Insulin Series

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Dear Dr Ajeet Singh, The dosage of Insulin is variable from person to person. Multiple factors influence the dosage like Depends on the situation. DKA T1DM T2DM GDM Associated comorbidities like complications of Diabetes OPD settings In patient settings The cause for admission in to Hospital etc. The Insulin Regimen is many fold like Basal Insulin Regimen Basal Plus Insulin Regimen Basal Bolus Insulin Regimen Regular/Short Acting Insulin Regimen Biphasic Premixed Insulin Regimen. 1) Usually either Insulin Degludec or Glargine we start with 10 inits at 10 pm before going to bed or 5 pm in the evening or rarely 10 am depending upon the situation. It's add on to existing OADs/OHAs/ADDs, in addition to Diet and Exercise. 2) Aspart is rapid activity Insulin Analogue, to be used as prandial Insulin 3 to 4 times a day depending upon the situation. Usually start with 10 units × 3 to 4 times a day. Canbe used as IV Infusion or SC route. Usual text book dosage is 0.2 to 0.5 units/kg/24 hrs in divided doses which never works out in practical real world settings. 3) This is typically a Biphasic Premixed Insulin Regimen to be used at least 2 times a day with 12 hrs gap in between. Start with 10 in the morning half an hour before breakfast like wise in the night. You need to increment the dose of Insulin by 2 to 4 units once in 3 days based on the Blood Glucose levels accordingly. Counseling regarding how to take Insulin like Site Method of Injection Route Site Rotation Syringe or pen fill needle usage like how many times, days, disposal Hypoglycemia. Maintaining the Logue Book of Blood Glucose levels. Thanks again for allowing me to answer your question. Regards and thanks, Dr Sepuri Krishna Mohan
Sir, very nicely explained.
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Every diabetic patient respond differently to medication than other diabetic patients Therefore, in treatment of diabetes there are no fixed rules and there is no generalisation Every patient need to be treated based on his blood sugar and based on response to treatment Mixtard 30/70 has slow rise in action of insulin and then gradual fall in action of insulin, there is no uniformity of action therefore more uniform acting insulin such as Degludec and Glargine are preferred over Human Mixtard - as basal insulin Always start with low dose and gradually increase the dose, remember every patient responds differently If post prandial blood sugar is not controlled by basal Degludec or basal Glargine, then add Aspart/Glulisine/Lispro insulin to control post prandial blood sugar. Again start with low dose and increase gradually.
Thank you doctor
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.ixtard 30-70