1 and improves the disease prognosis, significantly increasing life expectancy. A decrease in the quality of life (QOL) of patients with diabetes type 1 is associated with the disease complications development and carbohydrate metabolism status. In connection with the proven advantages of using indicators of time spent in glycemic ranges (TIR, TAR, TBR), the study of their associations with QOL in patients with type 1 diabetes when switching from long-acting analog insulins to insulin degludec is of particular interest.Aims. To assess the quality of life with diabetes type 1 when switching from long-acting analogs to insulin degludec in real world clinical practice.Materials and methods. The study was designed as a prospective, single-center, uncontrolled study. The recruitment of patients with diabetes type 1 who did not achieve the target values of control of carbohydrate metabolism control, who were on therapy with long-acting and ultrashort-acting analog insulin therapy, was carried out in accordance with the matching criteria. The calculation of TIR and TBR was carried out employing the data from professional continuous monitoring of glucose levels and selfmonitoring of blood glucose levels. The SF-36 Health Status Survey was used to assess QoL.Results. The study included 26 patients who met the inclusion criteria and did not have the exclusion criteria. The relationships between TIR, TBR and QoL parameters during insulin degludec therapy were revealed - with vitality, bodily pain, mental health, which demonstrates an increase in QoL mainly due to the mental component of health.Conclusions. Switching patients with type 1 diabetes from long-acting analog insulins to ultra-long-acting analog insulin on an outpatient basis provides an improvement in glycemic control due to HbA1c and TIR, TBR, and also increases QOL satisfaction, mainly due to the mental component of health.
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Santos, Leyna, Jamilly Santos, Luciano Barbosa, Ivan Silva, Célio de Sousa-Rodrigues, and Fabiano Barbosa. "Effectiveness of Insulin Analogs Compared with Human Insulins in Pregnant Women with Diabetes Mellitus: Systematic Review and Meta-analysis." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 41, no. 02 (February 2019): 104–15. http://dx.doi.org/10.1055/s-0038-1676510.
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AbstractDiabetes during pregnancy has been linked to unfavorable maternal-fetal outcomes. Human insulins are the first drug of choice because of the proven safety in their use. However, there are still questions about the use of insulin analogs during pregnancy. The objective of the present study was to determine the effectiveness of insulin analogs compared with human insulin in the treatment of pregnant women with diabetes through a systematic review with meta-analysis. The search comprised the period since the inception of each database until July 2017, and the following databases were used: MEDLINE, CINAHL, EMBASE, ISI Web of Science, LILACS, Scopus, SIGLE and Google Scholar. We have selected 29 original articles: 11 were randomized clinical trials and 18 were observational studies. We have explored data from 6,382 participants. All of the articles were classified as having an intermediate to high risk of bias. The variable that showed favorable results for the use of insulin analogs was gestational age, with a mean difference of - 0.26 (95 % confidence interval [CI]: 0.03–0.49; p = 0.02), but with significant heterogeneity (Higgins test [I2] = 38%; chi-squared test [χ2] = 16.24; degree of freedom [DF] = 10; p = 0.09). This result, in the clinical practice, does not compromise the fetal well-being, since all babies were born at term. There was publication bias in the gestational age and neonatal weight variables. To date, the evidence analyzed has a moderate-to-high risk of bias and does not allow the conclusion that insulin analogs are more effective when compared with human insulin to treat diabetic pregnant women.
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Degen, T., D. Beckers, S. Prugovecki, and B. Prugovecki. "XRPD lab instrument measurements and crystallographic analysis on insulin and insulin derivatives." Acta Crystallographica Section A Foundations of Crystallography 64, a1 (August 23, 2008): C633. http://dx.doi.org/10.1107/s0108767308079634.
