A young woman with no history of diabetes tried to commit suicide by injecting 2800 units of subcutaneous NPH insulin. She was transferred to Loghman Hospital within 12 hours. The main clinical symptom was continuous seizure activity which was resistant to all forms of routine drug therapy. The patient was treated with intravenous hypertonic glucose (50%) followed by continuous glucose (10...

BACKGROUND Insulin is an effective treatment for achieving glycemic control and preventing complications in patients with diabetes. In order to make insulin therapy more acceptable to patients, newer formulations of insulin have been developed, such as biphasic insulins. Biphasic insulins conveniently provide both prandial and basal insulin in a single injection. One of the most well-studied bi...

a young woman with no history of diabetes tried to commit suicide by injecting 2800 units of subcutaneous nph insulin. she was transferred to loghman hospital within 12 hours. the main clinical symptom was continuous seizure activity which was resistant to all forms of routine drug therapy. the patient was treated with intravenous hypertonic glucose (50%) followed by continuous glucose (10%) in...

Tight glucose control is essential to minimize complications in diabetic patients. However, the pharmacokinetic characteristics of the currently available rapid-, intermediate-, and long-acting preparations of human insulin make it almost impossible to achieve sustained normoglycemia. Until recently, improvements in insulin formulations were seriously limited as advances were only achieved in i...

OBJECTIVE To better understand exenatide's role in the treatment of type 2 diabetes, this analysis assessed its cost-effectiveness in comparison to an intermediate (NPH) and long-acting insulin (glargine). Exenatide is a recently approved medication for the treatment of type 2 diabetes for use in addition to frequently used oral diabetes medications. METHODS Two studies were identified by a M...

OBJECTIVE To compare the pharmacokinetics and pharmacodynamics of NPH, glargine, and detemir insulins in type 2 diabetic subjects. RESEARCH DESIGN AND METHODS This study used a single-blind, three-way, cross-over design. A total of 18 type 2 diabetic subjects underwent a euglycemic clamp for 32 h after a subcutaneous injection of 0.4 units/kg at 2200 h of either NPH, glargine, or detemir afte...

RESEARCH DESIGN AND METHODSdTwenty-eight male type 1 diabetic patients (age 36.9 6 9.7 years, BMI 24.9 6 2.7 kg/m, A1C 7.5 6 0.6%) successfully completed a randomized crossover study, consisting of two periods of 12-week treatment with either insulin detemir or NPH insulin, both in combination with prandial insulin aspart. After each treatment period, patients underwent positron emission tomogr...

Although insulin introduced nearly a century ago has saved the lives of countless people with diabetes, improvements of this therapy continue as significant unmet needs remain (1–4). Even persons with type 2 diabetes who, compared with those with type 1 diabetes, exhibit a much more stable, yet disordered, metabolic milieu only achieve an intended HbA1c target of 7% or lower without hypoglycemi...

N Engl J Med 2005;352:174-83. Copyright © 2005 Massachusetts Medical Society. he discovery of insulin more than 80 years ago is considered one of the greatest medical breakthroughs of the 20th century. 1 The first commercial insulin preparations contained numerous impurities and varied in potency from lot to lot by as much as 25 percent. Manufacturing techniques improved rapidly, however, which...