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Hourly Subcutaneous Insulin

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1. Hourly Subcutaneous Insulin

Hourly Subcutaneous Insulin Hourly Subcutaneous Insulin Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hourly Subcutaneous Insulin (...) Hourly Subcutaneous Insulin Aka: Hourly Subcutaneous Insulin , Hourly Subcutaneous Insulin Aspart , Hourly Subcutaneous Insulin Lispro From Related Chapters II. Indications in adults III. Protocol: Subcutaneous InsulinLispro Initial dose: 0.3 units/kg Next: 0.1 units/kg/hour until corrects Next: 0.05 units/kg/hour until DKA resolves Coadminister fluids as per Discontinue hourly dosing when 150-200 IV. Precautions Correct prior to Fluid administration is central to DKA treatment V. Monitoring every 30

2018 FP Notebook

2. Best Practice Guide: Continuous subcutaneous insulin infusion (CSII) A clinical guide for adult diabetes services

morning / afternoon 07:00 10:00 10:00 00:00 ? 10% Estimated hourly basal race Re?ned basal † Higher needed if marked dawn phenomenon. Lower if risk of night time hypoglycaemia * Lower if risk of night time hypoglycaemia Figure 2. Modified Basal Rate Profile (Adapted from Hussain & Oliver: Insulin Pumps and Continuous Glucose Monitoring Made Easy, 1e, 2016, Elsevier Ltd) 015 CLINICAL GUIDELINE BEST PRACTICE GUIDE CONTINUOUS SUBCUTANEOUS INSULIN INFUSION (CSII) Basal rate optimisation Basal insulin (...) Best Practice Guide: Continuous subcutaneous insulin infusion (CSII) A clinical guide for adult diabetes services BEST PRACTICE GUIDE: Continuous subcutaneous insulin infusion (CSII) A clinical guide for adult diabetes servicesBEST PRACTICE GUIDE CONTINUOUS SUBCUTANEOUS INSULIN INFUSION (CSII) 02 CLINICAL GUIDELINE BEST PRACTICE GUIDE CONTINUOUS SUBCUTANEOUS INSULIN INFUSION (CSII) CONTENTS Page Contributors 4 Foreword 5 Objectives 6 Access to CSII across the four nations 7 Best Practice Guide

2018 Association of British Clinical Diabetologists

3. Hourly Subcutaneous Insulin

Hourly Subcutaneous Insulin Hourly Subcutaneous Insulin Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hourly Subcutaneous Insulin (...) Hourly Subcutaneous Insulin Aka: Hourly Subcutaneous Insulin , Hourly Subcutaneous Insulin Aspart , Hourly Subcutaneous Insulin Lispro From Related Chapters II. Indications in adults III. Protocol: Subcutaneous InsulinLispro Initial dose: 0.3 units/kg Next: 0.1 units/kg/hour until corrects Next: 0.05 units/kg/hour until DKA resolves Coadminister fluids as per Discontinue hourly dosing when 150-200 IV. Precautions Correct prior to Fluid administration is central to DKA treatment V. Monitoring every 30

2015 FP Notebook

4. Insulin glargine (Lusduna) - Diabetes Mellitus

Insulin glargine (Lusduna) - Diabetes Mellitus 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2017. Reproduction is authorised provided the source is acknowledged. 10 November 2016 EMA/813309/2016 Committee for Medicinal Products for Human Use (CHMP) Assessment report LUSDUNA International non (...) -proprietary name: insulin glargine Procedure No. EMEA/H/C/004101/0000 Note Assessment report as adopted by the CHMP with all information of a commercially confidential nature deleted. Medicinal product no longer authorised Assessment report EMA/813309/2016 Page 2/76 Table of contents 1. Background information on the procedure 10 1.1. Submission of the dossier 10 1.2. Steps taken for the assessment of the product 10 2. Scientific discussion 11 2.1. Introduction 11 2.2. Quality aspects 12 2.2.1

2017 European Medicines Agency - EPARs

5. Flexible Catheter for Insulin in Diabetes

11, 2016 Actual Primary Completion Date : April 9, 2018 Actual Study Completion Date : April 9, 2018 Resource links provided by the National Library of Medicine available for: Arms and Interventions Go to Arm Intervention/treatment Experimental: flexible catheter The flexible Subcutaneous catheter for insulin administration Device: FLEXIBLE CATHETER Active Comparator: hourly rigid needle puncture Hourly rigid needle puncture for Subcutaneous insulin administration Device: hourly rigid needle (...) to Brief Summary: Use of a flexible subcutaneous catheter improves comfort in patients with DKA compared to the usual treatment with a metal needle. Condition or disease Intervention/treatment Phase Diabetic Ketoacidosis Device: FLEXIBLE CATHETER Device: hourly rigid needle puncture Not Applicable Detailed Description: Assess whether the use of a flexible subcutaneous catheter improves comfort in patients with DKA compared to the usual treatment with a metal needle. Compare the metabolic evolution

