Diabetes 3 Flashcards
Which type of diabetes is insulin essential for?
Type 1 but may be used for type 2 for better control of blood glucose
What are the different classifications of insulin?
- Short acting (Rapid acting insulin analogues and soluble insulin)
- Intermediate acting
- Long acting (Prolonged action analogues)
- Biphasic insulin (mixture of two)
When would Rapid acting insulin analogues be used and what’s their advantage over soluble insulin?
They would be injected immediately before meals and they have less post-prandial (after meal) hypoglycaemia than soluble insulin
What three types of rapid acting insulin analogues are available?
Insulin lispro (Humalog), Aspart (Novorapid) and Glulisine (Apidra)
When should soluble insulins be used and what is their disadvantage?
They should be injected 15-30 minutes prior to a meal and they have significant post-prandial and nocturnal hypoglycaemia
What is an example of a soluble insulin?
Insulin soluble human (Actirapid)
How quickly are intermediate acting insulins absorbed and what is an example of them?
Slowly, Insulin isophane human (insulatard)
What is the rate of release of prolonged action analogues?
Steady state release from injection site over 24 hours
What are the two advantages of constant insulin release over 24 hours with prolonged action analogues?
Reduction in hypoglycaemia and less weight gain
What’s are some examples of prolonged action analogues?
Insulin glargine (Lantus, Abasalgar), detemir (Levemir), degludec (Tresiba)
What are biphasic insulins and what are their two phases?
They are combinations of insulins.
- Immediate part to cover meal which follows injection e.g breakfast
- longer part to cover lunch/overnight
What is an advantage and a disadvantage of biphasic insulins?
Reduces number of injections required but there’s less flexibility as ratio of mixes fixed
What injection sites are used for insulin?
Abdomen (fastest), Upper arm, buttocks, thighs (slowest)
Why is site rotation essential for insulin injections?
Risk of lipohypertrophy and subsequent erratic absorption if site over-used
What are the storage requirements for insulin?
Fridge 2-8 degrees, do not freeze, avoid direct sunlight/heat, cap pens after use and store vials in cardboard packaging
