Manuela Stoicescu
University of Oradea, Romania
Title: The response to the administration of insulin is personalized - genetic determined
Biography
Biography: Manuela Stoicescu
Abstract
One of the most difficult problems in the medical practice is to establish the necessary of the insulin at a patient who need insulin therapy, indifferent that this is a young patient with type 1 insulin-depended diabetes mellitus or a patient with type 2 diabetes mellitus who in one moment need insulin administration – insulin necessitate. Theoretically appear simple in the first instance, because we have a standard protocol to calculate the necessary of insulin like 0,3 UI insulin/kg body and after that to devised the doses depend what type of scheme we want to start: an intensification scheme in four or three administrations per days fast insulin and one Lantus insulin at 21 a clock - more physiologically or an conventional scheme in two prizes of NPH insulin in the morning and afternoon and the doses depend the body mass of a person. But, practical experience showed that after scheme of insulin was started, the patient must to be very carefully monitories and supervise to adjust the doses of insulin in compliance with the glycemic profile of the patient, because hypoglycemia can appear unexpected any time especially after the intensification scheme and is very dangerous. For this reason the doctors all the time must to adjusted the dosages of insulin follow the glycemia profile if appear dawn phenomenon or Sömögyi phenomenon and to change the insulin dosages to avoid dangerous hypoglycemia. But also in the end of the scheme when insulin necessary is established, the patient isn’t yet in safe condition because a hypoglycemic accident can appear anytime. Of course we know that any other many factors can determine this like: physical efforts, stress, lunch (carbohydrate intake) and others but in this moment we must to understand that the response to insulin administration it is personalized and genetic determined.
Results and discussions: In this moment the decrease level of glycemia after insulin therapy is unpredictable. We can’t appreciate exactly how much follow to decrease the level of glycemia after was administrated the same quantity (units of insulin) at the same patient with the same body mass and the same level of glycemia. The response is different, but we expect to be the same. For this reason exist a specific response of every person, personalized and genetic determined. I believe with strong opinion that only in moment when we will know the genome of the patient (the genetic profile), to can calculate the genetic necessary of insulin of every person we can establish the truth and will be avoid so many dangerous hypoglycemic accidents in present.