DM day 2--> Insulin Flashcards
what does insulin do
regulates glucose metabolism released from pancreatic beta cells inhibits hepatic glucose prod. facilitates glucose transport into cells stimulates glucose storage (all this gets glucose out of blood stream)
Rapid Acting Insulin (lispro/humalog, aspart/novolog, gluisine/apidra)
begins working in 5-10 mins
peak in 1-2hrs
stop after 3-4
Short acting Insulin (Novolin-R, Humulin-R)
begin working 30-45min
peak 2-3hrs
stop after 4-8 hrs
Intermediate Acting Insulin (NPH)
begins working 120-240mins
peaks 4-8hrs
stops 10-16 hrs
Long Acting Insulin (glargine/lantis, dentimir/levamir)
begins working 120 hrs
doesnt peak
stops after 24 for lantis, 18-24 levamir
Insulin Analogs (Bolus dose)
targeets post prandial glucose peaks (rapid acting)
Basal Insulin
provides peakless prolonged insulin action
Dosing for Type 1 DM
.5units/kg/day
50% will be basal insulin
50% will be bolus insulin (1/3 for breakfast, 1/3 lunch, 1/3 at dinner)
1 unit of insulin will drop glucose by
30-60mg/dL
Carbohydrate based Adjustment
500 rule
500/total daily dose= grams of carbs covered by 1 unit of rapid acrting
Post-meal adjustment (sliding scale)
1800 rule (or 1500)
1800/total daily dose= # of mg/dL glucose that will be lowered by 1 Unit
3 ways to tx DMT2
Background Insulin (long acting) + Oral Agents
Background/Mealtime Insulin (blous)
Mixed Insulin +/- insulin sensitizers (metformin)
Somogyi Effect
high blood sugars in the AM which is a rebound effect to LOW bloodsugars during the over night
Dawn Phenomenin
Increase of glucose in morning as a result to counter regulatory hormones during the night
Hypoglycemia sx
Day–> sweating, tachy, palps, tremor, headache, confusion, visual disturbances, irritability, personality changes
Night–> nightmares, night sweats, morning headache