2017 Clinical Trials

6. Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients

to avoid hypoglycemia. Recommendations may not be applicable to all ICU populations, and limitations will be discussed when applicable. Future literature may alter the recommendations and should be considered when applying the recommendations within this article. Intravenous (IV) insulin will be the primary therapy discussed, but subcutaneous (SQ) administration may also have a role for GC in stable ICU patients. Other agents and approaches, including oral hypoglycemic drugs, and other antidiabetic (...) established. Published protocols generally initiate insulin therapy with hourly BG testing, and then may liberalize the testing to every 4 hrs based on the stability of the BG values within the desired range, as well as an assessment of patient clinical stability. The personnel time required for BG monitoring is the primary barrier to more frequent monitoring. We suggest that unstable patients (e.g., titrating catecholamines, steroids, changing dextrose intake) should have BG monitored at least every hour

2012 Society of Critical Care Medicine

7. Effects of saxagliptin add-on therapy to insulin on blood glycemic fluctuations in patients with type 2 diabetes: A randomized, control, open-labeled trial. (PubMed)

Effects of saxagliptin add-on therapy to insulin on blood glycemic fluctuations in patients with type 2 diabetes: A randomized, control, open-labeled trial. To investigate whether saxagliptin add-on therapy to continuous subcutaneous insulin infusion (CSII) further improve blood glycemic control than CSII therapy in patients with newly diagnosed type 2 diabetes (T2D).This was a single-center, randomized, control, open-labeled trial. Newly diagnosed T2D patients were recruited between February (...) 2014 and December 2015. Subjects were divided into saxagliptin add-on therapy to CSII group (n = 31) and CSII therapy group (n = 38). The treatment was maintained for 4 weeks. Oral glucose tolerance test was performed at baseline. Serum samples were obtained before and 30 and 120 minutes after oral administration for glucose, insulin, and C-peptide determination. Continuous glucose monitoring (CGM) was performed before and endpoint.A total of 69 subjects were admitted. After 4-week therapy, CGM

Full Text available with Trip Pro

2016 Medicine

8. Effect of NPH Insulin, Insulin Detemir and Insulin Glargine on GH-IGF-IGFBP Axis

: 16 hours (from 18:00 to 10:00 next day) ] Hourly samples will be taken from 18:00 to 10:00 next day. Secondary Outcome Measures : plasma glucose concentration (mmol/L) after a single injection of either NPH insulin, insulin Detemir or insulin glargine [ Time Frame: 16 hours (from 18:00 to 10:00 next day) ] Hourly samples will be taken from 18:00 to 10:00 next day. insulin concentration (mmol/L) after a single injection of either NPH insulin, insulin Detemir or insulin glargine [ Time Frame: 16 (...) for eligibility information Ages Eligible for Study: 18 Years to 65 Years (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Informed consent obtained before any trial-related activities. Diagnosis of diabetes mellitus according to WHO criteria; history and clinical course consistent with type 1 diabetes mellitus. Diagnosed with diabetes for more than 6 years and using continuous subcutaneous insulin infusion (CSII) at least 6 months at time

2011 Clinical Trials

9. Comparison of a New Formulation of Insulin Glargine With Lantus in Patients With Type 1 Diabetes Mellitus on Basal Plus Mealtime Insulin

2012 Actual Primary Completion Date : May 2013 Actual Study Completion Date : May 2013 Resource links provided by the National Library of Medicine related topics: related topics: available for: Arms and Interventions Go to Arm Intervention/treatment Experimental: HOE901-U300 Morning Then Evening HOE901-U300 (new insulin glargine 300 units per milliliter [U/mL]) subcutaneous (SC) injection once daily in morning for 8 weeks during treatment period A, followed by once daily in evening for 8 weeks (...) Comparison of a New Formulation of Insulin Glargine With Lantus in Patients With Type 1 Diabetes Mellitus on Basal Plus Mealtime Insulin Comparison of a New Formulation of Insulin Glargine With Lantus in Patients With Type 1 Diabetes Mellitus on Basal Plus Mealtime Insulin - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study