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Varlamov, Oleg, Romel Somwar, Anda Cornea, Paul Kievit, Kevin L. Grove, and Charles T. Roberts. "Single-cell analysis of insulin-regulated fatty acid uptake in adipocytes." American Journal of Physiology-Endocrinology and Metabolism 299, no. 3 (September 2010): E486—E496. http://dx.doi.org/10.1152/ajpendo.00330.2010.
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Increased body fat correlates with the enlargement of average fat cell size and reduced adipose tissue insulin sensitivity. It is currently unclear whether adipocytes, as they accumulate more triglycerides and grow in size, gradually become less insulin sensitive or whether obesity-related factors independently cause both the enlargement of adipocyte size and reduced adipose tissue insulin sensitivity. In the first instance, large and small adipocytes in the same tissue would exhibit differences in insulin sensitivity, whereas, in the second instance, adipocyte size per se would not necessarily correlate with insulin response. To analyze the effect of adipocyte size on insulin sensitivity, we employed a new single-cell imaging assay that resolves fatty acid uptake and insulin response in single adipocytes in subcutaneous adipose tissue explants. Here, we report that subcutaneous adipocytes are heterogeneous in size and intrinsic insulin sensitivity. Whereas smaller adipocytes respond to insulin by increasing lipid uptake, adipocytes with cell diameters larger than 80–100 μm are insulin resistant. We propose that, when cell size approaches a critical boundary, adipocytes lose insulin-dependent fatty acid transport. This negative feedback mechanism may protect adipocytes from lipid overload and restrict further expansion of adipose tissue, which leads to obesity and metabolic complications.
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Marra, Lays, Augusto Guerra, Vânia Araújo, Gerusa Oliveira, Leonardo Diniz, Francisco Acurcio, Brian Godman, and Juliana Alvares. "PP114 Clinical Effectiveness Of Insulin Glargine; Findings And Implications." International Journal of Technology Assessment in Health Care 34, S1 (2018): 109. http://dx.doi.org/10.1017/s0266462318002520.
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Introduction:There is continuing controversy surrounding the funding of insulin glargine versus neutral protamine Hagedorn (NPH) insulin in Brazil, due to substantial differences in their prices, and recent meta-analyses of randomized controlled trials and independent observational studies that show no difference in effectiveness; however, sponsored observational studies show greater effectiveness of insulin glargine. Overall, the cost-effectiveness of insulin glargine in Brazil is controversial. In view of the continuing controversy, there is a need to address this using patient level data within the public health system in Brazil.Methods:We conducted a retrospective historical cohort study of type 1diabetes patients receiving insulin glargine from January 2011 to January 2015, including patients in the public health system in Minas Gerais. Variables included (i) demographic variables, (ii) clinical variables e.g. time with a diagnosis of type 1 diabetes, (iii) treatment characteristics, and (iv) laboratory results of HbA1c. Individuals were compared with themselves in an analysis of HbA1c values before and after six months of using insulin glargine, with each patient acting as their own control.Results:Five hundred and eighty patients were included in the study. HbA1c varied from 8.80±1.98 percent in NPH insulin users to 8.54±1.88 percent after insulin glargine for six months, which is not clinically significant. The frequency of glycemic control varied from 22.6 percent with NPH insulin to 26.2 percent with insulin glargine. No statistically significant difference was observed between groups for all analyzed factors, including type and frequency of insulin use and carbohydrate counting.Conclusions:There were limited differences between NPH insulins and insulin analogues in this real world study. As a result, the continued appreciable cost difference in between insulin glargine and NPH insulin in Brazil cannot be justified.
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Davidson, Paul, Harry Hebblewhite, Robert Steed, and Bruce Bode. "Analysis of Guidelines for Basal-Bolus Insulin Dosing: Basal Insulin, Correction Factor, and Carbohydrate-to-Insulin Ratio." Endocrine Practice 14, no. 9 (December 2008): 1095–101. http://dx.doi.org/10.4158/ep.14.9.1095.
