Drugs for Type 1 DM

Question 1

What is Basal Insulin

Answer 1

(e.g Isophan, ultralente humulin, glargine)

administered to mimic the basal insulin production
○ Administered subcutaneously only
○ Contains protamine or zinc (prolongs insulin absorption and time of action)

Question 2

What is Bolus Insulin

Answer 2

(e.g Lispro, humulin R)

administered to mimic the prandial release of insulin
○ Administered subcutaneously or intravenously
○ Rapidly lower blood glucose

Question 3

What is Mixed Insulin

Answer 3

fixed combinations of basal and bolus insulins

Question 4

Types of Human Insulin

Answer 4

Humulin R
Isophane
Lente
Ultralente

Given Perinatal

Question 5

Types of Insulin Analogue

Answer 5

Lispro (Rapid Acting)
Glargine ( Long Acting)

Question 6

MOA of insulin

Answer 6

Anabolic hormone that acts through enzyme linked receptors (tyrosine kinase)

Insulin binds to insulin receptors (two alpha and two beta subunits) → dimerization → enzyme activation → activation of transcription factor → cellular response → production of GLUT4 → glucose uptake by cells

Question 7

Clinical Use of Insulin

Answer 7

Lower blood glucose level
● Facilitates glucose uptake by peripheral tissues
● Stimulates glycogenesis
● Inhibits glycogenolysis

Fat sparing effect
● Promotes lipogenesis
● Inhibits lipolysis

Anabolic effect
● Stimulates aa uptake by tissue
● Increase protein synthesis
● Inhibits proteolysis

Question 8

AE of Insulin

Answer 8

Hypoglycemia, lipodystrophy at the injection site, allergy, insulin resistance
*Hypoglycemia leads to tremor, dizziness, weakness, tachycardia, confusion
*Lipodystrophy is due to local immune reaction

Potassium is always administered before insulin to prevent hypokalemia.