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Sophomore - Pharm test 3 > DM2 - Insulin Management > Flashcards

DM2 - Insulin Management Flashcards

1
Q

What percentage of the Total Daily Dose (TDD) of insulin is apportioned to the Basal insulin?

A

50%

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2
Q

What is CSII?

A

Continuous
Subcutaneous
Insulin
Infusion

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3
Q

What type of insulin goes in a CSII?

A

Rapid-acting (one of the “logs”)

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4
Q

What is the average daily insulin requirement for a type 1 diabetic?

A

0.5units per kg

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5
Q

What percentage of the TDD is apportioned to each meal? (Appx)

A

10-20%

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6
Q

Describe traditional split-injections:

A

Breakfast - rapid AND NPH

Dinner - rapid AND NPH

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7
Q

A patient with T1DM who eats light lunched might be a candidate for which strategy of insulin therapy?

A

Traditional split-injections

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8
Q

Describe modified split injections:

A

Breakfast - rapid and intermediate
Dinner - rapid
Bedtime - intermediate

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9
Q

Describe Basal-Bolus insulin management:

A

Rapid at breakfast, lunch, and dinner

Intermediate at Bedtime
OR
Intermediate at breakfast and bedttime

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10
Q

What is the insulin to carbohydrate ratio for regular insulin?

A

450/TDD = CHO coverage dose

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11
Q

What is the insulin to carbohydrate ratio for rapid-acting insulin?

A

500/TDD = CHO coverage dose

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12
Q

Corrective or supplemental doses - what is the correction dose formula?

A

Correction dose = Current BG - Desired BG / Correction Factor

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13
Q

What is the correction factor for regular insulin?

A

1500/TDD

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14
Q

What is the correction factor for rapid-acting insulin?

A

1800/TDD

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15
Q

What does the carbohydrate coverage does tell you?

A

How many grams of carbohydrates 1 unit of insulin will cover

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16
Q

What is the Dawn Phenomenon?

A

Insufficient evening basal insulin leading to hyperglycemia in the morning

17
Q

What is the Somogyi Effect?

A

Too much evening basal insulin leading to hypoglycemia at 0300 - in response, body produces glucose leading to hyperglycemia in the morning

18
Q

What do the Dawn Phenomenon and Somogyi effect both have in common?

A

They both result in morning hyperglycemia, but via different mechanisms

19
Q

What is the normal starting dose of insulin for a T2DM patient? (TDD)

A

0.1 - 0.25 units per kg

20
Q

What is the big difference between insulin management for T1 and T2?

A

T2 does not get any BOLUS insulin - it’s 100% basal

21
Q

If the T2DM pt is not achieving their target goals, at what rate may you increase their basal insulin dose?

A

By adding 1 unit per day, and maintaining vigilant monitoring of BG

Sophomore - Pharm test 3 (7 decks)

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