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The article explores the relationship between sugar consumption and diabetes. It explains that while the prevalence of diabetes has been increasing, there is debate about whether sugar causes diabetes. The article discusses the two forms of diabetes, type 1 and type 2, and focuses on the effects of sugar intake on the development of type 2 diabetes. It cites studies that suggest a link between sugar-sweetened beverages and type 2 diabetes, but notes that sugar alone is not solely responsible for the increased risk. The article concludes that while observational studies suggest that sugar intake does not cause diabetes, a diet high in sugar-sweetened beverages may increase the risk of obesity, which is known to increase the risk of diabetes. [Extracted from the article]

Why you should read this article: • To learn about the types of diabetes mellitus and associated presentation • To refresh your knowledge of the complications that are associated with diabetes • To understand the nurse's role in managing patients with diabetes The incidence of diabetes mellitus is rapidly increasing, and this condition often results in significant metabolic disease and severe complications. Nurses have a crucial role in monitoring, educating and supporting people with diabetes, as well as their families and significant others. This article provides an overview of the main types and common symptoms of diabetes, its acute and long-term complications and its management. It also outlines the nurse's role in diabetes care, which frequently includes assessing and empowering patients. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your knowledge of the use of insulin therapy in diabetes mellitus • To familiarise yourself with the various types of insulin therapy available • To understand the safety measures required when administering insulin The year 2021 marks 100 years since the Nobel Prize-winning discovery of insulin as a medical treatment for diabetes mellitus. Its discovery changed type 1 diabetes from a terminal condition with a short life expectancy to one of long-term management, with patients now often living long and fulfilling lives. Today, much of the advice, support and prescribing of insulin is undertaken by nurses, including general nurses and those specialising in diabetes. This article provides an overview of the principles of insulin use in the management of diabetes, with the aim of enhancing nursing knowledge and improving the care of patients with diabetes. [ABSTRACT FROM AUTHOR]

The article offers information on introduction of biosimilar insulin has provided opportunities for health economies to make cost savings without compromising safety, efficacy and quality. Topics include Biosimilar medicines, by contrast, might have small differences to the structure of the originator molecule when produced; and high risk and variable nature of insulins, biosimilars should never be introduced as part of a whole-population switch.

AUTH Why you should read this article: • To be aware of the risks and adverse events that can occur at various points of patient transfer • To understand the importance of ensuring continuity of care for patients with diabetes mellitus • To ensure effective practice and patient care throughout the healthcare pathway Diabetes mellitus is a common long-term condition that requires careful monitoring and management. Patients with long-term conditions are often transferred between healthcare settings, for example: during admission to hospital from the community; transfer between hospital wards or inpatient departments; discharge from hospital into the community; and possible readmission to hospital. During the healthcare pathway of a patient with diabetes, there are frequent opportunities for treatment errors or miscommunication to occur, particularly related to medicines such as insulin. Therefore, it is important for nurses to develop effective communication skills to provide continuity of care as patients with diabetes navigate the healthcare pathway. This article examines the potential transfer points in the patient's healthcare pathway and discusses how effective diabetes care can be maintained throughout these transitions. [ABSTRACT FROM AUTHOR]

Hyperglycaemia is a defining feature of diabetes mellitus. It involves an elevated level of glucose in the blood, which develops as a result of the body's inability to produce insulin or process insulin effectively. If left unchecked and untreated, patients with diabetes are at risk of short-term, potentially life-threatening hyperglycaemic crises such as diabetic ketoacidosis or hyperosmolar hyperglycaemic state. Nurses frequently care for patients diagnosed with diabetes in various clinical settings; therefore, it is essential that they have an awareness of the prevention and management of hyperglycaemia and hyperglycaemic crises. This article explains the causes and clinical manifestations of hyperglycaemic crises, and details the management of patients with these conditions, in accordance with national guidelines. [ABSTRACT FROM AUTHOR]

Effective management of diabetes mellitus requires lifelong adherence to a plan that incorporates lifestyle changes, exercise and diet. Following a dietary plan is a fundamental component of diabetes management because this can regulate the body's supply of glucose and lipids, resulting in weight reduction, an improved response to pharmacotherapies, and optimal control of the patient's glycaemic status and lipid profile. This article examines the components of nutrition therapy recommended for people with diabetes. Initially, the patient's daily calorie requirements should be determined, and therapeutic objectives should be decided that take into account the individual's clinical profile and personal preferences. Subsequently, a dietary plan should be negotiated with the patient that considers the carbohydrate, protein, fat and fibre content of each food item. [ABSTRACT FROM AUTHOR]

