Insulin Delivery Systems Atlanta Diabetes Associates

Slides:

Advertisements

Similar presentations

Diabetes Care Tasks at School: What Key Personnel Need to Know Diabetes Care Tasks at School: What Key Personnel Need to Know INSULIN ADMINISTRATION.

Advertisements

Boluses, basals and corrections – Getting the doses right Stephen W. Ponder MD, FAAP, CDE Scott & White Clinic Temple, Round Rock and College Station.

1 Successful Transition to Insulin Therapy in T2DM Merri Pendergrass, M.D., Ph.D. Endocrinology, University of Arizona All Faculty, CME Planning Committee.

Insulin Diabetes Outreach (June 2011). 2 Insulin Learning outcomes >Understand the difference between insulin therapy in type 1 diabetes as compared to.

Insulin Pump What to tell your patient!! Prakash Abraham Isla Fairley.

Intensive Insulin Therapy Advances in MDI and CSII Bruce W. Bode, MD, FACE Atlanta Diabetes Associates Atlanta, Georgia.

Insulin Pump Therapy Case Studies Sandra Weber, MD and Bruce W. Bode, MD.

You Have Diabetes! New Diagnosis Scared 15 year old… What are your fears? Who are your stakeholders?

1-800-DIABETES DIABETES CARE TASKS AT SCHOOL: What Key Personnel Need to Know DIABETES CARE TASKS AT SCHOOL: What Key Personnel Need to.

Insulin therapy.

New Insulins and Insulin Delivery Systems Bruce W. Bode, MD, FACE Atlanta Diabetes Associates Atlanta, Georgia.

Intensive Insulin Therapy Robert E. Jones, MD, FACP, FACE Professor of Medicine University of Utah School of Medicine.

Therapeutic Options Insulins. 1 Insulin Preparations ClassAgents Human insulinsRegular, NPH, lente, ultralente Insulin analoguesAspart, glulisine, lispro,

INSULIN THERAPY IN TYPE 1 DIABETES

Are You A Candidate For An Insulin Pump?

Management of Inpatient Blood Glucose at Temple Housestaff Orientation 2014.

Diabetes Management in the Hospital: Case Studies Bruce W. Bode, MD, FACE Atlanta Diabetes Associates Atlanta, Georgia.

Inhaled Human Insulin Treatment in Patients with Type 2 Diabetes Mellitus Matthew Faiman.

Diabetes Technology Update

Guidelines for Diabetes Management September 20, 2012 Margaret Pochay RD CDE.

Basal and Meal Time Insulin Case Study

OnsetPeakDuration Rapid Acting Lispro (Humalog) min3-5 hours Aspart (Novolog)15-30 min1-3 hours3-5 hours Intermediate Acting NPH1-4 hours5-10.

Inpatient Glycemic Management

New Insulins and Insulin Delivery Systems Bruce W. Bode, MD, FACE Atlanta Diabetes Associates Atlanta, Georgia.

Basal Bolus: The Strategy for Managing All Diabetes Paul Davidson, MD, FACE Atlanta Diabetes Associates Atlanta, Georgia Presented in San Antonio, May.

Davida F. Kruger, MSN,APN-BC,BC-ADM Certified Nurse Practitioner Division of Endocrinology, Diabetes, Bone and Mineral Disorders Henry Ford Health System.

1 Carb Counting and Insulin Administration Module Georgia Hospital Association Diabetes Special Interest Group.

Insulin and Sensors Where are we now and where are we heading? Bruce W. Bode, MD, FACE Atlanta Diabetes Associates Atlanta, Georgia.

Basal Bolus: The Strategy for Managing All Diabetes Fall, 2003 Paul Davidson, MD, FACE Atlanta Diabetes Associates Atlanta, Georgia.

Insulin Initiation and Titration for Family Physicians: Case Study #2: Andy Alice Y.Y. Cheng, MD FRCPC Peter Lin, MD CCFP.

Type I Diabetes Mellitus

INSULIN PUMPS Shelby Polk DNP, FNP-BC, CDE. 2 MANAGEMENT OF DIABETES IN SCHOOLS Exercise Legal Rights Health & Learning Nutrition Insulin Administration.

50% Basal Total Daily Dose Split to mimic Euglycemic control 50% Bolus Establishing Starting Basal and Bolus Dosing Based on Pre-Meal Readings and Carb.

P UMPMASTER AND G LUCOMMANDER THE FAR SIDE OF THE DIABETES WORLD Presented by Paul Davidson MD at the MiniMed Symposium Atlanta, GA December 13, 2003.

Clarification of Pump Orders from Barbara Davis Center Diabetes Resource Nurse Winter/Spring 2013.

{ Practicalities of intesive insulin therapy to optimase diabetes control Ewa Pańkowska MD, PhD Warsaw, Poland Warsaw, Poland.

