Through a survey of the literature and an analysis of selected national and regional statistics, a review of the incidence of osteoporosis and its consequences was performed. Results illustrate that the consequences of osteoporosis are preventable and should sensitize clinicians to the importance of early detection and the identification of risk factors for disease prevention and to early treatment once disease has been established. A marked increase in the annual incidence of hip fractures in all Canadians is noted. Whereas the incidence was less than 20,000 in 1981, the incidence of hip fracture grew to 27,342 in 1995, with 73% occurring in women. It is estimated that in Canada at least one in four women older than 50 years will have one or more osteoporosis-related fractures in their lifetimes. The consequences of these fractures are considerable, both for patients and healthcare services. Only half of all victims regain total autonomy, and the total direct costs in Canada stemming from osteoporosis are estimated to be $1.3 billion per year.
The purpose of the present study was to evaluate the feasibility of using a jet injector in a split and mixed regular and NPH insulin regimen and to compare serum glucose and free-insulin profiles obtained with the injector and the conventional syringe and needle. Twelve insulin-dependent diabetic patients were hospitalized for 5 days. After a stabilization day, six patients received their insulin injection with the injector for 2 days and with the syringe and needle for the following 2 days; the regimen was reversed for the other six patients. Diet, exercise, and insulin dosage remained constant. The serum glucose levels with the injector were consistently lower than those obtained with the syringe at all times of the day except at 5:00 a.m. and 7:30 a.m., when mean values were similar for both treatments. Free-insulin levels were higher with the injector from 10:30 a.m. to 4:30 p.m. These findings suggest that insulin absorption is faster and possibly greater with the injector than with the syringe. When switching from a syringe to an injector insulin program, insulin dose adjustment may be necessary.
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