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7 .6 Insulin therapy J. Schulze, Η. Rietzsch 7.6.1 Introduction The problem of the therapy of N I D D M lies in its heterogeneity and in the stage by stage course of the disease, which by definition is "insulin independent". The degree of insulin resistance and its compensation by endogenous hyper-, normo- or hypoinsulin secretion are responsible for its sequential pattern of pathogenesis and the clinical picture of genetically programmed type II diabetes mellitus [2]. A further particularity is represented by environmental factors which favor

suppress several proinflammatory transcription factors and decrease the expression of endotoxin-mediated inflammatory mediators [ 15 ]. Insulin therapy Human insulin and insulin analogs can be used to manage hyperglycemia. Structurally, synthetic human insulin is identical to its natural endogenous counterpart. Insulin analogs have been developed by modifying the amino acid sequence of the insulin molecule. Differences between human insulin and insulin analogs are inconsequential for the management of type 1 and type 2 diabetes as well as diabetic ketoacidosis (DKA) [ 16

patients [ 4 ]. DMT2 patients with poor condition increasingly use insulin therapy [ 6 ]. The increasing number of DMT2 patients who use insulin, allows new problems arising about using them independently and appropriately. In fact, using insulin is indeed a new experience for DMT2 patients as they often use oral antidiabetics for medication. Inappropriate self-administration of insulin may cause therapeutic target in DMT2 not being achieved [ 7 ]. Self-administration of insulin injection in principle is a complex mechanism as it involves a number of internal and

DOI 10.1515/jpem-2012-0179       J Pediatr Endocr Met 2012; 25(11-12): 1201–1204 Patient report Naseer Ahmad Choh * Hepatic subcapsular steatosis: a rare complication of high dose insulin therapy Abstract: Hepatic subcapsular steatosis is a rare pattern of fatty infiltration of the liver exclusively described in diabetic patients undergoing peritoneal dialysis who had received insulin in peritoneal dialysate. We describe a first case of severe subcapsular hepatic steatosis in a young diabetic patient on high dose insulin therapy (with strik- ing

who were hospitalized at Universitas Airlangga Hospital on March to May 2017. The inclusion criteria were DM patients with or without any complication or comorbidity receiving intravenous (IV) insulin therapy, who had the data of BG levels before and after IV insulin therapy. The hyperglycemic crisis was confirmed by the physician through BG level and other manifestations, for example, air hunger, nausea, vomiting, abdominal pain and Kussmaul respiration. The BG data were collected from the patient’s medical record. The methodology of this study was approved by the

Hopp et al, Indications and results of insulin therapy for gestational diabetes mellitus 521 j. Perinat. Med. Indication and results of insulin therapy for gestational diabetes 24(1996)521-530 mellitlls Hartmut Hopp1, Walter Vollert1, Volker Ragosch1, Astrid Novak1, Hans K. Weitzel1, Eberhard Glöckner2, and Wolfgang Besch2 Department of Obstetrics and Gynecology "Klinikum Benjamin Franklin", The "Free University of Berlin", 2Central Institute of Research for Diabetes, Karlsburg, Fed. Rep. of Germany 1 Introduction Gestational diabetes mellitus is the most common

© Freund Publishing House Ltd., London Journal of Pediatric Endocrinology & Metabolism, 11, 159-166 (1998) Hypoglycaemia During Intensified Insulin Therapy of Children and Adolescents Johnny Ludvigsson and Sam Nordfeldt Division of Pediatrics, Department of Health and Environment, Linköping University, Sweden ABSTRACT Good metabolic control prevents or at least postpones late vascular complications, but several studies indicate that such good metabolic control cannot be reached without simultaneous increase in the incidence of severe hypoglyc- aemia. We

© Freund Publishing House Ltd., London Journal of Pediatric Endocrinology & Metabolism, 11, 153-158 (1998) Hypoglycemia During Intensified Insulin Therapy of Young Children Carine E. de Beaufort Clinique Pediatrique, Rue Ernest Barbie, L-1210 Luxembourg INTRODUCTION The duration of diabetes mellitus and metabolic control are the two key factors influencing the long term outcome of IDDM /1-4/. Near normal blood glucose levels reduce the risk of microvascular complications in a continuous non-linear relation- ship /4,5/. Thus, achievement of optimal

control (12). The issue of IGF-1 and diabetes in adults and type 2 diabetes has been well investigated, and it has been shown that low IGF-1 levels are associated with an increased risk for diabetes (13, 14). A few studies have investigated the serum IGF-1 level at the onset of T1DM in children (15, 16). Bereket et al. (17) first suggested that IGF-1 level increases after insulin therapy. On the basis of our database search, no study has been carried out to date comparing the IGF-1 level in DKA and non-DKA children. In the present study, we investigated the IGF-1 level

J Pediatr Endocr Met 2011;24(7-8):449–454 © 2011 by Walter de Gruyter • Berlin • Boston. DOI 10.1515/JPEM.2011.050 Low-dose insulin therapy in patients with cystic fi brosis and early-stage insulinopenia prevents deterioration of lung function: a 3-year prospective study Stanislava Kolou š kov á , Daniela Zemkov á , Jana Barto š ov á , Veronika Skalick á , Zden ě k Š umn í k, V ěra V á vrov á and Jan Lebl * Department of Pediatrics , Second Faculty of Medicine, Charles University in Prague and University Hospital Prague-Motol, V Uvalu