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Chapter-014d Intensive Insulin Regimen

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Bajaj Sarita
2. Aggarwal Sameer
ISBN
9789351526476
DOI
10.5005/jp/books/12535_19
Edition
2/e
Publishing Year
2015
Pages
6
Author Affiliations
1. MLN Medical College, Allahabad, India, MLN Medical College, Allahabad, Uttar Pradesh, India, Moti Lal Nehru Medical College, Allahabad 211 001, UP, India, South Asian Federation of Endocrine Societies (SAFES); Moti Lal Nehru Medical College, Allahabad, Uttar Pradesh, India, Moti Lal Nehru Medical College, Allahabad, Uttar Pradesh, India, Moti Lal Nehru Medical College, Allahabad, UP, India, MLN Medical College, Allahabad (UP), India, Motilal Nehru Medical College, Allahabad, Uttar Pradesh, India
2. Pandit Bhagwat Dayal Sharma Post, Graduate Institute of Medical Sciences, Rohtak, Haryana, India
Chapter keywords
Intensive insulin regimen, prandial insulins, basal insulins, detemir, glargine, degludec, diabetes complications and control trial, continuous subcutaneous insulin infusion

Abstract

Intensive insulin regimen provides better glycemic control when compared to insulin injections. Intensive insulin regimen mainly associated with type-1 diabetes but weight gain and increased incidence of hypoglycemia are some of the draw backs found in the intensive treatment. Prandial insulins are regular insulin, rapid acting analogs like insulin aspart, lispro and glulisine where as basal insulin are long acting insulin analogs like detemir, glargine and degludec. Decreased weight gain, less incidence of hypoglycemia and better control of fasting hyperglycemia are significant advantages of insulin pumps. Multiple daily insulin injections are mainly used in the intensive treatment of the diabetes complications and control trial DCCT. Insulin-to-carbohydrate ratios can differ with the time of day and it can be calculated by the two methods such as 450–500 rule and the weight method. Continuous subcutaneous insulin infusion (CSII) is the best way to match normal insulin secretion and the risks associated with CSII are explained in this chapter. Short-acting insulin (regular) or rapid-acting insulin are commonly used with continuous therapy.

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