Nurses commonly encounter patients with type 1 or type 2 diabetes mellitus in their practice. Management of these conditions requires an in-depth knowledge of blood glucose monitoring. It is essential that nurses are aware of normal blood glucose levels, so that they can respond to complications caused by elevated and reduced blood glucose levels. This article aims to enhance nurses' knowledge of the acute metabolic complications of diabetes, such as diabetic ketoacidosis and hyperosmolar hyperglycaemic state, to assist in their recognition and management in clinical practice. It discusses the causes, pathophysiology and treatment of these complications, which are regarded as potentially life-threatening medical emergencies. [ABSTRACT FROM AUTHOR]

A class action lawsuit has been filed against Medtronic Diabetes, alleging that the company illegally distributed personally identifiable and health information to Google and other third parties. The breach occurred through the use of Medtronic Diabetes' InPen system. The company admitted that users of the InPen mobile applications may have been exposed to a data privacy incident. This incident highlights the need for the medical devices industry to improve data privacy practices. Insulin pens with built-in data-tracking have become popular in managing diabetes, and the market for insulin pumps and continuous glucose monitors is valued at $10.56 billion. Medtronic currently holds the largest share of this market. [Extracted from the article]

Being admitted to hospital can be a frightening prospect for people with diabetes, with research showing high numbers of medication errors with the potential for serious harm or even death. [ABSTRACT FROM AUTHOR]

Hypoglycaemia is a potentially serious complication of diabetes mellitus in which an individual's blood glucose drops to dangerously low levels. This can cause signs and symptoms such as sweating, confusion and unusual behaviour and, if untreated, may lead to unconsciousness and death. Hypoglycaemia is a side effect of some treatments for diabetes, whereby injected insulin or oral medicines that stimulate insulin secretion cause an abnormally low blood glucose level. Nurses have an important role in educating and empowering patients and their families and carers to manage diabetes to prevent hypoglycaemia, and to initiate prompt treatment of this complication. [ABSTRACT FROM AUTHOR]

Working in partnership with patients to achieve optimal nutritional status, regardless of their underlying condition, is an important aspect of nursing care. This article examines malnutrition and diabetes mellitus, which are two common conditions that can have significant implications for patients' health and diet. It emphasises that, when managing patients with malnutrition or diabetes, nurses should undertake careful assessment of their nutritional requirements, tailoring interventions to the individual and involving family and carers where appropriate. It is also important for nurses to work with other members of the multidisciplinary team, notably dietitians, who can provide specialist dietary advice and support. [ABSTRACT FROM AUTHOR]

Continuously elevated insulinlevels can partially downregulate insulin signaling.15 As insulin resistance increases and clinicians doseescalate insulin to compensate, hyperinsulinemia canoccur. Conclusion As researchers better understand the causes and effectsof insulin resistance, insulin-sensitizing drugs arebeing used in different ways. Modulates the insulin-responsive glucosetransporter GLUT4, which is crucial for glucose uptakeand metabolism in insulin target tissues.7 Thus, TZDsoperate in intracellular metabolic pathways to improveglucose transport activity, enhance glycogen synthesis,and stimulate insulin-mediated glucose uptake anddisposal in skeletal muscle tissue.8 Subsequently, TZDsimprove endogenous insulin's action and increase criticaltissues' insulin sensitivity.9 Pioglitazone dosage starts at 15 mg and can be titratedup to 30 mg to 45 mg as needed and tolerated. [Extracted from the article]

The article focuses on researchers from ETH Zurich who proposed a self-sufficient glucose monitoring system for diabetes patients that combines a fuel cell for energy generation with artificial beta cells to release insulin in response to excess glucose.

The article offers step-by-step instructions for administering an insulin injection.

The medicines refrigerator is a common piece of equipment found in clinical areas. It is used to ensure specific medicines are safely stored within a narrow temperature range in line with manufacturers' instructions; this is usually between +2² and +8²C, and ideally +5²C. Drugs stored in the medicines refrigerator include: vaccines; insulin; chemotherapy drugs; topical preparations, such as some types of eye drops; and other treatments such as glucagon, which is used to manage severe hypoglycaemia. This article reviews the function of the medicines refrigerator and the checks required by healthcare practitioners to ensure that medicines remain safely stored and their effectiveness is maintained. It also outlines the medicines refrigeration procedure known as the 'cold chain', which includes the use of cold boxes or vaccine carriers to maintain the required temperature of medicines during transport from the manufacturer to user, or between healthcare departments. [ABSTRACT FROM AUTHOR]

