The aims of this study were to evaluate the effectiveness of a standardized insulin protocol in reducing glycemia, review (18)F-FDG biodistribution with such a protocol, and assess its clinical impact. METHODS: Sixty-three patients with glycemia greater than 10 mmol/L received insulin doses intravenously according to a standardized protocol. One hundred ...

PURPOSE: The droplet-size distribution (DSD) and stability of multiple lots of lipid injectable emulsions were studied. METHODS: A total of 234 commercial batches of Intralipid (Fresenius Kabi, Uppsala, Sweden) were characterized, and the influence of the emulsions' oil content on samples packaged in single- and three-chamber bags was tested. Larger-sized ...

Type 1 diabetics must inject exogenous insulin or insulin analogues one or more times daily. The timing and dosage of insulin administration have been a critical research area since the invention of insulin analogues. Several pharmacokinetical models have been proposed, and some are applied clinically in modeling various insulin therapies. ...

Prefilled insulin pens have become a convenient and accurate way for diabetes patients to inject insulin. Their ease of use has helped to reduce the resistance of patients with type 1 diabetes and type 2 diabetes in the United States and Europe toward initiation of insulin therapy. This study compared ...

OBJECTIVE: To provide an overview of U-500 regular insulin action, review published clinical studies with U-500 regular insulin, and offer guidance to practicing endocrinologists for identifying patients for whom U-500 regular insulin may be appropriate. METHODS: This review has been produced through a synthesis of relevant published literature compiled via ...

AIDA is an interactive educational diabetes simulator that has been available without charge via the Internet for over 12 years. Recent articles have described the incorporation of a novel generic model of insulin absorption into AIDA as a way of enhancing its capabilities. The basic model components to be integrated ...

PURPOSE: The routine use of intracavernosal injection before Doppler investigation may cause time loss, side effects due to vasoactive agents used and incorrect evaluation in the diagnosis of arterial insufficiency because of psychological inhibition and anxiety. Doppler investigation without intracavernosal injection avoids these pronounced disadvantages. In our study we tried ...

Multiple industry-sponsored studies have been published about the accuracy of insulin delivery using prefilled insulin pens. Although the study by Weise and colleagues in this issue of Journal of Diabetes Science and Technology found that the Novo Nordisk device was slightly more accurate than the Sanofi-Aventis device, one can anticipate ...

The authors present a case of an 80-year-old man, non-diabetic, who attempted suicide by injecting himself subcutaneously with 10,000 units of Humulin R and 6000 units of Humulin N. Administration of dextrose intravenously was required for 13 days to maintain the capillary blood glucose within the range of 100-180 mg/dl. ...

BACKGROUND: Because the use of insulin therapy can place a substantial burden on patients with diabetes, insulin administration should be as simple as possible. OBJECTIVES: The primary aim of this trial was to compare the use of 2 insulin delivery devices-one prefilled (NovoMix 30 FlexPen [FP]; Novo Nordisk, Copenhagen, Denmark) ...

To evaluate the efficacy of a multiple-daily injection regimen and a twice-daily injection regimen using biphasic insulin, we performed an observational study of 56 insulin-naïve patients with type 2 diabetes mellitus who began receiving insulin therapy while they were hospitalized. The subjects were divided into two groups: a multiple-daily injection ...

As part of the development of a percutaneous artificial pancreas islet, an insulin injection micropump was fabricated using micromachine techniques. The major components of the device were a thin-film, two-electrode system incorporated in a closed compartment, a silicone rubber diaphragm to separate an electrolyte solution from an insulin solution, a ...

The uptake of insulin pen use has been slow in the United States, despite their advantages over the vial/ syringe. We present results of a United States subset of 150 patients with type 1/type 2 diabetes, who were enrolled in an open-label study, that assessed usability, pen features, and patient ...

PURPOSE: The purpose of this article was to identify and address barriers to initiating insulin therapy in patients with type 2 diabetes. RESULTS: Insulin pen devices address many of the mechanical barriers associated with a syringe and vial. In addition, pen devices are increasingly being improved, offering long-term pen users ...

Insulin-Dependent Diabetes Mellitus (IDDM) is a chronic disease characterized by the inability of the pancreas to produce sufficient amounts of insulin. Daily compensation of the deficiency requires 4-6 insulin injections to be taken daily, the aim of this insulin therapy being to maintain normoglycemia - i.e., a blood glucose level ...

PURPOSE: To determine whether repetitive injections of intravitreal bevacizumab and/or triamcinolone acetate in patients with exudative age-related macular degeneration (AMD) results in a decrease in biological response. DESIGN: Retrospective comparative case series. PARTICIPANTS: Forty-three eyes of 43 patients with exudative AMD. METHODS: Pre- and postinjection optical coherence tomography (OCT) sections ...

To evaluate the effect of intra-articular steroid injection (IASI) of betamethasone acetate/betamethasone sodium phosphate (Celestone Chronodose) at the knee joint on blood glucose and fructosamine levels in controlled diabetic patients with osteoarthritis of the knee. Controlled diabetic patients (HgA1C < 7) with symptomatic osteoarthritis of the knee who failed medical ...