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Silva, Lorena Fortuna da, Marcela Dos Santos Ferreira, Sávio Dias de Paula Mello, Ana Beatriz de Andrade Soares de Oliveira, Júlio Cesar Santos da Silva, and Úrsula Pérsia Paulo dos Santos. "Análise da conservação dos frascos de insulina em refrigeradores domésticos." Revista Recien - Revista Científica de Enfermagem 10, no. 29 (March 31, 2020): 75–82. http://dx.doi.org/10.24276/rrecien2358-3088.2020.10.29.75-82.
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O objetivo deste estudo foi analisar a conservação da insulina nos refrigeradores domésticos. Foram verificadas temperaturas dos frascos de insulina em sete locais da geladeira, sendo realizadas 10 medições por região com duração de 12 horas cada, utilizando termômetros digitais de máximas e mínimas. Os melhores locais de conservação dos frascos de insulina identificados nesta pesquisa foram a terceira prateleira da geladeira e a gaveta, além da porta ter sido revelada como pior região para esta finalidade. A partir da análise dos testes realizados, pôde-se observar que tanto o local como interferências cotidianas na geladeira podem influenciar negativamente a temperatura dos frascos de insulina. A pesquisa mostra os locais mais ou menos preferíveis para conservação da insulina ao tornar evidente a sua temperatura dentro de refrigerador, contribuindo para o planejamento das práticas de educação em saúde direcionadas aos portadores de Diabetes Mellitus.Descritores: Insulina, Armazenamento de Medicamentos, Refrigeração. Analysis of storage of insulin flasks in domestic refrigeratorsAbstract: The aim of this study was to analyze the insulin storage inside domestic refrigerators. Temperatures of insulin flasks were verified on 7 locations in the fridge, being performed 10 measurements with a duration of 12 hours in each refrigerator space using digital thermometers which were able to register maximum and minimum temperatures. The best locations for insulin storage identified in this research were the third refrigerator shelf and the vegetable drawer, besides the refrigerator door has been revealed as the worst space for this purpose. From an analysis of the test results, it was observed that the storage locations and daily interferences inside the fridge can adversely affect the temperatures of insulin flasks. This research shows the more or less preferable locations for insulin storage by becoming clear temperatures inside domestic refrigerators, contributing to the planning of practices in health education directed to patients with diabetes mellitus (DM).Descriptors: Insulin, Storage of Medicine, Refrigeration. Análisis de la conservación de los envases de insulina en refrigeradores domésticosResumen: El objetivo del estudio fue analizar la conservación de la insulina en los refrigeradores domésticos. Se verificaron temperaturas de los envases de insulina en siete locales del refrigerador, realizándose 10 mediciones por región con una duración de 12 horas cada una, utilizando termómetros digitales de máximas y mínimas. Los mejores sitios de conservación de los envases de insulina identificados en la investigación fueron el tercer estante del refrigerador y el cajón, además de que la puerta fue revelada como peor región para este propósito. En vista del análisis de los ensayos realizados, se pudo observar que tanto el sitio como las interferencias cotidianas en el refrigerador pueden influenciar negativamente la temperatura de los envases de insulina. La investigación apunta los lugares más o menos preferibles para la conservación de la insulina al poner en evidencia las temperaturas en el refrigerador, así como contribuye para la planificación de las prácticas educativas en salud direccionadas a los portadores de Diabetes Mellitus.Descripitores: Insulina, Almacenamiento de Medicamentos, Refrigeración.
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Kolbin, A. S., A. A. Kurylev, Yu Ye Balykina, M. A. Proskurin, and S. A. Mishinova. "Pharmacoeconomic analysis of insulin aspart+nicotinamide versus insulin aspart in patients with diabetes mellitus." Pharmacoeconomics: theory and practice 9, no. 4 (December 15, 2021): 5–11. http://dx.doi.org/10.30809/phe.4.2021.1.
