Diabetes LearnPro Modules

Question 1

What are indications for IV insulin in patients with diabetes?

Answer 1

Acute Illness
DKA
Hyperosmolar hyperglycaemic state
Fasting
Antenatal patients receiving high dose steroids

Question 2

What is the half-life of insulin?

Answer 2

Approximately 5 minutes

Question 3

What are possible complications of inappropriate prolonged IV insulin use?

Answer 3

Risk of IV canula relates complications e.g.infection

Electrolyte abnormalities e.g. hyponatraemia

Question 4

What are the separate infusions given in IV insulin infusion?

Answer 4

IV fluid (glucose and potassium)
Insulin

Question 5

What is target blood glucose range?

Answer 5

6-12mMol/l

Question 6

What are the three main insulin groups?

Answer 6

Quick acting insulin

Immediate to long acting insulin

Question 7

Describe quick acting insulin

Answer 7

Given with Carbohydrates
Rapid acting analogue - works immediately; HUMALOG, NOVORAPID, APIRDRA
Short acting insulin -

Question 8

Describe intermediate to long acting insulin…

Answer 8

Given once per day
Intermediate acting isophane
Analogue insulin
Additional meal time insulin will also be required

Question 9

Describe fixed mix insulin

Answer 9

Rapid acting analogue intermediate mixture

Short acting insulin mixture

Question 10

What is a basal bolus regimen?

Answer 10

When patients take a long acting insulin and the a rapid acting insulin with each carbohydrate containing meal

Question 11

What can reduce insulin action?

Answer 11

Acute kidney injury

Question 12

What is the value for hypoglycaemia in patients of treatment for diabetes?

Answer 12

<4 mmol/l

Question 13

What is the cause of hypoglycaemia?

Answer 13

This is a transient biochemical condition caused by a mismatch of plasma insulin and glucose concentration

Question 14

How does the body react to hypoglycaemia?

Answer 14

There is a defence mechanism called counter regulation. The autonomic nervous system cooperates by releasing many different hormones: adrenaline, glucagon, cortisol, growth hormone.
The liver releases glucose from glycogen stores.

Question 15

Why might the liver not release adequate insulin in the case of hypoglycaemia?

Answer 15

The release of glucose will be impaired if glycogen levels are low. This may be in the case of malnourishment, repeated hypoglycaemia, severe liver disease, alcoholic excess

Question 16

What are the symptoms of hypoglycaemia?

Answer 16

Autonomic symptoms - trembling, palpitations, anxiety, sweating, hunger
Neuroglycopenic symptoms (<2mmol/l) - weakness, concentration loss, slurred speach, blurred vision, loss of consciousness, seizures