diabetes

Question 1

examples of rapid acting insulin?

Answer 1

NovoRapid, Humalog, Apidra

Question 2

examples of short acting insulin?

Answer 2

Actrapid, Humulin S, Insuman Rapid

Question 3

examples of intermediate insulin?

Answer 3

Insulatard, Humulin I, Insuman basal

Question 4

examples of long acting insulin?

Answer 4

Lantus, Abasaglar,

Question 5

examples of ultra long acting insulin?

Answer 5

Toujeo, Tresiba

Question 6

what would be used for a bolus balas regime?

1st line therpay for t1 in adults and children

Answer 6

Long-acting insulin analogue ONCE daily (night-time)
Long-acting insulin analogue TWICE daily (breakfast and night-time)

Rapid acting insulin analogue THREE times daily

• With meals
• Dose based on carb intake

Question 7

what is the biphasic regimen and an example of it?

Answer 7

Used mostly in patients with Type 2 but also in Type 1 where number of injections is problematic
2 injections a day – commonly with Breakfast and evening meal

Humulin M3
Insuman Comb 15, 25, 50
Humalog mix 25, 50
Novomix 30

Question 8

disadvantges of Sulfonylureas?

Answer 8

Can cause hypos
Can cause weight gain
Need residual pancreas function
Can be un-predicatable in renal impairment and in the elderly

Question 9

disadvantages of pioglitazone?

Answer 9

Associated with heart failure
Increased risk of bladder cancer and fractures
Causes weight gain
Rarely causes liver toxicity
Can take 3-6 months to show benefit

Question 10

disadvantages of DPP-4 inhibitors?

Answer 10

Commonly causes GI side-effects, rash and UTI

Rarely causes pancreatic inflammation

Question 11

disadvantages of SGLT-2 inhibtitors?

Answer 11

Can cause thrush and UTIs especially on starting treatment
Only effective if reasonable renal function
Lower BP can increase fall risk
Risk of DKA
?risk of kidney injury and foot ulcers?

Question 12

what are the steps for T1 diabetes?

Answer 12

• start metformin
• (dual therapy) metformin PLUS DPP-4 / pioglitazone / SU / SGLT-2
• (triple therapy)