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IR is insulin resistance and %β is the β-cell function (more precisely, an index for glucose tolerance, i.e. a measure for the ability to counteract the glucose load). Insulin is given in μU/mL. [7] Glucose and insulin are both during fasting. [2] This model correlated well with estimates using the euglycemic clamp method (r = 0.88). [2]
In this way, visitors can not only read about insulin dosage adjustment in diabetes, but also interactively simulate examples of what they are learning about. The tutorial is currently arranged in four sections: (1) Insulin-dosage adjustment, (2) Choosing the insulin dose, (3) Timing of meals & diet planning, and (4) Glucose & the kidney. [25]
The logbook automatically colors the box red for a low blood sugar, and blue for a high blood sugar. In the example chart, a pattern is easy to visualize: mornings tend to be a bit high (more insulin is needed at night) and there is a pattern of lows occurring after dinner (perhaps dinner insulin or the afternoon basal rates could be turned down).
The hyperglycemic clamps are often used to assess insulin secretion capacity. Hyperinsulinemic-euglycemic clamp technique: The plasma insulin concentration is acutely raised and maintained at 100 μU/ml by a continuous infusion of insulin. Meanwhile, the plasma glucose concentration is held constant at basal levels by a variable glucose infusion.
The long acting insulin is given once (usually glargine, Lantus) or twice (usually detemir, Levemir) daily to provide a base, or basal insulin level. Rapid acting (RA) insulin is given before meals and snacks. A similar profile can be provided using an insulin pump where rapid acting insulin is given as the basal and premeal bolus insulin.
An insulin pump and wristop controller is one way to arrange for a closely controlled basal insulin rate. The slow-release insulins (e.g., Lantus and Levemir) can provide a similar effect. In healthy individuals, basal rate is monitored by the pancreas, which provides a regular amount of insulin at all times.
Basal insulin is provided as a once or twice daily injection of dose of a long-acting insulin. In an MDI regimen, long-acting insulins are preferred for basal use. An older insulin used for this purpose is ultralente, and beef ultralente in particular was considered for decades to be the gold standard of basal insulin.
The AGP, as it is known in the diabetes community, now includes several additional sections: glucose statistics, glucose profile graph, and either daily glucose pattern calendar images or insulin dosage graphs.