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Glycemic control is a clinical goal in the treatment of diabetes mellitus. Currently available bolus insulin analogues do not follow the physiological pattern of insulin secretion after meals because they are slowly absorbed from the injection site. Insulin aspart+nicotinamide is an ultra-fast acting human insulin analog that can be administered before or after meals and the nicotinamide (vitamin B3) molecule provides optimal glycemic control. Aim. To evaluate clinical and economic efficacy of the drug insulin aspart+nicotinamide in comparison with insulin aspart in patients with diabetes mellitus. Materials and Methods. Clinical and economic analysis was performed in accordance with the standards and recommendations valid in the Russian Federation, the method of cost-effectiveness analysis for the first model population of patients with type 1 diabetes and the method of cost-minimization analysis for the second model population of patients with type 2 diabetes, modeling horizon was 26 weeks. Since the study is conducted from the per- spective of the health care system only direct medical costs were considered, that is, the cost of insulin therapy and the cost of complications treatment (hypoglycemia). During the budget impact analysis, the source of data on the target population was the registry of patients with diabetes mellitus of the Russian Federation. Probabilistic sensitivity analysis was performed to assess the impact of changes in the input parameters of the models. Results. Insulin aspart+nicotinamide has a clinical advantage in the effective- ness of HbA1c reduction in type 1 diabetes population. In patients with type 2 diabetes, the effectiveness of insulin aspart+nicotinamide and insulin aspart is comparable by a similar criterion. Direct medical costs of insulin aspart+nicotinamide are 10.64% lower in comparison with insulin aspart use in type 1 and type 2 diabetes patients’ population. The CER value in type 1 diabetes patient population for insulin aspart is 70% higher compared to insulin aspart+nicotinamide (7,410,353.83 and 4,348,513.94 RUR respectively). Budget impact analysis results are the following: that complete replacement of insulin aspart with insulin aspart+nicotinamide over 3 years is accompanied by a 5.3% reduction of regional drug benefit budget costs. Conclusion. The clinical and economic analysis confirms the economic feasibility of insulin aspart + nicotinamide use
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Larasanty, Luh Putu Febryana, Made Ary Sarasmita, and I. Gusti Ngurah Agung Dewantara Putra. "COST-EFFECTIVENESS ANALYSIS OF INSULIN REGIMEN ON TYPE 2 DIABETES MELLITUS OUTPATIENT IN DENPASAR MUNICIPALITY." Asian Journal of Pharmaceutical and Clinical Research 11, no. 1 (January 1, 2018): 89. http://dx.doi.org/10.22159/ajpcr.2017.v11i1.18695.
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Objective: Insulin is one of the antidiabetic agents that available for the treatment of type 2 diabetes mellitus (T2DM) patients. Insulin has several types of formulation, with its cost and effectiveness. The aim of this study was to compare the cost-effectiveness of insulin regimen in the therapy management of T2DM outpatient.Methods: Cost-effectiveness analysis has been done by calculating the average cost-effectiveness ratio (ACER) and incremental cost-effectiveness ratio (ICER) of each insulin regimens. Effectiveness was measured by improvement of fasting blood glucose, postprandial blood glucose, and HbA1c value. The total cost of insulin regimen was calculated from direct medical cost, direct nonmedical cost, and indirect nonmedical cost.Results: Overall, 42 patients meet the inclusion criteria were included this study. There were four insulin regimens compared, namely, insulin detemir,premixed insulin aspart, insulin aspart, and a combination of insulin aspart + insulin glargine. The combination of insulin aspart + insulin glargine provides pre-eminent therapy effectiveness (58.82%), whereas insulin detemir regimen has the lowest total cost (102.62 USD). Calculation of ACER showed that insulin aspart has the lowest ACER value, in an amount of 1.91 USD per percentage of effectiveness. Based on ICER value, insulin aspart was the better choice compared to the combination of insulin aspart + insulin glargine (0.18 USD vs. 0.82 USD).Conclusion: The variation of therapeutic effectiveness and total cost was observed in the management of T2DM outpatient. Based on ACER and ICER value, insulin aspart was the most cost-effective insulin compared to another insulin regimen on the study.