Allergy to human insulin is relatively rare in clinical practice. This report describes a patient referred for suspected "insulin allergy" due to lesions appearing at all sites of insulin injection. Careful evaluation confirmed contamination of the insulin syringes due to faulty techniques used by the patient. The report discusses the ...

PURPOSE: This study seeks to determine differences in key characteristics between adolescents with type 1 diabetes who experience the adverse outcomes of poor glycemic control, hypoglycemic events, and hospitalizations due to their disease versus those who do not experience such events. A secondary purpose is to examine differences in outcomes ...

OBJECTIVE: To assess patient perception of usability, safety and convenience of Next Generation FlexPen (NGFP), a newly modified version of the insulin delivery device FlexPen (FP), and the ease of attaching NovoTwist and NovoFine needles. RESEARCH DESIGN AND METHODS: A 35-item questionnaire was completed by patients with Type 1 or ...

OBJECTIVE: A modified version of the widely used pen FlexPen (FP), called Next Generation FlexPen (NGFP), has been designed to reduce the injection force with this pen. In this study, the injection force of NGFP was compared with another insulin pen, SoloStar (SS). RESEARCH DESIGN/METHODS: The injection force of 24 ...

BACKGROUND/AIMS: Opinions vary among endoscopists concerning the indications for submucosal saline-epinephrine injection for the prevention of postpolypectomy complications after colonic snare polypectomy. This study was performed to determine the appropriate indications for submucosal saline-epinephrine injection. METHODOLOGY: Clinical characteristics and complications (hemorrhage and perforation) in polypectomies were retrospectively evaluated. Postpolypectomy complications ...

PURPOSE: To report on the intraocular use of a steroid slow-release device in an attempt to avoid multiple intraocular triamcinolone injections in chronic sympathetic ophthalmia. METHODS: A 47-year-old patient with sympathetic ophthalmia had received 17 intravitreal triamcinolone injections to suppress the uveitis, to increase intraocular pressure, and to reduce systemic ...

BACKGROUND: Insulin pen devices offer patients a more convenient, accurate, and discreet mode of insulin delivery than traditional syringes and vials. This open-label, randomized, comparative crossover study assessed patient preference for two reusable pens: NovoPen 4 (Novo Nordisk A/S, Copenhagen, Denmark) and OptiClik (Sanofi-Aventis, Bridgewater NJ). METHODS: Thirty-five diabetes patients ...

Despite the development of alternative therapies in recent years, insulin injections remain essential treatment for type 2 diabetes once oral therapy alone becomes inadequate. However, neither patients nor physicians are proactive enough with regard to starting insulin, despite the well-known benefits of early insulin initiation and aggressive dose titration. Barriers ...

The introduction of insulin pens has helped improve adherence in Type 1 or 2 diabetes, and reduce inaccurate dosing, fear of injection, and social embarrassment associated with vial and syringe. This report presents the published evidence base for the accuracy, patient preference and economic evaluation of one prefilled pen, FlexPen ...

AIMS/HYPOTHESIS: This study evaluates the pharmacodynamic and pharmacokinetic properties of the novel ultra-fast insulin product VIAject, a formulation of human soluble insulin and generally recognised as safe ingredients designed to increase the rate of absorption. METHODS: We performed five euglycaemic glucose clamps (Biostator; target blood glucose 5 mmol/l) in ten ...

OBJECTIVE: To determine the way in which physicians perceive insulin pens and the factors that affect their recommendations and their patients' pen initiation/use. RESEARCH DESIGN AND METHODS: Primary care physicians ( N = 300; 108 family practice, 192 internal medicine) and endocrinologists (N = 225) were recruited from national databases ...

New basal insulin formulation was designed and their structural characteristics were investigated in vitro and biological activities in type 1 diabetic rats. Zinc-crystallized insulin was physically loaded into hydrophobically modified glycol chitosan (HGC) nanoparticles by a dialysis method. The series of insulin-HGC formulations were prepared with different feed weight ratio ...

Diabetes represents one of the main chronic diseases worldwide. Diabetes and its associated complications may be detectable even at early stages in the urinary proteome. In this article we review the current literature on urinary proteomics applied to the study of diabetes and diabetic complications. Further, we present recent data ...

BACKGROUND: The variability of the metabolic action of insulin after subcutaneous (sc) injection hampers optimal insulin therapy. Insulin formulations with a reduced tendency to form hexamers might exhibit a reduced variability of absorption from the sc insulin depot into the blood stream. METHODS: We investigated the within-subject variability of pharmacodynamic ...

Since the dawn of civilization, elemental gold and gold compounds have been revered and utilized by Shamen and medical practitioners alike for many varied pathological problems. In the 20(th) century following the observations of Jacques Forestier, injectable gold compounds were successfully used for the treatment of rheumatoid arthritis. Of the ...

Insulin therapy is integral to the treatment of diabetes mellitus. Epidemiologic studies have shown its benefits both in terms of improving glycemic control and reducing the risk for long-term diabetic complications for both type 1 and type 2 diabetes. Despite these benefits, barriers to insulin therapy are well documented and ...

