ENDO + REPRO: INSULIN

Question 1

INSULIN: INDICATIONS

Answer 1

• Insulin replacement in people with T1DM and control of blood glucose in people with T2DM where oral hypoglycemia tx is inadequate or poorly tolerated
• Diabetic emergencies (DKA,HONK)
• Perioperative glycaemic control in selected diabetic patients
• Tx hyperkalemia

Question 2

INSULIN: MOA

Answer 2

• In diabetes mellitus, exogenous insulin functions similarly to endogenous insulin
• It stimulates glucose uptake from the circulation into tissues, including skeletal muscle and fat, and increases use of glucose as an energy source
• Insulin stimulates glycogen, lipid and protein synthesis and inhibits gluconeogenesis and ketogenesis
• For the treatment of hyperkalaemia, insulin drives K+ into cells, reducing serum K+ concentrations.
• However, once insulin treatment is stopped, K+ leaks back out of the cells into the circulation, so this is a short-term measure while other treatment is commenced.

Question 3

INSULIN: ADVERSE EFFECTS

Answer 3

• Hypoglycemia which if severe enough cam lead to coma and death

Question 4

INSULIN: WARNINGS

Answer 4

• Renally impaired patients have an increase risk of hypoglycemia

Question 5

INSULIN: INTERACTIONS

Answer 5

• Combining insulin with other hypoglycaemic agents increases the risk of hypoglycaemia
• Concurrent therapy with systemic corticosteroids increases insulin requirements

Question 6

INSULIN: EXAMPLES

Answer 6

• insulin aspart
• insulin glargine
• biphasic insulin
• soluble insulin