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Larasanty, Luh Putu Febryana, Made Ary Sarasmita, and I. Gusti Ngurah Agung Dewantara Putra. "COST-EFFECTIVENESS ANALYSIS OF INSULIN REGIMEN ON TYPE 2 DIABETES MELLITUS OUTPATIENT IN DENPASAR MUNICIPALITY." Asian Journal of Pharmaceutical and Clinical Research 11, no. 1 (January 1, 2018): 89. http://dx.doi.org/10.22159/ajpcr.2018.v11i1.18695.
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Objective: Insulin is one of the antidiabetic agents that available for the treatment of type 2 diabetes mellitus (T2DM) patients. Insulin has several types of formulation, with its cost and effectiveness. The aim of this study was to compare the cost-effectiveness of insulin regimen in the therapy management of T2DM outpatient.Methods: Cost-effectiveness analysis has been done by calculating the average cost-effectiveness ratio (ACER) and incremental cost-effectiveness ratio (ICER) of each insulin regimens. Effectiveness was measured by improvement of fasting blood glucose, postprandial blood glucose, and HbA1c value. The total cost of insulin regimen was calculated from direct medical cost, direct nonmedical cost, and indirect nonmedical cost.Results: Overall, 42 patients meet the inclusion criteria were included this study. There were four insulin regimens compared, namely, insulin detemir,premixed insulin aspart, insulin aspart, and a combination of insulin aspart + insulin glargine. The combination of insulin aspart + insulin glargine provides pre-eminent therapy effectiveness (58.82%), whereas insulin detemir regimen has the lowest total cost (102.62 USD). Calculation of ACER showed that insulin aspart has the lowest ACER value, in an amount of 1.91 USD per percentage of effectiveness. Based on ICER value, insulin aspart was the better choice compared to the combination of insulin aspart + insulin glargine (0.18 USD vs. 0.82 USD).Conclusion: The variation of therapeutic effectiveness and total cost was observed in the management of T2DM outpatient. Based on ACER and ICER value, insulin aspart was the most cost-effective insulin compared to another insulin regimen on the study.
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Hosawi, Salman B., Jonathan D. Humphries, Richard J. Coward, David Knight, Martin J. Humphries, and Rachel Lennon. "Global proteomic analysis of insulin receptor interactors in glomerular podocytes." Wellcome Open Research 5 (August 26, 2020): 202. http://dx.doi.org/10.12688/wellcomeopenres.16072.1.
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Background: Insulin signalling contributes to diverse cellular activities including protein synthesis, proliferation and cell survival. Insulin resistance describes the inability of cells to activate the insulin signalling pathway effectively; leading to pathological effects in multiple organ systems including the kidney. In diabetic kidney disease, there is progressive glomerular dysfunction and recent studies have demonstrated that the kidney podocyte is a direct target for insulin action. In this study we defined the literature-based insulin receptor (INSR) interactome and utilised an unbiased proteomic approach to examine INSR interactors in podocytes. Methods: Human podocytes expressing the INSR were characterised under basal and insulin resistant conditions. The INSR was isolated by whole cell immunoprecipitation following a time course stimulation of 2, 7, and 15 minutes with of 100nM insulin. The resulting INSR complexes were analysed by label-free mass spectrometry (MS) to detect protein interactors. Results: We identified 27 known, direct INSR interactors in addition to novel interactors including doublecortin domain-containing protein 2 (DCDC2). The interaction of DCDC2 with the INSR was confirmed by immunoprecipitation and immunofluorescence, and under insulin resistant conditions, DCDC2 had increased association with the INSR. siRNA knockdown of DCDC2 in podocytes resulted in cell morphological change and altered INSR localisation. Conclusion: This study provides insight into the complexity of INSR interactors in podocytes and highlights DCDC2 as a novel INSR binding protein. Involvement of this novel interactor in insulin signalling and podocyte biology may explain how insulin resistance alters morphology and integrity of the glomerular filtration barrier.
