Insulin: Therapy and Types – Treatment of Diabetes Mellitus

by Carlo Raj, MD

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    Now that we have the pathogenesis and the complications of diabetes mellitus behind us, we’ll take a look at an important topic of management of diabetes mellitus. Ultimate objective… glycemic control, if you were able to properly monitor it, it would decrease the complications, big time, of… especially of your blood vessels. Once again, we talked about microvascular complications of type I and type II diabetes mellitus. You’re referring to your issues of diabetic retinopathy, diabetic nephropathy, diabetic neuropathy. If it’s macrovascular diseases, that-that is referring to your atherosclerosis and you’re referring to coronary arterial disease, referring to your renal arterial stenosis, referring to cerebrovascular accidents, peripheral vascular disease… things that we have talked about with complications. The Diabetic Association offers the following recommendations. Prior to eating preprandial, you want your glucose level to be between 80 to 120… 80 to 120 milligrams per decilitre. At bedtime before going to sleep, you would want your glucose levels to be between 100 and 140. After eating, obviously your glucose levels would rise. However, you still want it to be less than 180 because a big time pathologic effect of your diabetes mellitus is after you eat and you have the spikes and that’s the problem, isn’t it? The spikes over a long period of time, say years and years and years… the spikes are what really, truly causes the ultimate damage to let’s say the blood vessels in vascular diseases. For you to be able to control the spikes, you should be able to control your complications. You would like the HbA1C to be less than seven percent and what this means, once again, is that you have your glucose that is then being bound to haemoglobin and over let’s say the lifespan of an RBC will give you an average....

    About the Lecture

    The lecture Insulin: Therapy and Types – Treatment of Diabetes Mellitus by Carlo Raj, MD is from the course Pancreatic Disease & Diabetes.

    Included Quiz Questions

    1. 80-120 mg/dL
    2. 60-80 mg/dL
    3. 100-140 mg/dL
    4. <180 mg/dL
    5. 140-180 mg/dL
    1. <7%
    2. <6%
    3. <8%
    4. <9%
    5. <10%
    1. 0.5 units/kg/day
    2. 1 unit/kg/day
    3. 1.5 units/kg/day
    4. 2 units/kg/day
    5. 3 units/kg/day
    1. Insulin aspart
    2. NPH
    3. Intermediate insulin
    4. Insulin glargine
    5. Insulin detemir
    1. TDD is identical for Type I and Type II DM patients
    2. Long acting insulin preparations are intended to maintain blood glucose throughout the day
    3. Meals require addition of short acting or regular insulin in order to control blood glucose
    4. Half of administered insulin maintains basal blood glucose levels, the other half addresses blood glucose spikes associated with meals
    5. Insulin is the only approved therapy for diabetes during pregnancy

    Author of lecture Insulin: Therapy and Types – Treatment of Diabetes Mellitus

     Carlo Raj, MD

    Carlo Raj, MD

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