inhaled insulin therapy rai rai rai g

... International Diabetes Center Overcoming Insulin Resistance Insulin Glucose G G G G GG G G G G G G Nucleus G Insulin Receptor Glucose Transporter (GLUT4) Insulin Sensitive Cell (Muscle or Fat) ... and Glargine (G) Insulin Stage Glargine (G) Insulin Stage S–0–0 G S–0–0 G Serum insulin (mU/L) Sulfonylurea stimulated insulin secretion 50 Glargine (0.1 U/kg) Glimepiride ( mg) 40 30 20 Glargine ... (G) Insulin Stage Glargine (G) Insulin Stage M–0–M G M–0–M G Serum insulin (mU/L) Endogenous Insulin Metformin (1000 mg) 50 Metformin Glargine (1000 mg) (0.1 U/kg) 40 30 20 Glargine 10 Metformin:...

Ngày tải lên: 12/08/2014, 20:58

... maintaining blood pressure, blood glucose and energy levels during times of physiological stress, such as illness, surgery or injury) It can result from any etiology (i.e., genetic, iatrogenic, ... Weakness/fatigue, malaise, nausea, vomiting, diarrhea, abdominal pain, headache (usually in the morning), poor weight gain, myalgia, arthralgia, psychiatric symptom, poor growth, hypotension*, hypoglycemia* ... insufficiency ► Weakness/fatigue ► Malaise ► Nausea ► Vomiting ► Diarrhea ► Abdominal pain ► Headache (usually in the morning) ► Poor weight gain ► Poor linear growth ► Myalgia ► Arthralgia ► Psychiatric...

Ngày tải lên: 08/08/2014, 21:20

... several perceptions of insulin therapy (difficulty taking insulin at the right time, and effect of insulin on overall glucose control, on high glucose levels, and on low glucose levels); treatment ... (strongly disagree = 0, disagree = 20, mildly disagree = 40, mildly agree = 60, agree = 80, strongly agree = 100) Where necessary, items were reverse scored so that all were in the direction of greater ... any insulin therapy and potentially discriminate inhaled and injected insulin therapy, and perceptions of the device used to deliver inhaled insulin that could apply only to an inhaled insulin delivery...

Ngày tải lên: 12/08/2014, 01:21

... previous findings, insulin- naïve patients Page of had a significantly more negative appraisal of insulin therapy than patients who already were being treated with insulin The insulin- treated ... remained on an oral regimen, the negative appraisal of insulin therapy increased, whereas in patients who were switched to insulin therapy the negative appraisal of insulin therapy was reduced ... remained on insulin therapy The same pattern of change was present regarding the subscale of negative appraisal of insulin treatment In the subscale of positive appraisal of insulin therapy the...

Ngày tải lên: 12/08/2014, 01:21

... available long-acting analog is insulin glargine Insulin Glargine Insulin glargine is an extended-action insulin analog and was created by the recombinant DNA modification of human insulin Alterations ... of action (NPH insulin and lente insulin [Lente; Eli Lilly and Company]), and long-acting insulins (ultralente insulin and insulin glargine) Short-Acting Insulins Short-acting insulins are used ... titration algorithm There were no significant between-group differences in FPG (insulin glargine, 117 mg/dL; NPH insulin, 120 mg/ dL) and HbA1C (insulin glargine, 6.96%; NPH insulin, 6.97%) However, the...

Ngày tải lên: 12/08/2014, 20:59

... changing over to insulin from OHA and to regular insulin from intermediate acting insulin Surgery should be scheduled in the morning Omit BBF insulin Do fasting blood sugar and put patient on GIK ... ketoacidosis) insulin dose and after recovery discharge on previous or twice a day regimen Glucose -Insulin- Potassium (GIK) Regimen Blood/Plasma Glucose mg.% Fluid 100 ml/hr Insulin U/100ml Insulin ... Carry 25-50 gm glucose while travelling even from home to place of work Relatives and friends be taught to give Inj glucagon Insist on self injecting of insulin Allergy (Localised/Generalised)...