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Jomar, Rafael Tavares, and Lilian Dos Santos Rodrigues. "Nursing care for critical patients receiving intravenous insulin infusion: review study." Revista de Enfermagem UFPE on line 6, no. 2 (January 7, 2012): 431. http://dx.doi.org/10.5205/reuol.2052-14823-1-le.0602201224.
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ABSTRACTObjective: to identify nursing scientific papers approaching intravenous (IV) insulin infusion in critical patients, analyzing its applicability to the nurse's clinical practice. Method: this is a literature review study carried out between July and August 2010 in the following databases: Latin American and Caribbean Literature in Health Sciences (LILACS), Scientific Electronic Library Online (SciELO), Nursing Database (BDENF), and Medical Literature Analysis and Retrieval System Online (MEDLINE), using the descriptors insulina/insulin; infusões intravenosas/infusions, intravenous; and enfermagem/nursing. For this, the following guiding question was developed: "What nursing care actions should be provided to the critical patient who needs continuous IV insulin infusion for glycemic control?". The analysis of the papers was carried out through critical and detailed reading, identifying the most relevant factors affecting the nurse's clinical practice with regard to the nursing care actions in the continuous IV insulin infusion in critical patients. Results: the nurse's work in the IV insulin infusion and in the prevention of its adverse effects showed to be wide and indispensable. Conclusion: one believes that the results from this study can be useful in order to turn the nursing assistance into a safer and better quality practice, as it contains updated information and stimulates nursing care actions. Descriptors: nursing care; infusions, intravenous; insulin; intensive care units.RESUMOObjetivo: identificar artigos científicos de enfermagem que contemplem a infusão intravenosa (IV) de insulina em pacientes críticos, analisando sua aplicabilidade à prática clínica do enfermeiro. Método: trata-se de estudo de revisão de literatura, realizado entre julho e agosto de 2010, nas seguintes bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Electronic Library Online (SciELO), Base de Dados de Enfermagem (BDENF) e Medical Literature Analysis and Retrieval System Online (MEDLINE), empregando os descritores insulina/insulin; infusões intravenosas/infusions, intravenous; e enfermagem/nursing. Para isso, formulou-se a seguinte questão norteadora: “Quais cuidados de enfermagem devem ser prestados ao paciente crítico que necessita de infusão contínua de insulina IV para controle glicêmico?”. A análise dos artigos deu-se a partir da leitura crítica e detalhada, extraindo-se os fatores mais relevantes que afetam a prática clínica do enfermeiro no que se refere aos cuidados de enfermagem na infusão contínua de insulina IV em pacientes críticos. Resultados: a atuação do enfermeiro na infusão IV de insulina e na prevenção de seus efeitos adversos mostrou-se ampla e indispensável. Conclusão: acredita-se que os resultados deste estudo podem ser úteis para tornar a assistência de enfermagem uma prática mais segura e de melhor qualidade, por conter informações atualizadas e estimular cuidados de enfermagem. Descritores: cuidados de enfermagem; infusões intravenosas; insulina; unidades de terapia intensiva.RESUMENObjetivo: identificar artículos científicos de enfermería que aborden la infusión intravenosa (IV) de insulina en pacientes críticos, analizando su aplicabilidad a la práctica clínica del enfermero. Método: esto es un estudio de revisión de literatura realizado entre julio y agosto de 2010 en las siguientes bases de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Scientific Electronic Library Online (SciELO), Base de Datos de Enfermería (BDENF) y Medical Literature Analysis and Retrieval System Online (MEDLINE), empleando los descriptores insulina/insulin; infusões intravenosas/infusions, intravenous; y enfermagem/nursing. Para lo tanto, se formuló la siguiente cuestión orientadora: "¿Cuales cuidados de enfermería deben ser prestados al paciente crítico que necesita de infusión contínua de insulina IV para control glicémico?". El análisis de los artículos tuvo lugar a partir de la lectura crítica y detallada, se extrayendo los factores más relevantes que afectan la práctica clínica del enfermero en lo que se refiere a los cuidados de enfermería en la infusión contínua IV en pacientes críticos. Resultados: la actuación del enfermero en la infusión IV de insulina y en la prevención de sus efectos adversos se mostró amplia e indispensable. Conclusión: se cree que los resultados de este estudio pueden ser utiles para tornar la asistencia de enfermería una práctica más segura y de mayor calidad, por contener informaciones actualizadas y estimular cuidados de enfermería. Descriptores: atención de enfermería; infusiones intravenosas; insulina; unidades de terapia intensiva.
