Diabetes management and therapeutics

Question 1

What is endogenous insulin?

Answer 1

Produced in islets of Langerhans

Question 2

structure of insulin

Answer 2

Polypeptide chains A and B connected by 2x disulphide bridges

Question 3

How is insulin formed

Answer 3

Preproinsulin formed in RER
Cleaved into proinsulin
Transported to Golgi and packaged into granules
Equal amounts of proinsulin are cleaved into C peptide and insulin

Question 4

How do you measure insulin production

Answer 4

C-peptide

Question 5

Characteristics of rapid insulin

Answer 5

Takes 15 mins to onset, lasts 2-4h

Question 6

Examples of rapid insulin

Answer 6

Aspart and lispro

Question 7

Characteristic of short insulin

Answer 7

30-60min onset, lasts 6-8h

Question 8

Examples of short insulin

Answer 8

Soluble, regular insulin

Question 9

Characteristics of intermediate insulin

Answer 9

1-2h onset, lasts 11-18h

Question 10

Examples of intermediate insulin

Answer 10

NPH (isophane insulin)

Question 11

Characteristics of long acting insulin

Answer 11

1-2h onset, lasts 20-24 h

Question 12

Examples of long insulin

Answer 12

Glargine, deter

Question 13

Why does intermediate insulin take so long to act?

Answer 13

Administered with protamine

The crystals dissolve slowly = delayed absorption

Question 14

Biphasic regimen

Answer 14

2x intermediate insulin at morning and evening meal

short acting insulin when needed

Question 15

Why does insulin demand increase after surgery?

Answer 15

Cortisol increases