Glucagon is an essential drug, used for the management of hypoglycaemia. Currently available inje... more Glucagon is an essential drug, used for the management of hypoglycaemia. Currently available injectable preparations are cumbersome, difficult to use and not easily acceptable by many patients. Injection glucagon is also not available in all parts of the world. Intranasal glucagon offers a novel, effective and convenient mode of delivery of this emergency drug. This review covers the basic and clinical pharmacology of nasal glucagon, and describes its potential use in practice.
JPMA. The Journal of the Pakistan Medical Association, 2018
This communication highlights the unique features of insulin injection technique in the paediatri... more This communication highlights the unique features of insulin injection technique in the paediatric age group. It describes the anatomical, neurodevelopmental and psychosocial characteristics of children and adolescents of various age groups. These are correlated to highlight 'best practices' or 'injection manner' which diabetes care providers and care givers should observe, in order to achieve a 'happy' and healthy insulin injection experience for the child. The softer side of paediatric insulin injection technique adds to existing guidelines on insulin delivery. It encourages research on the special needs and challenges of children and adolescents living with diabetes.
JPMA. The Journal of the Pakistan Medical Association, 2019
Glucagon is an essential drug, used for the management of hypoglycaemia. Currently available inje... more Glucagon is an essential drug, used for the management of hypoglycaemia. Currently available injectable preparations are cumbersome, difficult to use and not easily acceptable by many patients. Injection glucagon is also not available in all parts of the world. Intranasal glucagon offers a novel, effective and convenient mode of delivery of this emergency drug. This review covers the basic and clinical pharmacology of nasal glucagon, and describes its potential use in practice.
Management of diabetes in infants and toddlers requires the administration of multiple subcutaneo... more Management of diabetes in infants and toddlers requires the administration of multiple subcutaneous insulin injections and frequent monitoring of blood glucose. However, there are significant unique challenges in managing insulin injections in this age group due to unpredictable eating and activity patterns, less subcutaneous fat, increased risk of hypoglycaemia, and the child's inability to communicate symptoms and comprehend the need for insulin. Insulin pumps and pen devices are preferable to insulin syringes. Injection should be administered with smaller and finer gauge needles and care should be taken to ensure correct injection technique to avoid inadvertent intramuscular injection. In this article, we highlight some of these challenges and summarize the strategies to optimize insulin administration in infants and toddlers.
Type 1 Diabetes Mellitus is a complex and polygenic disease due to gene-environment interactions.... more Type 1 Diabetes Mellitus is a complex and polygenic disease due to gene-environment interactions. The role of genetic background of diabetes has been extensively investigated. However, final conclusions have not yet been reached. Family and twin studies have shown that genetic factors are important contributors to the genetic risk of the disease. Although more than 18 diabetes-predisposing genes have been reported to date, only the major histocompatibility complex (HLA) region on chromosome 6p21 (IDDM1) and the insulin gene on chromosome 11p15 (IDDM 2) have been conclusively associated with susceptibility to type 1 diabetes. However, it has been shown recently that cytotoxic lymphocyte antigen 4 (CTLA4) on chromosome 2q33 (IDDM12) and LYP/PTPN22 on chromosome 1p13 also contribute to the genetic risk of T1DM. The article reviews the recent advances in this field. By identifying new loci or reanalyzing the known ones and with the help of more powerful studies, it is possible in the future to be able to shed more light on the complex field of the genetics of type 1 diabetes and to further understand the pathophysiology of the disease, which will allow us eventually to treat or prevent it.
Glucagon is an essential drug, used for the management of hypoglycaemia. Currently available inje... more Glucagon is an essential drug, used for the management of hypoglycaemia. Currently available injectable preparations are cumbersome, difficult to use and not easily acceptable by many patients. Injection glucagon is also not available in all parts of the world. Intranasal glucagon offers a novel, effective and convenient mode of delivery of this emergency drug. This review covers the basic and clinical pharmacology of nasal glucagon, and describes its potential use in practice.
JPMA. The Journal of the Pakistan Medical Association, 2018
This communication highlights the unique features of insulin injection technique in the paediatri... more This communication highlights the unique features of insulin injection technique in the paediatric age group. It describes the anatomical, neurodevelopmental and psychosocial characteristics of children and adolescents of various age groups. These are correlated to highlight 'best practices' or 'injection manner' which diabetes care providers and care givers should observe, in order to achieve a 'happy' and healthy insulin injection experience for the child. The softer side of paediatric insulin injection technique adds to existing guidelines on insulin delivery. It encourages research on the special needs and challenges of children and adolescents living with diabetes.
JPMA. The Journal of the Pakistan Medical Association, 2019
Glucagon is an essential drug, used for the management of hypoglycaemia. Currently available inje... more Glucagon is an essential drug, used for the management of hypoglycaemia. Currently available injectable preparations are cumbersome, difficult to use and not easily acceptable by many patients. Injection glucagon is also not available in all parts of the world. Intranasal glucagon offers a novel, effective and convenient mode of delivery of this emergency drug. This review covers the basic and clinical pharmacology of nasal glucagon, and describes its potential use in practice.
Management of diabetes in infants and toddlers requires the administration of multiple subcutaneo... more Management of diabetes in infants and toddlers requires the administration of multiple subcutaneous insulin injections and frequent monitoring of blood glucose. However, there are significant unique challenges in managing insulin injections in this age group due to unpredictable eating and activity patterns, less subcutaneous fat, increased risk of hypoglycaemia, and the child's inability to communicate symptoms and comprehend the need for insulin. Insulin pumps and pen devices are preferable to insulin syringes. Injection should be administered with smaller and finer gauge needles and care should be taken to ensure correct injection technique to avoid inadvertent intramuscular injection. In this article, we highlight some of these challenges and summarize the strategies to optimize insulin administration in infants and toddlers.
Type 1 Diabetes Mellitus is a complex and polygenic disease due to gene-environment interactions.... more Type 1 Diabetes Mellitus is a complex and polygenic disease due to gene-environment interactions. The role of genetic background of diabetes has been extensively investigated. However, final conclusions have not yet been reached. Family and twin studies have shown that genetic factors are important contributors to the genetic risk of the disease. Although more than 18 diabetes-predisposing genes have been reported to date, only the major histocompatibility complex (HLA) region on chromosome 6p21 (IDDM1) and the insulin gene on chromosome 11p15 (IDDM 2) have been conclusively associated with susceptibility to type 1 diabetes. However, it has been shown recently that cytotoxic lymphocyte antigen 4 (CTLA4) on chromosome 2q33 (IDDM12) and LYP/PTPN22 on chromosome 1p13 also contribute to the genetic risk of T1DM. The article reviews the recent advances in this field. By identifying new loci or reanalyzing the known ones and with the help of more powerful studies, it is possible in the future to be able to shed more light on the complex field of the genetics of type 1 diabetes and to further understand the pathophysiology of the disease, which will allow us eventually to treat or prevent it.
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