The onset of type 2 diabetes mellitus is associated with various modifiable and non-modifiable risk factors, including lifestyle factors. Obesity is the principal lifestyle factor associated with an increased risk of developing type 2 diabetes. It is essential for nurses to have an understanding of the pathophysiology associated with factors that contribute to an increased risk of type 2 diabetes, particularly those associated with obesity. Nurses who have an understanding of the interaction between obesity and the onset of type 2 diabetes are better equipped to discuss the importance of weight loss and other necessary lifestyle adjustments in the prevention and management of obesity and diabetes associated with obesity, to implement evidence-based practice and to support patients to manage their health effectively. [ABSTRACT FROM AUTHOR]

In his March 2023 State of the Union Address, the president called for capping the cost of insulin at $35 for all Americans.3 Hopefully, the days of rationing insulin are nearing an end. Said it would take steps to cap insulin prices, and Novo Nordisk and Sanofi followed suit 2 weeks later.1 This is great news for the millions of Americans with diabetes who depend on the critical medication, because these 3 companies dominate the insulin market.2 The high cost of insulin has been a pain point for patients for many years and has moved into the spotlight recently. [Extracted from the article]

Billionaire Mark Cuban of the Mark Cuban Cost PlusDrug Company, an online retailer that allows drugmakersto sell generic drugs directly to pharmacies, said thatadding low-cost insulin to his site's listings couldcost upwards of $250 million for various costs,including manufacturing.7 Getting affordable insulin to the market "may be a month,it may be 6 months, it may be 2 years", he told NBC.7Low-cost insulin is also harder to manufactureand sell compared with synthetic generic drugs,according to Cuban.7 Insulin is a biologic medicine, extracted from livingcells.7 Insulin is unique in that not every patient cantake the same type.7 In addition, pharmacy benefit managers (PBMs)could be inhibiting the the more widespread access toaffordable insulin.3 PBMs, including CVS Health, Express Scripts,and OptumRx, are estimated to control 80% of theUS insulin market.4 PBM representatives work on the behalf of insurersto negotiate rebates off the list price of drugs set bythe drug companies.4 They have a symbiotic business relationship withpharmaceutical companies, which incentivizes them"to forever raise the price" of insulin, according to LarryLevitt, executive vice president for health policy at theKaiser Family Foundation.4 Thus the relationship among drug companies, insurers,and PBMs may ultimately inflates insulin prices, especiallyfor patients who pay out of pocket, he said.4 Individual states can combat high insulin prices bymaking their own insulin, which California plans to do.6 The state is also taking on high insulin prices by filing alawsuit against the 3 big insulin companies.4 Other nonprofit companies are planning to manufactureand sell low-cost types of insulin. Low-Cost Versions of the Hormone Prove Harder to Manufacture and Sell Compared With Synthetic Generics Why Is It So Difficult to Get Affordable Insulin?. [Extracted from the article]

The article outlines the clinical procedure nurses must follow for monitoring capillary blood glucose. It provides information on the preparation and equipment necessary for blood glucose monitoring, the steps for preparing and conducting for the test and for documenting and acting on the result. Guidance is offered to nurses to ensure accurate performance of blood glucose testing in patients with type 1 or type 2 diabetes.

The number of people with diabetes in the UK is increasing. Many are aged over 75 years, and this has resulted in rising numbers of patients for whom diabetes exists comorbidly with other disease processes. Those with life-limiting illness require palliative care services. However, end of life care for patients with diabetes is generally poor. The aim of end of life care for these individuals is to maintain comfort, while minimising the risks of osmotic symptoms. The wishes of patients, carers and families should be taken into consideration when agreeing new glucose control targets, adjusting treatment or changing focus on diet. Patients and carers should feel that the condition is being managed with the support of healthcare professionals. These professionals need the knowledge, skills and confidence to recognise the end of life to tailor diabetes care appropriately. [ABSTRACT FROM AUTHOR]

Te article presents a continuing education program about the challenge of administering insulin and availability of alternative therapies for patients with type two diabetes (TTD). Topics discussed include cost of managing the disease, pathophysiology of TTD and guidelines of the American Diabetes Association on the achievement of a glycosolated hemoglobin target. Also mentioned are the roles of postprandial hyperglycemia and prandial insulin in TTD.

The article focuses on the challenges and barriers to insulin therapy in patients with Type 2 diabetes. Topics discussed include the problem of uncontrolled Type 2 diabetes mellitus (T2DM) in the U.S., the basics of insulin therapy, including the most common strategy of starting with basal insulin, and the patient-related and health care provider-related barriers to insulin therapy. Also stressed is the important role of pharmacists in preventing errors associated with insulin therapy.

