Endocrine - Insulins

Question 1

Describe what is in a basal bolus regimen?

Answer 1

Long acting (Basal) & Short acting (Bolus)

Question 2

Long acting insulins?

Answer 2

Detemir
Degludec
Glargine

DDG

Question 3

Short acting insulin?

Answer 3

Lispro
Aspart
Glulisine

no LAG

Question 4

First line Basal?

Answer 4

Detemir BD

Question 5

Second line Basal?

Answer 5

Glargine OD

Question 6

When to increase insulin?

Answer 6

Stress
Infections
Trauma
Surgery

SITS

Question 7

When to decrease insulin?

Answer 7

Physical activity
Impaired renal function
Intercurrent illness
Reduced food intake
Endocrine disorders (Addison, coelicac, thyroid disorders)

Question 8

Why is insulin not given orally?

Answer 8

It is a protein so it will denature if give orally

Question 9

Which area of the body when injecting insulin would be fast absorption rate?

Answer 9

Abdomen

Question 10

Which area of the body when injecting insulin would be slow absorption rate?

Answer 10

Buttocks / outer thighs

Question 11

What can occur if repeating injecting in same area and how would you avoid it?

Answer 11

Lipohypertrophy - rotate sites as can cause erratic absorption of insulin

Question 12

Soluble insulin examples?

Answer 12

Human/porcine / bovine

Question 13

When to inject soluble insulin?

Answer 13

15-30 mins before meals

Question 14

Soluble insulin onset time?

Answer 14

30 to 60 minutes

Question 15

Soluble insulin Peak action?

Answer 15

1-4 hours

Question 16

When to inject Short acting insulin?

Answer 16

Immediately before meals

Question 17

Onset time for short acting insulin?

Answer 17

Up to 15mins

Question 18

Duration of short acting insulins?

Answer 18

2.5 hours

Question 19

What are examples of intermediate insulins?

Answer 19

Bisophasic - isophane, lispro/aspart

Question 20

When to inject Intermediate insulin?

Answer 20

1 - 3 times a day

Question 21

Onset time of intermediate insulin?

Answer 21

1 - 2 hours

Question 22

Peak time of intermediate insulin?

Answer 22

3 - 12 hours

Question 23

Duration time of intermediate insulin?

Answer 23

11 - 24 hours

Question 24

When to inject long acting insulin?

Answer 24

Inject OD

Question 25

Onset time for long acting insulin?

Answer 25

2 - 4 days onset

Question 26

Duration time of long acting insulin?

Answer 26

36 hours