Diabetes: Tests & Medications Flashcards
State some of the different plasma glucose tests you can use to screen for diabetes
- Random plasma glucose
- Oral glucose tolerance test
- Fasting plasma glucose
- HbA1c
Describe the oral glucose tolerance test
- Pt must fast for 8-12hrs before
- Measure fasting plasma glucose
- Give 75g of glucose, dissolved in solution, to take orally
- Measure plasma glucose 2 hours later
- If plasma glucose >11.1mmol/L = DIABETES
What results, for the following tests, confirm diagnosis of diabetes:
- Random glucose test
- Oral glucose tolerance test
- Fasting glucose
- HbA1c
- Random glucose test: >11.1mmol/L
- Oral glucose tolerance test: >11.1mmol/L
- Fasting glucose: >7mmol/L
- HbA1c: >/= 48mmol/L (>6.5%)
State the 4/5 classes of insulin
- Rapid acting
- Short acting
- Intermediate acting
- Long acting
- Mixed acting
State the time for onset of action for the following insulins:
- Rapid acting
- Short acting
- Intermediate acting
- Long acting
- Rapid acting: 10-15 mins
- Short acting: 30-60 mins
- Intermediate acting: 1-2 hours
- Long acting: 1-2 hours
State when the maximal effect is for each of the following insulins:
- Rapid acting
- Short acting
- Intermediate acting
- Long acting
- Rapid acting: within an hour
- Short acting: 1-4hr
- Intermediate acting: 3-12hr
- Long acting: plateau between 2-20hr
State the duration of action for each of the following insulins:
- Rapid acting
- Short acting
- Intermediate acting
- Long acting
- Rapid acting: 2-5hr
- Short acting: 5-9hr
- Intermediate acting: 11-24hr
- Long acting: up to 36hr
State some examples of rapid acting insulin; include the insulin type and the brand/trade name
- Insulin aspart (Novarapid)
- Insulin glulisine (Apidra)
- Insulin lispro (Humalog)
Trade/brand name is in brackets
State some examples of short acting insulins; include the insulin type and the brand/trade name
Soluble/regular insulin (Humulin S, Actrapid)
State some examples of intermediate acting insulin; include insulin type and trade/brand name
Isophane insulin (also known as NPH). Trade names include Humulin I, Insulatard
State some examples of long acting insulin; include insulin type and trade/brand name
- Insulin glargine (Lantus)
- Insulin degludec (Tresiba)
- Insulin detemir (Levemir)
What are biphasic insulins?
Pre-mixed preparations of a rapid or short acting insulin with an intermediate acting insulin. Percentage of rapid or short acting insulin varies from 15-50%. Should be admistered before meal.
State some examples of mixed preparation/biphasic insulins
- Mixtard 30 (30% Actrapid, 70% isophane insulin)
- Humalog mix (25% humalog, 75% intermediate acting)
- NovoMix (30% Novorapid, 70% isophane insulin)
When do you inject each of the following insulins:
- Rapid acting
- Short acting
- Intermediate acting
- Long acting
- Rapid acting: 15 mins before meal
- Short acting: 30 mins before meal
- Intermediate acting: once daily
- Long acting: once daily
What is meant by basal bolus dosing?
- Give long acting insulin once daily
- Give rapid or short acting inuslin before meals
SEE CPT CARDS FOR MECHANISM OF ACTION, ADRS etc.. OF MOST OF T2DM DRUGS
For alpha-glucosidase inhibitors state:
- Mechanism of action
- Side effects
- Example drug
- Increase the time it takes to absorb oligosaccharides; this then allows time for second phase insulin to be produced/released and hence at on plasma glucose
- Side effects: flatulence
- Example: acarbose
