DM - Other Issues

Question 1

Usage and peak time of U-200 insulin lispro Humalog U-200 KwikPen®)

Answer 1

Rapid-acting, prandial human insulin analogue
* DM Type I & II
* Peak plasma time: ~0.5-1.5 hr
* Half-life: 1 h

Most common adverse effect is Hypoglycemia

Question 2

Usage and peak time for U-200 insulin degludec (Tresiba FlexTouch pen®)

Answer 2

• Once-a-day, long acting, concentrated basal insulin analogue
• Peak plasma time → 9 hr
• Protein bound: >99% to albumin
• Half-life: ~25 hr
• DM Type I & II
• Do not use with alcohol
• Adverse effects (>10%): Severe hypoglycemic episode (0.3-12.3%), Headache (8.8-11.8%)

Question 3

Usage for U-300 insulin glargine (Toujeo®)

Answer 3

• Once-a-day, long acting, concentrated basal insulin analogue
• Onset of action: 3-4 hr
• Duration: 24 hr (range: 10.8 hr to >24 hr)
• DM Type I & II
• Adverse effects: Hypoglycemia

Question 4

Usage of U-500 insulin (Humulin R®)

Answer 4

• Basal/Bolus insulin concentrated
• Onset: 0.5 hr (early effect); 2.5-5 hr (peak effect)
• Duration: up to 24 hr (U-500)
• Peak plasma time: 0.8-2 hr
• DM Type I & II

Question 5

Common adverse effect of insulin medication

Answer 5

Hypoglycemia

Question 6

For children under 4 years old with T1D, how should insulin be administered?

Answer 6

• Picky eating
• Bolus insulin may be given after, rather than before, meals
• Carbs may vary from what was calculated & dosed

Question 7

How does puberty affect T1D management?

Answer 7

• ↑ insulin-to-carb ratios may be needed
• Girls may require 20-50% ↑ insulin
  dose during menstrual periods

Question 8

Studied in peds, but “off-label” usage for T2D management

Answer 8

• Rosiglitazone
• Glimepiride

Question 9

A _____ is a health professional who possesses comprehensive knowledge of & experience
in prediabetes, diabetes prevention & managemen

Answer 9

Certified Diabetes Educator®
(CDE®)

Question 10

Assessing DM & Depression

Answer 10

Screen all adults with DM for depression
* Treat Major Depression according to the standards of care

Question 11

What cancers have strong associations with Diabetes mellitus?

Answer 11

endometrial, hepatic, bladder, pancreatic gall bladder, esophageal , renal, thyroid, ovarian, breast, & colorectal cancer

Question 12

Cancers that have Weaker associations with Diabetes Mellitus?

Answer 12

leukemia, malignant & multiple melanoma, pancreatic cancer, non-Hodgkin lymphoma

Question 13

WHat is the National Registry of Certified Medical Examiners?

Answer 13

PA, APRN, MD, DO, DC complete an educational program & pass a written exam to provide Department of Transportation (DOT)
physical examinations to CMV drivers (high risk of T2D in this population)

Question 14

Annual monitoring of diabetes includes:

Answer 14

Foot exam
Fundascopic exam
Kidney function