BOOK
Insulin Therapy, An Issue of Endocrinology and Metabolism Clinics - E-Book
John L. Leahy | William T. Cefalu
(2012)
Additional Information
Book Details
Abstract
This issue of Endocrinology Clinics brings the reader up do date on the current standards and important advances in insulin therapy. The following clinical topics are discussed: types of insulins, including new insulins; goals of therapy; pathophysiology of, and insulin treatment in type1 and type 2 diabetes mellitus; pumps and glucose sensors; alternative insulin delivery; patient and provider insulin resistance; inpatient insulin therapy; insulin therapy in pregnancy; and pediatric insulin therapy.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Endocrinology and Metabolism Clinics of North America | i | ||
| Copyright Page | ii | ||
| Table of Contents | v | ||
| Contributors | iii | ||
| Foreword | ix | ||
| Preface | xiii | ||
| Chapter 1. Insulins: Past, Present, and Future | 1 | ||
| DISCOVERY AND EVOLUTION OF INSULIN | 1 | ||
| INSULIN PHYSIOLOGY | 3 | ||
| GOALS OF INSULIN THERAPY | 4 | ||
| INSULIN PREPARATIONS IN CLINICAL USE | 5 | ||
| CURRENT CONTROVERSIES IN THE USE OF INSULIN | 10 | ||
| FUTURE PERSPECTIVES | 12 | ||
| SUMMARY | 14 | ||
| REFERENCES | 15 | ||
| Chapter 2. Physiology of Glucose Homeostasis and Insulin Therapy in Type 1 and Type 2 Diabetes | 25 | ||
| GLUCOSE HOMEOSTASIS: THE FASTING STATE | 26 | ||
| THE FASTING STATE IN DIABETES | 31 | ||
| GLUCOSE HOMEOSTASIS: THE FED STATE | 32 | ||
| THE FED STATE IN DIABETES | 35 | ||
| SUMMARY | 36 | ||
| REFERENCES | 37 | ||
| Chapter 3. Reevaluating Goals of Insulin Therapy: Perspectives from Large Clinical Trials | 41 | ||
| EPIDEMIOLOGIC ASSOCIATION OF HYPERGLYCEMIA WITH DIABETIC COMPLICATIONS | 41 | ||
| EARLY IN DIABETES: INSULIN-AUGMENTING TREATMENT REDUCES MICROVASCULAR COMPLICATIONS | 43 | ||
| LATER IN TYPE 2 DIABETES: INTENSIVE TREATMENT OF HYPERGLYCEMIA YIELDS MIXED RESULTS | 44 | ||
| TEN YEARS AFTER CESSATION OF RANDOMIZED TREATMENT IN DCCT AND UKPDS: MICROVASCULAR BENEFITS PERSIST AND CARDIOVASCULAR BENEFITS ARE EVIDENT | 46 | ||
| CONCEPTS DERIVED FROM EXPERIENCE WITH LARGE MEDICAL END POINT TRIALS TO DATE | 47 | ||
| A1c LEVELS DURING THE NATURAL HISTORY OF TYPE 2 DIABETES: EVOLVING PATTERNS | 48 | ||
| INDIVIDUALIZATION OF INSULIN THERAPY FOR TYPE 2 DIABETES: NEW GOALS, NEW TACTICS | 49 | ||
| SUMMARY | 51 | ||
| REFERENCES | 52 | ||
| Chapter 4. Insulin Therapy and Hypoglycemia | 57 | ||
| THE IMPORTANCE OF HYPOGLYCEMIA IN TYPE 1 DM | 59 | ||
| HYPOGLYCEMIA IN TYPE 2 DM | 62 | ||
| CLINICAL DETERMINATION OF RISK FACTORS FOR HYPOGLYCEMIA | 65 | ||
| MANAGING PATIENTS WITH HYPOGLYCEMIA ON INSULIN THERAPY | 67 | ||
| β-CELL MIMICRY AS AN INSULIN STRATEGY TO REDUCE HYPOGLYCEMIA | 69 | ||
| MONITORING OF DIABETES TO ADJUST INSULIN THERAPY | 71 | ||
| TREATMENT OF HYPOGLYCEMIA (A TREATMENT, NOT A TREAT) | 74 | ||
| EVOLUTION OF INSULIN THERAPY AND HYPOGLYCEMIA | 75 | ||
| SUMMARY | 82 | ||
| REFERENCES | 82 | ||
