In a number of large-scale studies, intensive therapy regimens have improved glycemic control while reducing the microvascular complications of type 2 diabetes. However, insulin use has been associated with weight gain, thereby hampering patient compliance with intensive insulin therapy. As the prevalence of type 2 diabetes and obesity continues to increase worldwide, health care providers must...

The superiority of the Intensive insulin regimen over the conventional split mix is very well established in Western centres, often considered a prelude to pump therapy. Developing countries find it a challenge to initiate Basal bolus therapy. The main problems include: lack of support systems in school environment to take up the injections and glucose monitoring at school, and difficulties in ...

to achieve tight glycemic control in diabetic patients, it may be necessary to introduce insulin therapy much earlier in the disease course. poor glycemic control is a risk factor for the development of diabetic complications. many patients require insulin therapy after several years of disease in order to maintain good glycemic control and prevent complications. but many patients do not receiv...

Type 1 diabetes mellitus patients on intensive insulin therapy use advanced carbohydrate counting to proper dose prandial insulin. Therefore, the patient’s ability accurately estimate meal’s content is paramount. However, despite its significance, several studies show that estimates far from ideal and identify need for continuous education counting. In this context, authors have proposed in pre...

INTRODUCTION Hyper- and hypoglycemia are strongly associated with adverse outcomes in critical care. Neurologically injured patients are a unique subgroup, where optimal glycemic targets may differ, such that the findings of clinical trials involving heterogeneous critically ill patients may not apply. METHODS We performed a systematic review and meta-analysis of randomized controlled trials ...

perglycemic nonketotic hyperosmolar coma may even ensue. Increased steroid levels are not the only factor promoting diabetes in cancer patients; infection, inactivity, emotional stress, intravenous glucose, and high carbohydrate diets also increase the tendency toward hyperglycemia. Multiple reviews have emphasized the importance of intensive insulin therapy in hospitalized patients,2–5 and sev...

BACKGROUND Our objective was to determine the cost-effectiveness of Continuous Glucose Monitoring (CGM) technology with intensive insulin therapy compared to self-monitoring of blood glucose (SMBG) in adults with type 1 diabetes in the United States. METHODS A Markov cohort analysis was used to model the long-term disease progression of 12 different diabetes disease states, using a cycle leng...

context since 2006 a relevant number of therapeutical algorithms for the management of type 2 diabetes have been proposed, generating a lively debate in the scientific community, particularly on the ideal timing for introduction of insulin therapy and on which drug should be preferred as add-on therapy in patients failing to metformin. at the moment, there is no real consensus. the aim of the p...

Despite the essential role of insulin in the management of patients with insulin deficiency, insulin use can lead to adverse effects such as hypoglycaemia and weight gain. Rarely, crucial fluid retention can occur with insulin therapy, resulting in an oedematous condition. Peripheral or generalised oedema is an extremely rare complication of insulin therapy in the absence of heart, liver or ren...