Ngày tải lên: 12/08/2014, 20:59

... nitrogen intake was 0.19±0.08 g per kilogram per 24 hours in both groups Blood Glucose Control In the intensive-treatment group, almost all the patients required exogenous insulin, and the morning ... EG Expression of apoptosis-regulatory genes in renal proximal tubular epithelial cells exposed to high ambient glucose and in diabetic kidneys J Investig Med 1997;45:50-6 20 Said G, Goulon-Goeau ... corresponding need for prolonged antibiotic therapy The higher risk in the conventional-treatment group may reflect the deleterious effects of hyperglycemia on macrophage or neutrophil function33-36 or insulin- induced...

Ngày tải lên: 12/08/2014, 20:59

... Furnary AP, Gao G, Grunkemeier GL, et al Continuous insulin infusion reduces mortality in patients with diabetes undergoing coronary artery bypass grafting J Thorac Cardiovasc Surg 2003;125:1007-21 ... patients with brain injury who received intensive insulin therapy during intensive care.24 Mortality in a subgroup with a diagnosis of diabetes appeared to be unaffected by intensive insulin therapy, ... ICU of medicine Thus, targeting blood glucose levels to below 110 mg per deciliter with insulin therapy prevented morbidity but did not significantly reduce mortality among all patients in our medical...

Ngày tải lên: 12/08/2014, 20:59

... 20.18 ± 3.28 kg/m ) The initial, first month and 12th month mean blood glucose, HbA1c, insulin dosage and anti -insulin antibody levels are given in Table Although the insulin dosage (U/kg) (p>0.05) ... control group First month (mean±SD) Initial (mean±SD) Triglyceride (mg/dl) VLDL triglyceride (mg/dl) T cholesterol (mg/dl) HDL-c (mmol/L) LDL-c (mmol/L) VLDL-c(mg/dl) ApoA1 (mg/dl) ApoB (mg/dl) ... a conventional insulin regimen, after treatment was changed to an intensive insulin regimen Although we did not achieve optimal metabolic control, total triglyceride, VLDL triglyceride, cholesterol,...

Ngày tải lên: 12/08/2014, 20:59

... A: Intensive insulin in intensive care N Engl J Med 2006, 354:516-520 Clinicaltrials.gov [http://www.clinicaltrials.gov] Devos P, Chioléro R, Van den Berghe G, Preiser JC: Glucose, insulin and ... 110 mg/dl) and 10 to 11 mmol/l (180 to 200 mg/dl), implying that there was no assessment of an intermediary blood glucose value, which is often used [13] Greet Van den Berghe and colleagues already ... mortality among these patients was higher than in the entire set Clearly, the safety of IIT needs to be assessed in patients with significant risk of hypoglycaemia [12] The target ranges of glycaemia...

Ngày tải lên: 12/08/2014, 23:23

... body mass index ranges Box and whisker plot of percentage time in predefined glycaemic ranges TGC, tight glycaemic control between correct timing of blood glucose assays and TGC, based on the univariate ... 29.1) Underweight (BMI 30 kg/m2; n [%]) (12%) Patients taking drugs influencing glycaemia (n ... the percentage of time spent within the target TGC range (Table 6) In this study, the percentage time spent in the target range (blood glucose 4.4 to 6.1 mmol/l) was taken to describe TGC, and the...

Ngày tải lên: 13/08/2014, 03:21

... Enteral Nutr 2003, 27:355-373 Kreymann KG, Berger MM, Deutz NE, Hiesmayr M, Jolliet P, Kazandjiev G, Nitenberg G, van den Berghe G, Wernerman J; DGEM (German Society for Nutritional Medicine), ... patients following general surgery, trauma, burns, spinal injuries, cardiothoracic surgery and neurosurgery; is IIT indicated in any or all of these patient groups? Given the bewildering proliferation ... or against the use of IIT [33] Even if we conclude that current evidence is not strong enough to advocate targeting normoglycaemia, the concept of IIT remains intuitively appealing and doing nothing...