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Renard, Eric. "Analysis of “A New Optimized Percutaneous Access System for CIPII”." Journal of Diabetes Science and Technology 11, no. 4 (April 13, 2017): 822–24. http://dx.doi.org/10.1177/1932296817703671.
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While only used initially in cases with resistance to subcutaneous insulin therapy, intraperitoneal insulin therapy provides an overall more stable glucose control than subcutaneous insulin therapy thanks to its pharmacokinetics as pointed by Garcia-Verdugo et al from the experience of implantable insulin pumps. The expansion of these devices has been limited by underdelivery issues and high cost. The availability of a new percutaneous access to intraperitoneal route could allow a similar glucose control with less constraints of follow-up and expected lower cost. Currently reported clinical experience does not allow a reliable assessment of its main risk of infection which could impair its sustained usability. Because intraperitoneal insulin could allow a fully automated closed-loop insulin delivery, a specific interest for its means of performance is relevant.
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Waldenmaier, Delia, Katharina Schöllkopf, Antje Westhoff, Lutz Heinemann, and Guido Freckmann. "Comparative Handling Analysis of Different Insulin Pump Systems." Journal of Diabetes Science and Technology 12, no. 2 (September 14, 2017): 401–6. http://dx.doi.org/10.1177/1932296817729391.
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Insulin pumps are used by many patients with diabetes to manage their diabetes therapy. Adequate handling of the systems is important to avoid errors. In this study, one aspect of device handling—the number of steps required to operate the system—was evaluated for different insulin pump systems. Specific tasks that are usually performed by insulin pump users were simulated and all necessary actions were documented. Differences between the required numbers of steps strongly depended on the specific task. So did the level of guidance for these tasks provided by the systems. Results of this study provide an overview of this particular aspect of insulin pump handling rather than a general advice.
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Diab, Maram, Al-Sayed Sallam, Imad Hamdan, Randa Mansour, Rohanah Hussain, Giuliano Siligardi, Nidal Qinna, and Enam Khalil. "Characterization of Insulin Mucoadhesive Buccal Films: Spectroscopic Analysis and In Vivo Evaluation." Symmetry 13, no. 1 (January 6, 2021): 88. http://dx.doi.org/10.3390/sym13010088.
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Insulin mucoadhesive buccal films (MBF) are a noninvasive insulin delivery system that offers an advantageous alternative route of administration to subcutaneous injection. One major concern in the formulation of insulin MBF is the preservation of an insulin secondary structure in the presence of the other film components. Buccal films were formulated using chitosan, glycerin, and L-arginine. The MBF-forming solutions (MBF-FS) and the films (MBF) were examined for their chemical and structural stability and for their in vivo activity. Enzyme-Linked Immunosorbent Assay (ELISA) of the insulin-loaded MBF showed that each individualized unit dose was at least loaded with 80% of the insulin theoretical dose. Results of Synchrotron Radiation Circular Dichroism (SRCD) measurements revealed that MBF-FS retained the α-helices and β–sheets conformations of insulin. Fourier transform infrared (FTIR)-microspectroscopy (FTIR-MS) examination of insulin MBF revealed the protective action of L-arginine on insulin structure by interacting with chitosan and minimizing the formation of an unordered structure and β-strand. A blood glucose-lowering effect of insulin MBF was observed in comparison with subcutaneous (S.C) injection using a rat model. As a result; chitosan-based MBFs were formulated and characterized using SRCD and FTIR-MS techniques. Furthermore, the results of in vivo testing suggested the MBFs as a promising delivery system for insulin.
