Insulin Tutorial 4-Summary

You have come to the end of this Diabetes / Insulin Tutorial (as it stands at present). This last lesson - Section 4 - has been concerned with glucose in the urine and the role of the kidney.

We have seen that the kidney acts as a dam for blood sugar. It will prevent normal blood sugar from flowing into the urine, and even if the glucose level rises well above its normal value, the kidney keeps it in the blood stream.

However, if the blood glucose level becomes higher than the renal threshold of glucose - the dam height - blood sugar will overflow into the urine. This renal threshold is usually about 160 mg/dl (8.9 mmol/l) of glucose, although it does vary from individual to individual.

Therefore, if you find sugar in your urine, you know there must have been high sugar in the blood too.

If, on the contrary, you do not find any sugar in the urine, you cannot be certain that the blood glucose level was normal: it may have been quite high and still not pass into the urine.

That is why urine sugar control is not sufficient to manage your diabetes: you need blood glucose determinations.


Conclusion

In conclusion, in this Tutorial we have studied the available insulin preparations and their use (Section 1); conventional and intensive insulin therapy and insulin dosage (Section 2); how it is possible to manage the timing and quantity of meals in intensive insulin therapy (Section 3); and the relationship between sugar in the blood and in the urine (Section 4).

Hopefully this Tutorial will have raised some awareness of practical ways of achieving improved metabolic control in diabetes. However, it should be stressed that diabetes practices and regimens can vary between countries, hospitals / clinics, and even between specialists. Therefore what may be encouraged in one setting may not be so recommended in another. This insulin tutorial is not meant to provide a didactic (regimented / fixed) plan for using insulin. Rather the tutorial is intended to show some possible ways of doing things, and provide some explanations as to why things may be done in a certain way. Furthermore it is hoped that this tutorial may encourage people to think a bit more about what insulin regimens are feasible, and how such regimens might be improved and / or tailored for an individual. In all this it is important to remember that people's mileage may vary - so what works for one person may not necessarily be appropriate for someone else.

In addition it should be highlighted that care needs to be taken if 'chasing' the latest test result. Adjusting the insulin regimen on the basis of the latest blood glucose test result does have its place - especially for people who are experienced with their diabetes. But a slightly more conservative / less reactive approach where one tries to avoid "chasing one's tail" also has a place in diabetes care. For all these reasons - if you have diabetes - it is strongly recommended that you consult your doctor or diabetes specialist before considering any changes to your therapy, and / or before acting on any of the information discussed in this Tutorial.

That's all for now. We hope this Tutorial has been of some use.


Future Developments / Staying Informed

Our plan / intention is that this Tutorial should become a dynamic resource and over time grow / expand. If you are a health-carer and would be interested in contributing some material for a further lesson / chapter please do get in touch - either using the on-line Contact Form, or by emailing: www@2aida.org.

We can offer a standard HTML template to help ensure that any material used matches the style / format of this Website. Alternatively we can also help with converting more standard material on paper into a form suitable for display on the Web. All material / contributions to AIDA / 'AIDA on-line' and / or this Tutorial are fully acknowledged on our Credits page.

Obviously we can take care of setting up links from the Tutorial to the 'AIDA on-line' Web-based diabetes simulator - to illustrate various educational points from the Tutorial.

If you would like to be informed by email as soon as new sections / lessons for this Tutorial become available for free use at this Website - please enter your email id below and press the Submit button

or send a blank email note to: subscribe@2aida.org

Finally, there are some other ways that you can browse some of the example clinical diabetes case scenarios which can be simulated via this site. Click here for a list of sample AIDA cases. You can also test out your insulin-dosage adjustment skills, and hopefully some of what you have learnt in this tutorial, by clicking here to try and improve the blood glucose levels of some 'virtual diabetic patients'. Enjoy!