Type 1 diabetes basal insulin analog,lg g4 4g ,glwiz free download - Good Point


Toujeo (insulin glargine [rDNA origin]) is an insulin injection approved for the treatment of type 1 and type 2 diabetes to improve glycaemic control in adult patients.
Toujeo's mechanism of actionToujeo contains an active ingredient called insulin glargine whose primary activity is to regulate glucose metabolism by controlling high blood sugar levels in patients with type 1 and type 2 diabetes. Toujeo is a US FDA-approved insulin injection to improve glycaemic control in diabetes patients. Toujeo was compared to once-daily Lantus, another insulin injection, in Phase III clinical trials.
Sanofi also manufactures medical devices for diabetes including blood glucose monitoring systems.
In patients with type 2 diabetes mellitus , insulin degludec can be administered alone, in combination with oral anti-diabetic products as well as in combination with bolus insulin.
The development of insulin analogs has made improved treatment of type 2 diabetes possible.The flatter activity profiles of insulin glargine and insulin detemir translate into good clinical efficacy with a lower risk of hypoglycemia relative to neutral protamine Hagedorn insulin.
Insulin degludec has an onset of action of 30–90 minutes (similar to insulin glargine and insulin detemir).
Basal-bolus treatment with insulin degludec was superior to long-acting insulin analogues detemir and glargine in reducing the rate of nocturnal hypoglycaemia. Insulin degludec was studied as an alternative to insulin glargine as part of a basal-bolus regimen in the BEGIN Basal-Bolus Type 1 trial. In the BEGIN Basal-Bolus Type 2 trial, insulin degludec was studied as an alternative to insulin glargine in patients with type 2 diabetes mellitus. The ultra-long pharmacokinetic properties of insulin degludec were preserved in subjects with hepatic impairment and there were no statistically significant differences in absorption or clearance compared with subjects with normal hepatic function.
Dosing of insulin degludec to healthy normo-glycaemic animals lowered blood glucose to levels belowthe normal physiological concentration and thereby induced clinical signs of hypoglycaemia and hypoglycaemia-related mortality.
Insulin degludec showed no carcinogenic potential in a 52-week toxicity study in Sprague Dawley rats upon complete histopathological evaluation of all animals.
In accordance with the ICH S6 guideline, genotoxicity studies were not performed as insulin degludec is considered a biotechnology-derived product.
Hexadecanedioic acid being a long-chain dicarboxylic fatty acid, and in general, fatty acids are not considered to possess a mutagenic potential. Elsewhere we defined a€?good regulationa€? of diabetes as the best blood sugar levels your dog can achieve safely. If the insulin gets ahead of the food being digested and turned into glucose, your doga€™s blood sugar can drop too far too fast.
A good way to see how your dog's regulation is coming along is to keep a daily record of what and how much you fed him and how much insulin he was given in his injection. Following is a brief summary of some of the key points about the insulins most often used with diabetic dogs. Some dogs have been put on glargine (Lantus) in recent years and some of them have done well using it either alone or with a faster acting insulin.
As a human-type insulin molecule, this insulin differs slightly from a doga€™s natural insulin. NPH is generally given twice a day - an injection with a meal every 12 hours - and provides control of the doga€™s blood sugar level for about 8–14 hours. It is a very popular insulin for treating diabetic dogs as it has a very good track record of providing good blood sugar control, is less expensive than newer insulin formulations, and can be purchased without a prescription. Walmart sells this insulin as Relion N (Walmart packages the name brand product) for significantly less. This insulin molecule comes from pigs and is chemically identical to a doga€™s natural insulin molecule. Vetsulin is a more dilute insulin, with 40 units of insulin in 1 milliliter of fluid (called a U-40 insulin). NPH is more concentrated, with 100 units of insulin in 1 milliliter of fluid (called a U-100 insulin). Syringes used for each insulin are different and the U-100 syringes used for NPH insulin are more readily available and come in a greater variety of sizes and needle gauges. It is possible to use the U-40 Vetsulin insulin in a U-100 syringe by converting the measurement of the fluid in the syringe.
It is extremely important, however, when doing the conversion to know precisely how many international units of insulin you are giving your dog so that you can communicate the number of units of insulin being given to veterinary personnel.
Limiting simple sugars and carbohydrates is an important part of matching the digestion of food with the absorption of injected insulin.
For many years, a high fiber diet has been the mainstay of veterinary prescriptions for diabetic dogs. Click here to see a list of the various diets people are using with their diabetic dogs and the insulin that is used with them. Changing the diet is one good way to get a better balance between food and insulin and therefore better blood sugar control. If you find that the diet for your diabetic dog is not giving good regulation, talk with your veterinarian about changing it to find a better balance. Simple carbohydrates and sugars will raise blood sugar faster than insulin can be absorbed and used.


