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Protamine insulin was first created in 1936 and NPH insulin in 1946. [1] It is on the World Health Organization's List of Essential Medicines. [4] NPH is an abbreviation for "neutral protamine Hagedorn". [1] In 2020, insulin isophane was the 221st most commonly prescribed medication in the United States, with more than 2 million prescriptions.
Conventional insulin therapy is characterized by: Insulin injections of a mixture of regular (or rapid) and intermediate acting insulin are performed two times a day, or to improve overnight glucose, mixed in the morning to cover breakfast and lunch, but with regular (or rapid) acting insulin alone for dinner and intermediate acting insulin at bedtime (instead of being mixed in at dinner).
A fasting blood sugar level of ≥ 7.0 mmol / L (126 mg/dL) is used in the general diagnosis of diabetes. [17] There are no clear guidelines for the diagnosis of LADA, but the criteria often used are that the patient should develop the disease in adulthood, not need insulin treatment for the first 6 months after diagnosis and have autoantibodies in the blood.
Prandial insulin, also called mealtime or bolus insulin, is designed as a bolus dose of insulin prior to a meal to regulate the spike in blood glucose that occurs following a meal. The dose of prandial insulin may be static, or may be calculated by the patient using either their current blood sugar, planned carbohydrate intake, or both.
Regular insulin, also known as neutral insulin and soluble insulin, is a type of short-acting medical insulin. [2] It is used to treat type 1 diabetes , type 2 diabetes , gestational diabetes , and complications of diabetes such as diabetic ketoacidosis and hyperosmolar hyperglycemic states . [ 5 ]
The main goal of diabetes management is to keep blood glucose (BG) levels as normal as possible. [1] If diabetes is not well controlled, further challenges to health may occur. [1] People with diabetes can measure blood sugar by various methods, such as with a BG meter or a continuous glucose monitor, which monitors over several days. [2]
The leading cause of hyperglycemia in type 2 diabetes is the failure of insulin to suppress glucose production by glycolysis and gluconeogenesis due to insulin resistance. [39] Insulin normally inhibits glycogenolysis, but fails to do so in a condition of insulin resistance, resulting in increased glucose production. [40]
An insulin analog (also called an insulin analogue) is any of several types of medical insulin that are altered forms of the hormone insulin, different from any occurring in nature, but still available to the human body for performing the same action as human insulin in terms of controlling blood glucose levels in diabetes.
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