2012 Clinical Trials

10. Managing diabetic ketoacidosis in non-intensive care unit setting: Role of insulin analogs. (PubMed)

treated with intravenous regular insulin infusion and admitted in intensive care unit. The patients in group 2 were treated with subcutaneous insulin lispro 2 hourly and managed in the emergency medical ward. Response to therapy was assessed by duration of treatment and amount of insulin administered until resolution of hyperglycemia and ketoacidosis, total length of hospital stay, and number of hypoglycemic events in the two study groups.The baseline clinical and biochemical parameters were similar (...) Managing diabetic ketoacidosis in non-intensive care unit setting: Role of insulin analogs. To compare the efficacy and safety of rapid acting insulin analog lispro given subcutaneously with that of standard low-dose intravenous regular insulin infusion protocolin patients with mild to moderate diabetic ketoacidosis.In this prospective, randomized and open trial, 50 consecutive patients of mild to moderate diabetic ketoacidosis were randomly assigned to two groups. The patients in group 1 were

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2011 Indian journal of pharmacology

11. Effectiveness of low-dose continuous intravenous insulin infusion in diabetic ketoacidosis. A prospective comparative study. (PubMed)

Effectiveness of low-dose continuous intravenous insulin infusion in diabetic ketoacidosis. A prospective comparative study. Twenty pediatric patients with diabetic ketoacidosis were randomly assigned in equal numbers to receive insulin either as a low-dose continuous intravenous infusion or as high-dose intermittent subcutaneous injections. Blood was obtained hourly for determinations of total CO2, plasma glucose, and osmolality, and, in previously untreated patients, plasma insulin. Serum (...) values of beta hydroxybutyrate, electrolytes, and acetone were monitored every two hours. Plasma insulin levels were in the therapeutically effective range with each method of administration. There were no statistically significant differences in rate of correction of ketoacidosis, rate of reduction of plasma glucose, or decline in plasma osmolality. The incidence and the severity of hypokalemia were increased in the patients receiving subcutaneous insulin. There was less variation in the rate

1977 The Journal of pediatrics

13. A cost-utility analysis of biosimilar infliximab compared to reference infliximab in adult switch patients with Crohn’s disease: A Canadian analysis

on the top biologics accounted for 15.9% of all of Canada’s pharmaceutical sales in 2016, with sales growing from $0.8 billion in 2006 to $3.6 billion in 2016 (National Prescription Drug Utilization Information System, April 27, 2017). Furthermore, the market is highly concentrated with five top selling biologics (infliximab, adalimumab, ranibizumab, etanercept and insulin glargine) accounting for 11.4% of total pharmaceutical sales (National Prescription Drug Utilization Information System, April 27 (...) , & Lichtenstein, 2014). It starts with therapies that are less costly and/or with more preferable routes of administration, but potentially less effective. It escalates to the therapies which are more effective, but also more costly and with intravenous or subcutaneous administration (Lin et al., 2014). If a patient fails one level of therapy or becomes intolerant they are moved up to the next strategy (Lin et al., 2014). However, using this method also means that effective therapy may be delayed, with a risk

2019 SickKids Reports

15. ABCD position statement on standards of care for management of adults with type 1 diabetes

preventable precipitating cause o complete loss of awareness of hypoglycaemia o frequent (more than 2 episodes a week) asymptomatic hypoglycaemia that is causing problems with daily activities o extreme fear of hypoglycaemia. [new 2015] ? For people who are having continuous glucose monitoring, use the principles of flexible insulin therapy with either a multiple daily injection insulin regimen or continuous subcutaneous insulin infusion (CSII or insulin pump) therapy. [new 2015] 17 Continuous glucose (...) and wellbeing ? Set glycaemic targets (taking into account individual risk of hypoglycaemia) ? Provide individual dietetic advice ? Consider an insulin pump if targets cannot be achieved by MDI ? Explain the effects of pregnancy on glycaemic control (early instability/increasing insulin resistance in second half of pregnancy) ? Warn of increased risk of hypoglycaemia 7.3.3 Intrapartum care ? CBG should be monitored hourly and maintained between 4-7 mmol/L (4-8 mmol/L acceptable) during labour to minimise