Protein and fat tend to be digested more slowly, providing a less intense, longer lasting supply of glucose.
A serial blood glucose curve is the best way to assess how well balanced your doga€™s diet and insulin is.
A curve is just a series of tests of the blood glucose level, starting just before you feed and inject in the morning and continuing for as long as possible.
There is a small difference, approximately 100 points, between the lowest and highest blood sugar and the blood sugar never falls below 100. In this curve, the blood sugar falls sharply because there is more action from the insulin in the first three hours after the injection is given. Much can be done to improve problems of poorly matched food and insulin if there is someone at home every day to keep a more flexible schedule. For an example of how curves can be used to solve regulation problems, please see Chrisa€™ case study. NOTICE: The content on this site is provided for informational and educational purposes only.
FDA Advisory Panel votes 8-2 in favor of an insulin dosing label update for Dexcom's G5 CGM! On July 13, Johnson & Johnson acquired Calibra Medical, maker of the Finesse “insulin patch-pen” for type 1 and type 2 diabetes. We think this acquisition represents exciting news for patients, as the strong resources and expertise of Johnson & Johnson should help bring the Finesse to market in a big way. Our mission is to help individuals better understand their diabetes and to make our readers happier & healthier. Our mission is to help individuals better understand their diabetes and to make our readers happier and healthier.
The addition of hexadecanedioic acid to lysine at the B29 position allows to form soluble and stable multi-hexamers, resulting in a depot in the subcutaneous tissue after injection.
Weight gain is consistently lower with insulin detemir than with neutral protamine Hagedorn insulin. In comparison with other long-acting analogues, treatment with insulin degludec was safe and patients obtained similar metabolic control expressed by HbA1c and FPG levels with the added benefit of a reduced basal and total insulin dose. 629 patients with type 1 diabetes were randomized in a 3:1 ratio to either insulin degludec (n=472) or insulin glargine (n=157) in addition to mealtime insulin aspart. The female mammary gland was the focus of special attention and no treatment-related increase in incidences of hyperplasia, benign or malignant tumours was recorded in females dosed with insulin degludec. Insulin degludec consists of desB30 human insulin, glutamate and 1,16-hexadecanedioic acid and none of the individual components are considered to possess a mutagenic potential. The level of glucose in the bloodstream stays fairly stable and there is little difference between the highest level and the lowest level.
You can use a notebook, a computer spreadsheet, or a calendar to keep your notes, which will allow you to look back over time to see what worked well and what didn't and trends in your dog's blood sugar in response to his diet and insulin. For detailed, comprehensive information on any kind of insulin, please see the Canines Diabetes Wikia€™s insulin pages.
But glarginea€™s reliability as an insulin for dogs has not been demonstrated and its use remains limited. It is an intermediate acting insulin that uses protamine, a protein from fish, to delay the absorption of the insulin so that one injection can have a measured effect on blood glucose over 8–12 hours in dogs. This can result in some resistance to the insulin because the doga€™s body sees the insulin molecule as foreign. Put very simply, the larger the crystalline structure is, the longer it takes the body to break the insulin out of that structure so it can be used. This typically results in no immune system reaction as the body recognizes the insulin molecule but also can make a dog more sensitive to the insulin because there is no resistance from the immune system. The consequences of not understanding the difference between marks on the syringe and units of insulin can be lethal for your dog in an emergency situation.
More dilute insulins like Vetsulin are useful for small dogs who may need just a unit or two of insulin.
Foods that are digested too quickly, as simple sugars and carbohydrates are, generally cannot be matched to a doga€™s absorption of the insulin, even with faster acting insulin.
Simple changes to the composition of your doga€™s food will shift the speed at which that meal is converted to glucose so it can stay neck and neck with the insulin. If you choose to change diets, home blood glucose testing is recommended as you will need to be able to monitor the effects of changes in diet.
Ideally 24 hours, preferably a minimum of 12 hours, with a test done at least every two hours. They can also be done by your veterinarian, either by leaving your dog at the vet for the day or, if stress is an issue and you can arrange it, by taking your dog in for quick blood draws every couple of hours. Keeping the blood sugar at 100 or higher allows for natural variation in blood sugar from day to day without the risk of your dog suffering from low blood sugar.
While we make every effort to present information that is accurate and reliable, the views expressed here are not meant to be a substitute for the advice provided by a licensed veterinarian. Compared to syringes or pens, we think the Finesse will offer a very useful alternative for people with type 2 diabetes who currently take (or should be taking) mealtime insulin.


There is no timeline yet on when the device might be available to patients, though we note that FDA first approved it in 2010 (see new now next in diaTribe #20).