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Szymczak-Pajor, Izabela, and Agnieszka Śliwińska. "Analysis of Association between Vitamin D Deficiency and Insulin Resistance." Nutrients 11, no. 4 (April 6, 2019): 794. http://dx.doi.org/10.3390/nu11040794.
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Recent evidence revealed extra skeleton activity of vitamin D, including prevention from cardiometabolic diseases and cancer development as well as anti-inflammatory properties. It is worth noting that vitamin D deficiency is very common and may be associated with the pathogenesis of insulin-resistance-related diseases, including obesity and diabetes. This review aims to provide molecular mechanisms showing how vitamin D deficiency may be involved in the insulin resistance formation. The PUBMED database and published reference lists were searched to find studies published between 1980 and 2019. It was identified that molecular action of vitamin D is involved in maintaining the normal resting levels of ROS and Ca2+, not only in pancreatic β-cells, but also in insulin responsive tissues. Both genomic and non-genomic action of vitamin D is directed towards insulin signaling. Thereby, vitamin D reduces the extent of pathologies associated with insulin resistance such as oxidative stress and inflammation. More recently, it was also shown that vitamin D prevents epigenetic alterations associated with insulin resistance and diabetes. In conclusion, vitamin D deficiency is one of the factors accelerating insulin resistance formation. The results of basic and clinical research support beneficial action of vitamin D in the reduction of insulin resistance and related pathologies.
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Kikimbayeva, A. A., A. P. Andreyeva, A. B. Aubakirov, A. N. Bazhanov, and A. S. Lebedev. "Histofluorometric assessment of insulin content in the endocrine tissue of the rat pancreas in the postreanimation period." Problems of Endocrinology 42, no. 3 (June 15, 1996): 35–37. http://dx.doi.org/10.14341/probl12044.
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Histofluorometric measurement of insulin was carried out in В cells of the rat pancreas after pseudoisocyanine staining of slices in various terms of the postreanimation period following 10-min clinical death after V.G. Korpachev. The studies showed that the reanimation factor enhanced insulin release into the blood and changed the morphology of islet endocrine tissue of the gland. Hypoxia promoted transformation of mixed acinar insular, acinar glandular, and ductal epithelial cells into insulin-producing cells in experimental animals. Histofluorometric analysis of assessing insulin content in histological preparations gives reliable data on the production of this hormone in the glandular B-cells.
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Scapin, Giovanna, Venkata P. Dandey, Zhening Zhang, Winifred Prosise, Alan Hruza, Theresa Kelly, Todd Mayhood, Corey Strickland, Clinton S. Potter, and Bridget Carragher. "Structure of the insulin receptor–insulin complex by single-particle cryo-EM analysis." Nature 556, no. 7699 (February 28, 2018): 122–25. http://dx.doi.org/10.1038/nature26153.
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Ali, S. T., R. N. Shaikh, N. A. Siddiqi, and P. Q. R. Siddiqi. "Semen Analysis in Insulin-Dependent/Non-Insulin-Dependent Diabetic Men with/without Neuropathy." Archives of Andrology 30, no. 1 (January 1993): 47–54. http://dx.doi.org/10.3109/01485019308988368.
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Lester, M., and A. L. O'Kell. "Exploratory analysis of anti‐insulin antibodies in diabetic dogs receiving recombinant human insulin." Journal of Small Animal Practice 61, no. 4 (February 3, 2020): 236–40. http://dx.doi.org/10.1111/jsap.13102.
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