Insulin titration

Subcutaneous injection 2-4 injections per day. Give 2/3 of total insulin requirement as NPH and l as regular requires titration. 

Once or twice daily dosing 2/3 of total insulin is given as NPH and MZ as regular. 20-60 U/day requires titration. 

Exenatide is approved for use in individuals who fail to achieve desired glycemic control on biguanides, or biguanides plus sulfonylureas. Hypoglycemia is a risk when exenatide is used with an insulin secretagogue or with insulin. The doses of the latter drugs have to be reduced at the initiation of exenatide therapy and subsequently titrated. 

Weigh insulin in a clean glass container and dissolve in acid buffer and titrate to a pH of 7 with Tris buffer. 

Johnston PS, Feig PU, Coniff RF, Krol A, Davidson JA, Haffner SM. Long-term titrated-dose alpha-glucosidase inhibition in non-insulin-requiring Hispanic NIDDM patients. Diabetes Care 1998 21(3) 409-15. 

A sliding scale insulin infusion of Actrapid 50 units made up to 50 mL with sodium chloride 0.9% was initiated and titrated against blood glucose. 

The titration curve can give no information on the subject of reversible conformational change in insulin because there is extensive pH-dependent association between insulin molecules. The absence of other conformational change is indicated by hydrodynamic measurements of Fredericq (1966). 

Titration curves of insulin have been determined by Tanford and Epstein (1954) and by Fredericq (1954, 1956). As Table XII shows, the count of groups obtained for zinc-free insulin is in agreement with analytical data. This is true in spite of the fact that insulin is insoluble between pH and pH 7. The precipitate is evidently highly hydrated, so that titration of the acidic groups occurs as if they were in solution. 

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