Melanocortin-4 receptors (MC4R) are key factors in the depression of appetite during disease. This study was designed to determine the role of agouti-related protein (AgRP) in the effect of endotoxin (lipopolysaccharide, LPS) on appetite. Sheep received an intracerebroventricular injection of either saline or AgRP (0.5 nmol/kg of BW) 1 h ...

OBJECTIVE: To investigate the impact of insulin lispro on patients' quality of life (QOL) in diabetic patients who need insulin treatment. METHODS: In this open-label, 12-week study 770 diabetic patients whose medications were switched to insulin lispro from human insulin were evaluated. Main outcome measures were compliance with insulin injection ...

Insulin pen devices allow for accurate, flexible, and less complicated delivery of insulin for the treatment of diabetes mellitus. These devices permit small dose administration, and can be used by patients with limited dexterity and visual impairment. These characteristics may prove beneficial when considering their usefulness. The article by Hanel ...

AIMS: To compare insulin and glucose profiles during basal continuous subcutaneous infusion of a rapid-acting insulin analogue and once daily subcutaneous injection of a long-acting insulin analogue in Type 2 diabetes. METHODS: Twenty-one patients with Type 2 diabetes treated with oral glucose-lowering agents were randomized in this two-period crossover study ...

An endocrinologic evaluation of patients who have male-factor infertility has clearly evolved and leads to specific diagnoses and treatment strategies in a large population of infertile men. A well-considered endocrine evaluation is especially essential with the ever-growing popularity of assisted reproductive techniques and continued refinements with intracytoplasmic sperm injection.

BACKGROUND: Modern insulin injection pens provide a convenient and accurate way for diabetes patients to inject insulin. They have widespread use among children and adults with type 1 and type 2 diabetes in the U.S. and Europe. This study compared the dosing accuracy of four commonly available insulin pens (OptiClik ...

PURPOSE: The purpose of this study is to explore the attitudes that contribute to psychological insulin resistance (PIR) in insulin-naive patients with type 2 diabetes and to identify predictors of PIR. METHODS: A prospective study using 2 self-report surveys and incorporating demographic and health variables was conducted to determine the ...

DESIGN: The purpose of this study was to generate insulin dose (ID) percentiles for children and adolescents with type 1 diabetes mellitus (DM1) having the opportunity to assess this important parameter in relation to age and sex. METHODS: Daily IDs per weight (ID/kg) were recorded in 22,177 patients with DM1 ...

BACKGROUND: Development of improved oral insulin administration is necessary for the treatment of diabetes mellitus, to overcome the problem of daily subcutaneous injections. The vast amount of literature data on oral insulin delivery prompted us to cover this area in a review. OBJECTIVE: Insulin delivery using polymeric devices is discussed, ...

BACKGROUND: The effect of radiofrequency ablation (RFA) can be modulated by fluid injection. PURPOSE: To evaluate the potential of different fluids to modulate the effect of bipolar RFA in an ex-vivo liver model. MATERIAL AND METHODS: A bipolar RFA system with an internally cooled needle-shaped applicator (20-mm active tip) was ...

OBJECTIVES: To identify and address issues specific to elderly patients with diabetes, including goal setting, prevention of hypoglycemia,and product and device selection, and to summarize recommendations for the addition and dosing of insulin to treatment regimens and the appropriate continuance or discontinuance of oral medications in elderly patients taking insulin. ...

Diabetes affects most aspects of everyday life and places considerable responsibility on the patient; therefore, without patient acceptance of what we offer, the therapy is unlikely to be adhered to especially when that therapy happens to be insulin injection. In 2008, almost every physician/health care provider carries new and sleek ...

As a percutaneous delivery device, self-dissolving micropiles (SDMPs) composed of chondroitin sulfate and insulin were prepared under room temperature from highly concentrated solution, glue. The mean weight of SDMP was 1.03+/-0.04 mg. One insulin SDMP was percutaneously administered to the shaved abdominal skin of four beagle dogs at insulin dose ...

BACKGROUND: Forgotten or omitted insulin injections are an important contributing factor to poor glycemic control in people with type 1 diabetes. This study uses mathematical modeling and examines the impact on hemoglobin A1c (HbA1c) levels if insulin injections are forgotten. The simulation concerns people with type 1 diabetes on intensive ...

Lipoatrophy is a rare cutaneous side-effect that can develop at the site of insulin injection. Since the introduction of human recombinant insulin the number of cases has decreased although cases have been reported in association with the use of rapid acting insulin analogues and continuous subcutaneous insulin infusion (CSII), recently ...

Erectile dysfunction is a common complication of diabetes. Clinical practice has no treatment modality specifically designed for the difficult to treat diabetic erectile dysfunction due to the multifactorial and complex pathophysiology of development. PDE type 5 inhibitors are the first-line treatment option. Non-responders should have total and free testosterone checked ...

PEGylated liposomes (approximately 100 nm in diameter) lose their long-circulating characteristic upon repeated injection at certain intervals in the same animal (referred to as the "accelerated blood clearance (ABC) phenomenon"), as described by our group and by researchers in the Netherlands. Recently, it was demonstrated by our group that anti-PEG ...