The article discusses the management of hyperglycemia in patients with type 2 diabetes mellitus (T2DM). Also cited are the considerations in glycemic control targets including duration of disease, risks of hypoglycemia, and estimated life expectancy, as well as the treatment options for T2DM like insulin secretagogues, insulin sensitizers, and dipeptidyl peptidase-4 (DPP-4) inhibitors.

Injections are routinely administered by nurses in acute care settings and in the community. Nurses require a thorough understanding of anatomy and physiology, pharmacological principles and equipment, and potential risks to the patient of injections. Nurses should also take an active approach to patient assessment before injecting medicines. This article, the first of two, provides an evidence-based review of injection administration, with particular reference to subcutaneous injections, and suggests a framework for best practice. [ABSTRACT FROM AUTHOR]

Adherence to self-management and medication regimens is required to achieve optimal blood glucose control in adolescents with type 1 diabetes mellitus. Non-adherence places adolescents at serious risk of short and long-term health complications. Adherence difficulties may be exacerbated by concurrent eating disorders. Diabulimia is a term used to describe the deliberate administration of insufficient insulin to maintain glycaemic control for the purpose of causing weight loss. This article explores the concept of diabulimia and the compounding complications of an eating disorder on maintaining self-management regimens in adolescents with diabetes. [ABSTRACT FROM AUTHOR]

Patients without diabetes who have surgery often develop elevated blood glucose levels. This article describes the effects of stress on blood glucose levels and the importance of treating stress-induced hyperglycaemia in surgical patients. It suggests that all patients with or without diabetes could benefit from the maintenance of strict blood glucose control within set parameters during and after surgery. The evidence suggests that strict control of blood glucose levels and frequent monitoring and maintenance of normoglycaemia may reduce post-operative complications and promote better patient long-term outcomes. The use of intensive insulin therapy is recommended for all post-operative patients in intensive care. [ABSTRACT FROM AUTHOR]

The article presents a continuing professional education (CPE) activity for U.S. pharmacists on the regulation of glucose balance in the body. Insulin and glucagon are the most frequently used hormones in blood glucose regulation. Among the systems involved in glucose regulation are muscle, liver and adipose tissue. Some of the factors that contribute to type 2 diabetes development are insulin deficiency and increased hepatic glucose production.

Hypoglycaemia has many possible causes, although similar symptoms in each case can make diagnosis of the cause complex. Common early warning signs of hypoglycaemia include blurred vision, dizziness, shakiness, sweating, irritability, nausea and palpitations, progressing to confusion, syncope, headache and disturbances of vision. Loss of consciousness and convulsions may follow if corrective steps are not taken to increase blood glucose concentration. In rare cases death may occur if blood glucose remains low for 12 hours or more, as brain function is reduced and cannot be sustained. However, death from hypoglycaemia is avoidable. Causes of non-diabetic hypoglycaemia are an under-reported area in the nursing and wider literature. This article aims to help nursing staff recognise the types and causes of this condition. [ABSTRACT FROM AUTHOR]

The article discusses the advantage of an oral dosage form of insulin instead of delivery through injection. With the global diabetes market earning an annual 30 billion U.S. dollars, drug companies have clearly the business incentive to search for an oral dosage form of insulin that can withstand digestive tract degradation. Currently, drug companies are looking for promising candidates such as the use of a polyethylene glycol derivative conjugated insulin molecule or the use of permeability/absorption enhancers.

Diabetic ketoacidosis is a common life-threatening complication, which usually occurs in patients with type 1 diabetes, but it may also occur in those with type 2 diabetes during severe concurrent illness, such as sepsis, myocardial infarction or corticosteroid treatment. This article provides an overview of the diagnosis, pathophysiology and management of diabetic ketoacidosis. The differential diagnosis and treatment of hyperosmolar non-ketotic coma is also discussed, as is the nurse's role in promoting and providing health education to patients with diabetic ketoacidosis. [ABSTRACT FROM AUTHOR]

The article discusses the contribution of disruptions of insulin signaling and glucose regulation to development of Alzheimer's disease. According to neurobiologist David R. Schubert, people with type 2 diabetes face a 50-100% higher risk of developing Alzheimer's than nondiabetics. It is said that chilling is an implication of an association between Alzheimer's and diabetes.

The article presents an overview of cystic fibrosis-related diabetes (CFRD), including diagnosis, treatment, and dietary advice. Diagnosis using random or fasting glucose levels, glycosylated haemoglobin, and the oral glucose tolerance test is described. The choices of insulin for treatment for CFRD are also examined. The importance of a personalised nutrition plan for people diagnosed with CFRD is also discussed.