| Chapter 5. Intensive Insulin Therapy in Patients with Type 1 Diabetes Mellitus | 89 | ||
| INSULIN THERAPY OPTIONS | 92 | ||
| BLOOD GLUCOSE TESTING | 97 | ||
| CLOSED-LOOP THERAPY | 99 | ||
| GLUCOSE VARIABILITY | 100 | ||
| SUMMARY | 100 | ||
| ACKNOWLEDGMENTS | 100 | ||
| REFERENCES | 101 | ||
| Chapter 6. Closed-Loop Insulin Delivery in Type 1 Diabetes | 105 | ||
| COMPONENTS OF THE CLOSED-LOOP SYSTEMS | 106 | ||
| ARTIFICIAL PANCREAS PROTOTYPES | 108 | ||
| CLOSED-LOOP APPROACHES | 109 | ||
| LIMITATIONS AND OBSTACLES | 113 | ||
| FUTURE DIRECTIONS | 113 | ||
| REFERENCES | 114 | ||
| Chapter 7. Insulin Therapy in Type 2 Diabetes Mellitus | 119 | ||
| INTRODUCTION | 119 | ||
| PROGRAMS FOR STARTING INSULIN IN TYPE 2 DIABETES | 120 | ||
| INTENSIFICATION OF INSULIN THERAPY IN TYPE 2 DIABETES | 123 | ||
| INCRETIN-BASED THERAPY: IN PLACE OF OR TOGETHER WITH INSULIN IN TYPE 2 DIABETES? | 127 | ||
| WHICH ORAL AGENTS TO USE WHEN INSULIN IS STARTED IN TYPE 2 DIABETES? | 130 | ||
| SUMMARY | 131 | ||
| HOW-TOS OF INSULIN THERAPY IN TYPE 2 DIABETES | 132 | ||
| EPILOGUE | 134 | ||
| REFERENCES | 135 | ||
| Chapter 8. Insulin Therapy in Children and Adolescents | 145 | ||
| AVAILABLE INSULIN FORMULATIONS | 146 | ||
| INSULIN DELIVERY OPTIONS FOR INJECTION THERAPY | 147 | ||
| INITIATING INSULIN THERAPY | 147 | ||
| BASAL-BOLUS TREATMENT REGIMENS | 148 | ||
| GETTING STARTED WITH CSII | 152 | ||
| GLUCOSE MONITORING | 156 | ||
| INSULIN USE IN T2D | 157 | ||
| THE FUTURE: CLOSED-LOOP SYSTEMS AND THE ARTIFICIAL PANCREAS | 158 | ||
| REFERENCES | 158 | ||
| Chapter 9. Insulin Therapy in Pregnancy | 161 | ||
| INSULIN THERAPY IN PREGNANCY: WHAT PHYSICIANS ARE TRYING TO MIMIC | 162 | ||
| INSULIN USE IN PREGNANCY: AN INCREASINGLY COMMON REQUIREMENT | 162 | ||
| INSULIN USE | 163 | ||
| RISKS OF INSULIN THERAPY: HYPOGLYCEMIA AND RETINOPATHY | 163 | ||
| RAPID-ACTING INSULIN ANALOGUES AND PREGNANCY | 163 | ||
| LONG-ACTING ANALOGUES | 165 | ||
| HOW TO ADMINISTER THE INSULIN | 165 | ||
| WHEN TO ADMINISTER: BEFORE OR AFTER MEALS | 166 | ||
| HOW OFTEN TO ADMINISTER | 166 | ||
| HOW TO INITIATE INSULIN THERAPY: GDM | 166 | ||
| WHEN TO INTENSIFY OR INITIATE INSULIN THERAPY | 167 | ||
| GLYCEMIC TARGETS | 167 | ||
| WHEN TO MONITOR | 168 | ||
| INSULIN THERAPY DURING LABOR, DELIVERY, AND THE IMMEDIATE POSTPARTUM PERIOD | 169 | ||
| WHAT TO DO IN PRACTICE | 170 | ||
| REFERENCES | 170 | ||
| Chapter 10. Insulin Therapy for the Management of Hyperglycemia in Hospitalized Patients | 175 | ||
| PREVALENCE OF HYPERGLYCEMIA AND DIABETES IN HOSPITALIZED PATIENTS | 175 | ||
| PATHOPHYSIOLOGY OF HYPERGLYCEMIA DURING ILLNESS | 176 | ||
| HYPERGLYCEMIA IN ACUTE ILLNESS: RATIONALE FOR PROACTIVE TREATMENT | 179 | ||
| GLYCEMIC TARGETS IN ICU AND NON-ICU SETTINGS | 184 | ||
| MANAGING HYPERGLYCEMIA IN THE HOSPITAL ENVIRONMENT | 184 | ||
| PHARMACOLOGIC TREATMENT OF INPATIENT HYPERGLYCEMIA | 186 | ||
| RECOGNITION AND MANAGEMENT OF HYPOGLYCEMIA IN THE HOSPITAL SETTING | 191 | ||
| SUMMARY | 192 | ||
| REFERENCES | 192 | ||
| Index | 203 |