Ngày tải lên: 13/08/2014, 08:21

... treatment? • Insulin analogues • Physiological insulin replacement • Aggressive “intensive” management – – – – injections per day Insulin infusion pumps Continuous glucose monitoring systems Integrated ... management • Assist you in initiating insulin in your office – When to start insulin therapy? – Insulins, doses, delivery options – Patient training www.diabetesclinic.c Challenges in Initiating ... (target: over 5.5 mmol/L) • Perform two SMBG 30 minutes apart prior to bedtime (confirming rising or falling BG) • When drinking alcohol, perform SMBG hourly • With exercise, perform SMBG pre-...

Ngày tải lên: 13/08/2014, 09:38

... Regarding Self-Monitoring of Blood Glucose Diabetes Technology and Therapeutics 2008, 10(supplement 1) Garg SK: Glucose Monitoring: An Important Tool for Improving Glucose Control and Reducing ... of evidence by suggesting that CGM may also provide a cost-effective means of lowering A1c in a general population As long as the evidence continues to suggest that use of CGM helps to lower ... While SMBG with intensive insulin therapy has been shown to be important for managing glucose levels [2,7-9], recent evidence has shown that continuous glucose monitoring (CGM) with intensive insulin...

Ngày tải lên: 13/08/2014, 11:22

... change Crit Care 2008, 12:R49 Wong XW, Singh-Levett I, Hollingsworth LJ, Shaw GM, Hann CE, Lotz T, Lin J, Wong OS, Chase JG: A novel, model-based insulin and nutrition delivery controller for glycemic ... den Berghe G: Glycemic penalty index for adequately assessing and comparing different blood glucose control algorithms Crit Care 2008, 12:R24 Egi M, Bellomo R, Stachowski E, French CJ, Hart G: Variability ... Pro/con debate: is intensive insulin therapy targeting tight blood glucose control of benefit in critically ill patients? Crit Care 2008, 12:212 Bellomo R, Egi M: Glycemic control in the intensive...

Ngày tải lên: 13/08/2014, 11:22

... generation/ deficient scavenging of reactive oxygen species In addition, insulin itself may have some benefits by affecting the balance between anabolic and catabolic hormones Page of 12 (page ... evaluated, to be sig- Figure CONSORT diagram of the study IIT = intensive insulin therapy; MICU = medical intensive care unit; SICU = surgical intensive care unit study Page of 12 (page number not ... than in the 'after' sample Glycaemia control and general outcome We noticed a significant reduction of mean morning blood glucose from 144 ± 20 mg/dl before to 107 ± 10 mg/dl after IIT had become...

Ngày tải lên: 13/08/2014, 11:23

... might logically have one of two meanings: ‘decreasing mean blood glucose concentrations’ or ‘decreasing variability in glycemia’ Decreasing the variability of blood glucose concentration might ... fluctuations from hyperglycemia to normoglycemia when compared with sustained hyperglycemia Monnier and colleagues [27] have shown that glycemic variability might trigger adverse biological events and ... Critical Care Vol 13 No Egi et al NICE-SUGAR trial The NICE-SUGAR (Normoglycemia in Intensive Care Evaluation-Survival Using Glucose Algorithm Regulation) trial is a large (n = 6,100) multicenter...

Ngày tải lên: 13/08/2014, 16:20

... 2009, 119:439-446 Wang LC, Lei S, Wu YC, Wu JN, Wang LF, Guan TR, Jiang HF, Ni HX, Ye XH: Intensive insulin therapy in critically ill patients [in Chinese] Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 2006, ... glucose range in the intervention group (4.4 to 6.1 mM) but achieved slightly higher mean values (6.2 to 6.6 mM) Although there was a nonsignificant trend to benefit of IIT in the surgical subgroup ... DE, Cartlidge NEF, Bamford JM, James OF, Alberti KGMM; GIST Trialists Collaboration: Glucose– potassium -insulin infusions in the management of post-stroke hyperglycaemia: the UK Glucose Insulin...

Ngày tải lên: 13/08/2014, 21:21