Alec Smith Insulin Affordability Act provides citizens with a long-term solution to diabetes expenditures. The average individual with diabetes will spend approximately $16,752 per year on medical expenditures, with $9601 attributed to diabetes, according to the American Diabetes Association.1 This is estimated to be 2.3 times more than an individual without diabetes may spend each year on health care costs. [Extracted from the article]

The article discusses ways for overcoming barriers to insulin therapy. It notes the importance of making diabetics understand that insulin therapy could be a consequence of the natural course of the disease and not a failure on their part. For patients who have needle anxiety, pharmacists should reassure patients by explaining that insulin injections are now relatively painless. Also noted is the ability of new insulin regimens and pen devices to decrease the complexity of insulin therapy. The cost and future trends in diabetes care are also noted.

The incidence of diabetes is set to rise dramatically in the next five years so there is a growing focus on ‘shared care’ for people with diabetes, involving healthcare professionals from primary and secondary care in patient management. Insulin initiation and dose adjustment in patients with type 2 diabetes are increasingly being carried out in the primary care. This article discusses the important role of practice nurses in managing the care of patients with type 2 diabetes and the specific challenges presented by patient fears and resistance to insulin treatment. Current recommended targets for glycaemic control are identified and treatment plans discussed with a focus on transferring patients from oral hypoglycaemic drugs to insulin treatment. [ABSTRACT FROM AUTHOR]

The article provides information on several unique and important medications approved by the U.S. Food and Drug Administration in 2006. It includes the insulin human inhalation powder Exubera from Pfizer Laboratories, the papillomavirus quadrivalent human vaccine Gardasil from Merck & Co. Inc., and the rasagiline Azilect from Teva Neuroscience Inc.

The article focuses on diabetes in later life and provides several guidance and treatments. The prevalence of diabetes in Great Britain is rising more quickly than prevalence of other chronic diseases, and is predicted to rise further by 2010. The most important evidence-based guidance to emerge recently is the International Diabetes Federation-sponsored document produced by the European Diabetes Working Party for Older People 2001-2004. This systematically examines the evidence base for diabetes management in later life and includes treatment for diabetes and cardiovascular risk, as well as covering functional impairment, physical disability and diabetes in care homes.

The process of method transfer can be tedious and time-consuming, especially for a validated method. As a result, many LC methods developed using dated technology are still in use today. However, with the incentive of significant potential improvements in chromatographic separation speed and resolution, taking the necessary steps to transfer an existing protocol over to newer, better performing technology becomes less daunting. The transfer of the USP (United States Pharmacopeia) method for the related compounds of human insulin is particularly challenging, as it often requires re-optimization for each analysis. In this application note, we outline the successful method transfer steps from the USP-recommended 4.6 × 250 mm, 5 ×sm LI column run on a traditionai HPLC system to a Waters® ACQUITY UPLCM BEH 2.1 × 100 mm μ.7 pm column on a Waters ACQUIY Ultra Performance LC™ System. To optimize the new method, experimental van Deemter curves were generated to determine the optimal flow rate. Due to the high molecular weight of the human insulin molecule (∼5800), diffusion into the pores of the packing material is slower. Therefore, the optimal flow rate for the separation is relatively slow and its impact on run time was considered for the final method. Instrument considerations, such as detection parameters for sensitivity and injector carry-over performance, were optimized to maximize the benefits of the ACQUITY UPLC system for this method. The resulting UPLC™ method reduced the overall run time by 60%, with improved resolution. The data meets or exceeds acceptance criteria. [ABSTRACT FROM AUTHOR]

This article outlines the pharmacological management of type 2 diabetes and its complications in adults. Practical aspects of the drug options and the evidence supporting their use are discussed. The need for a holistic, patient-centred approach to achieve the treatment goals of glycaemic control and prevention of complications is emphasised. [ABSTRACT FROM AUTHOR]

The article discusses the problems faced in initiation of insulin to patients. Initiating insulin is a difficult consultation because insulin has to be injected, and there are also concerns surrounding hypoglycemia. Many patients associate insulin with coma. Some will know of people who gained weight on insulin or, worse still, of people who started insulin just as they approached renal replacement therapy or limb amputation. People who live alone are at greater risk from hypoglycemia, as are alcoholics.

Studies the use of insulin for the treatment of patients with type 2 diabetes. Time to initiate insulin in patients with the disease; Benefits of insulin for patients; Types of insulin; Role of primary care team in diabetes management.