2017 Association of British Clinical Diabetologists

17. Diabetes (type 1 and type 2) in children and young people: diagnosis and management

with type 1 diabetes multiple daily injection basal–bolus insulin regimens from diagnosis. If a multiple daily injection regimen is not appropriate for a child or young person with type 1 diabetes, consider continuous subcutaneous insulin infusion (CSII or insulin pump) therapy as recommended in continuous subcutaneous insulin infusion for the treatment of diabetes mellitus (NICE technology appraisal guidance 151). [new 2015] [new 2015] Dietary management for children and young people with type 1 (...) diabetes Offer level 3 carbohydrate-counting [2] education from diagnosis to children and young people with type 1 diabetes who are using a multiple daily insulin injection regimen or continuous subcutaneous insulin infusion (CSII or insulin pump) therapy, and to their family members or carers (as appropriate), and repeat the offer at intervals thereafter. [new 2015] [new 2015] Blood glucose and HbA1c targets and monitoring for children and young people with type 1 diabetes Advise children and young

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

18. Practical Management of Hyperglycaemic Hyperosmolar State (HHS) in children

/ HHS picture) ? Start continuous insulin infusion at approximately 0.025-0.05 units/kg/hour, and aim to achieve a fall of plasma glucose of 3-4mmol/L per hour ? Do not give insulin boluses or subcutaneous insulin 9 Version 2, July 2017 Review 2020 Authors: SM Ng, JA Edge, AE Timmis ssociation of Children’s Diabetes Clinicians Clinicians Electrolytes Patients with HHS will have significant depletion of potassium, phosphate and magnesium. Potassium ? Prior to insulin starting, potassium replacement (...) insulin is initiated ? Monitor potassium levels 2-3 hourly with blood gases ? ECG monitoring is required to recognise early signs of potassium derangement. Phosphate Phosphate should be checked every 2-3 hours as severe hypophosphataemia can contribute to rhabdomyolysis, haemolytic uraemia, muscle weakness and paralysis. There are no studies on the use of phosphate therapy for HHS and the beneficial effect of phosphate therapy is purely theoretical. ? If replacement required, give a 50:50 mix

2018 British Society for Paediatric Endocrinology and Diabetes

19. Care of children under 18 years with Diabetes Mellitus undergoing Surgery

Surgery 7 f. Maintenance Fluid Guidelines 8 g. Insulin Infusion Guidelines 8 h. Restarting Subcutaneous Insulin 9 8. Guideline for Children on Oral Medications 9 9. References 10 Appendix 1 Insulin Infusion Calculator Clinical Guideline Care of children under 18 years with Diabetes Mellitus undergoing Surgery ssociation of Children’s Diabetes Clinicians Clinicians 2 Version 3, Aug 2017 Review 2020 Authors: J Chizo Agwu, SM Ng, JA Edge, J H Drew, C Moudiotis, NP Wright, M. Kershaw, N Trevelyan (...) of the surgery o Child should be first on the list ideally o IV Cannula to be placed on admission to the ward. o No IV fluids or insulin infusion needed o Measure and record the capillary BG hourly preoperatively and half hourly during the operation For those patients on basal bolus regimen using multiple daily injection regimens: If BG is stable between 5-11.1mmol/L: Omit rapidacting insulin (e.g insulin aspart, (NovoRapid)insulin lispro (Humalog),glulisine (Apidra) )in the morning until after procedure

2018 British Society for Paediatric Endocrinology and Diabetes

20. ABCD position statement on standards of care for management of adults with type 1 diabetes - this has been superseded by the 2017 version - see above

injection insulin re.gimen or continuous subcutaneous insulin infusion (CSII or insulin pump) therapy. [new 2015] Continuous glucose monitoring should be provided by a centre with expertise in its use, as part of strate.gies to optimise a person’s HbA1c levels and reduce the frequency of hypoglycaemic episodes. 4.4 Unexplained or unpredictable blood glucose results Unpredictable results can be a source of frustration and anger for the individual. Specialist referral is essential and the following (...) ? consider an insulin pump if targets cannot be achieved by MDI ? explain the effects of pre.gnancy on glycaemic control (early instability/increasing insulin resistance in second half of pre.gnancy) ? warn of increased risk of hypoglycaemia 7.3.3 Intrapartum care ? CBG should be monitored hourly and maintained between 4-7mmol/l (with 4- 8mmol/l acceptable) during labour to minimise the risk of neonatal hypoglycaemia. This may require intravenous insulin infusion as per local or JBDS-IP (under

2016 Association of British Clinical Diabetologists

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