The gradual separation of IDeg monomers from the multi-hexamers results in a slow and continuous delivery of IDeg from the subcutaneous injection site into the circulation, leading to the observed long pharmacokinetic and pharmacodynamic profiles.
Patients in the degludec treatment arm were switched from their basal insulin to insulin degludec in a 1:1 ratio, with a 20-30% dose reduction in patients receiving multiple basal doses per day. In addition, the effect on blood glucose resulted in compensatory adaptive changes such as increased body weight gain and food consumption, various changes in clinical pathology, decreased liver weight and depletion of liver glycogen.
No treatment related changes in the female mammary gland cell proliferation were found using BrdU incorporation. Glutamate is a commonly used food additive and mutagenicity has been investigated and found negative in Ames test and in vitro chromosomal aberration test.
With injections you are seeking to replace a very sensitive body system that adjusts the amount of insulin available moment by moment with an artificial system that provides a few injections of insulin a day and meals that deliver sugar into the bloodstream as they are digested. A tie is what you want - food and insulin being delivered in balance, giving your dog a steady supply of glucose in a good range throughout the day. But that resistance can also be helpful is slowing the insulina€™s absorption, allowing it to have an effect on blood glucose for a longer period of time. Most often the conversion is done because the finest gauge of needle that comes on a U-40 syringe is 29 while U-100 syringes come with needles two gauges finer, 30 and 31. With less insulin per drop of fluid, it is easier to measure fractions of a unit of insulin or even less than 1 unit of insulin with the U-40 Vetsulin. The glucose from these foods speeds into the bloodstream far faster than the insulin can get there.
In recent years that approach has been relaxed and people are finding that there are many diets that can balance the insulina€™s action to give good blood glucose control throughout the day. And then the insulin runs out (because it was used up so quickly) and the blood sugar goes high again.
Please consult your veterinarian for specific advice concerning the medical condition or treatment of your dog and before administering any medication or pursuing any course of treatment that you may read about on this site.
A preset dose of one or two units of bolus insulin can be administered per click, and if more insulin is needed than the preset dose, the buttons can be pushed repeatedly.
Additionally, we believe some people with type 1 diabetes may be attracted to Calibra’s device as well – while they would still need to take basal insulin using an insulin pen or syringe, the Finesse should make taking mealtime insulin much less of a hassle and much more private. Good glycaemic control is an important part of diabetes care as both hyperglycaemia (elevated blood sugar levels) and hypoglycaemia (low blood sugar) may lead to chronic complications of diabetes. It is recommended to optimise glycaemic control via dose adjustment based on fasting plasma glucose. As a result of the changed pharmacokinetics with continuous release of IDeg monomers from the soluble multihexamer subcutaneous depot, IDeg has a longer duration of action than currently available basal insulin analogues such as insulin glargine (IGlar) and insulin detemir (IDet). After 52 weeks, patients treated with insulin degludec produced a similar reduction in HbA1c (0.40% vs. After 52 weeks, insulin degludec was found to be noninferior to insulin glargine, providing a similar HbA1c lowering effect (-1.10 vs. In studies of 26 weeks duration or longer, recombinant human Neutral Protamine Hagedorn insulin (NPH insulin) was included as comparator to differentiate between effects considered related to pharmacological action of insulin and possible toxic effects of insulin degludec.
The changes seen were similar in nature and magnitude to those induced by NPH insulin and showed recovery.
They are a mixture of 30% semilente (a micro-sized zinc insulin crystal) and 70% ultralente (a large zinc insulin crystal). In large dogs, however, the more concentrated insulin means large numbers of units of insulin can be injected using a relatively small amount of fluid. And the result is that the dog will have very high blood sugar a few hours after eating - because the insulin hasna€™t caught up - and then could have dangerously low blood sugar six or seven hours later when the food is exhausted and the insulin is getting its second wind and sprinting for the bloodstream.
The device does not deliver basal insulin or a basal rate, so patients using it take their basal insulin separately – this allows the device to be far smaller than a typical pump, although it is obviously not as physiologic. In the future, we also believe the device could be used not only for just insulin, but potentially for Symlin, GLP-1, and other hormones in development. It takes a unique approach of engaging with people suffering with diabetes, derives insights from it and forms a partnership to offer diagnostics, therapies, services and devices. As with all insulin products adjustment of dose may be necessary if patients undertake increased physical activity, change their usual diet or during concomitant illness.
Once injected, the 30% semilente crystals are processed first and then the 70% ultralente crystals enter the bloodstream later. The company markets injectable, inhaled and oral medications for type 1 or type 2 diabetes. And, like all insulins, there is a tremendous amount of variation in how an individual dog absorbs the insulin and puts it to work.
The reduction in the incidence of hypoglycemia was seen as a therapeutic benefit, as hypoglycemia is often a dose limiting toxicity in insulin therapy.



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