Insulin Pump Therapy Bruce W. Bode, MD and Sandra Weber, MD.

Insulin initiation in Type 2 Diabetes

What Key Personal Need To Know INSULIN ADMINISTRATION.

Insulin Therapy-What’s New

Diabetes Mellitus Part 2 Kathy Martin DNP, RN, CNE.

Lesson One Cabin/ Archery Station (Vocabulary). Doctor’s Video What is Type-1 Diabetes What causes Type-1 Diabetes What are the symptoms How is it diagnosed.

Quality of Life Matters NOT TOO HIGH… NOT TOO LOW… A PLAN FOR OPTIMIZING DIABETES MANAGEMENT IN NURSING HOMES 5. Insulin: Part 1.

Small concise points on Insulin

Insulins Roland Halil, BScPharm, ACPR, PharmD

Insulin Initiation and Titration

Inpatient Glycemic Management

The Ontology of Diabetes Camp

Representative insulin regimens for the treatment of diabetes

Representative insulin regimens for the treatment of diabetes

Insulins Roland Halil, BScPharm, ACPR, PharmD

The What, When, Where, Who and Why

Insulins Roland Halil, BScPharm, ACPR, PharmD

Karen McAvoy RN, MSN, CDE Joslin Diabetes Center

Innovations in Insulin

T1DM: Insulin Initiation

New Patient-Friendly Options for Managing Insulin Dosing

INSULIN BASICS 12/2008.

Distribution of the absolute percentage differences of each basal rate estimate to final basal rates. Distribution of the absolute percentage differences.

Approach to starting and adjusting insulin in type 2 diabetes.

Frequency of potential risk of hypoglycemia for each estimate method, defined as a percentage difference between the estimate and final basal rate. Frequency.

Distribution of the percentage differences of each basal rate estimate to final basal insulin rates. Distribution of the percentage differences of each.

Modern strategies for management of glycaemia in type 1 diabetes

INSULINS Dr.R.Sajjad december INSULINS Dr.R.Sajjad december 2018.

Insulin Delivery Systems Atlanta Diabetes Associates

Inpatient Insulin Management on the Wards

MANDATORY INSULIN EDUCATION

INSULIN BASICS 12/2008.

INSULIN BASICS 12/2008.

Presentation transcript:

Insulin Delivery Systems Atlanta Diabetes Associates New Insulins and Insulin Delivery Systems Bruce W. Bode, MD, FACE Atlanta Diabetes Associates Part 4

Novo Nordisk devices in diabetes care First pen (NovoPen 1) launched in 1985 Committed to developing one new insulin administration system per year.

Lilly Insulin Pens

Prefilled Syringe with Flexible Dosing Title Subtitle Prefilled Syringe with Flexible Dosing

NovoLog® FlexPen® 82% of DNEs Preferred FlexPen® ® Title Subtitle 82% of DNEs Preferred FlexPen® ® Source: Diabetes Nurse Educators In-Depth Study—Reactions to FlexPen.

Starting MDI Starting insulin dose is based on weight 0.2 x wgt. in lbs. or 0.45 x wgt. in kg Bolus dose (aspart/lispro) = 20% of starting dose at each meal Basal dose (glargine/NPH) = 40% of starting dose at bedtime

Starting MDI in 180 lb person Starting dose = 0.2 x wgt. in lbs. 0.2 x 180 lbs. = 36 units Bolus dose = 20% of starting dose at each meal 20% of 36 units = 7 units ac (tid) Basal dose = 40% of starting dose at bedtime 40% of 36 units = 14 units at HS

Estimating the Carbohydrate to Insulin Ratio (CIR) Individually determined CIR = (2.8 x wgt in lbs) / TDD Anywhere from 5 to 25 g CHO is covered by 1 unit of insulin

Correction Bolus (Supplement) Must determine how much glucose is lowered by 1 unit of short- or rapid-acting insulin This number is known as the correction factor (CF) Use the 1700 rule to estimate the CF CF = 1700 divided by the total daily dose (TDD) ex: if TDD = 36 units, then CF = 1700/36 = ~50 meaning 1 unit will lower the BG ~50 mg/dl

Correction Bolus Formula Current BG - Ideal BG Glucose Correction factor Example: Current BG: 220 mg/dl Ideal BG: 100 mg/dl Glucose Correction Factor: 50 mg/dl 220 - 100 50 =2.4u

Options to MDI A Simpler Regimen Insulin Pump Premixed BID (DM 2 only)

Human Insulin Time-action Patterns Title Subtitle Human Insulin Time-action Patterns Normal insulin secretion at mealtime Regular insulin NPH insulin Premix 70/30 Change in serum insulin Baseline level Time (h) SC injection