Diabetes injectables

Question 1

What is the fastest acting insulin, fast acting

Answer 1

Insulin Aspart (Fiasp)/ Insulin Lispro, Insulin Aspart, Insulin Glulisine

Question 2

What are the fast acting insulin pens

Answer 2

Humalog and Admelog (Lispro), Novolog (Aspart), Apirda (Glusine)

Question 3

What are the short-acting/regular insulins

Answer 3

Humulin R and Novolin R

Question 4

What are the intermediate-acting insulins/NPH

Answer 4

Humulin N and Novolin N

Question 5

What are the long-acting insulins and their pens

Answer 5

Insulin Glargine (Lantus and Basaglar) and Insulin Determir (Levemir)

Question 6

What are the ULTRA long lasting insulin and their pens

Answer 6

Insulin Glargine (Toujeo) and Insulin Degludec (Tresiba)

Question 7

When are the fast acting analogs (Fiasp) dosed

Answer 7

Beginning of a meal or within 20 minutes after starting a meal

Question 8

When are the rapid acting analogs administered

Answer 8

Administration immediately prior to meals (Novolog: 5-10 minutes before meals/ Humalog and Ademolg: 15 minutes before eating or right after eating)

Question 9

What is the duration of action for regular (short-acting) insulin, when should it be given

Answer 9

Up to 8 hours (slow to correct hyperglycemia/could cause post prandial hypoglycemia)/ Give 20 to 40 minutes before a meal

Question 10

T/F: Intermediate (NPH) acting insulin has variable absorption but is always less than 24 hours, usually around 12 to 16

Answer 10

True

Question 11

How often should intermediate (NPH) acting insulin should be dosed

Answer 11

Twice a day

Question 12

What are the benefits of long-lasting or ultra long lasting insulins

Answer 12

They lower the risk of hypoglycemia

Question 13

How long dose ultra long acting insulin last

Answer 13

Troujeo/Glargine: 36 hours

Tresiba/Degludec: Greater than 42 hours

Question 14

How should insulin be stored

Answer 14

Store unopened products in the refrigerator, insulin in use can be kept at room temperature,

Question 15

What insulins cannot be mixed in the same syringe

Answer 15

glargine, determir, degludec

Question 16

T/F: NPH insulin can be mixed with regular insulin or any of the rapid-acting insulin analogs in the same syringe

Answer 16

True

Question 17

What are the adverse effects of insulin

Answer 17

Hypoglycemia, weight gain, lipohypertrophy, noctornal hypoglycemia followed by rebound hyperglycemia

Question 18

What are symptoms of hypoglycemia

Answer 18

Shaking, sweating, anxious, dizziness, hunger, tachycardia, impaired vision, fatigue. headache

Question 19

To prevent injection site complications what are tips that patients should take

Answer 19

Rotate injection sites, use larger injection sites, do not reuse needles

Question 20

How is the bolus/basal regimen initiated

Answer 20

1) Give a typical daily dose based on weight: 0.4-0.5 units/kg/ day
2) Give 20% of the total daily dose for each meal as a bolus insulin (aspart/lispro/glulisine)
3) Give 40% of the total daily dose at bedtime (glargine/determir/degludec/NPH)

Question 21

How is the mixed insulin regimen initiated

Answer 21

1) Estimate a total daily dose

2) Split two-thirds of the total daily dose before breakfast and one-third of the total daily dose before breakfast