FN: Diabetes Insulin

Question 1

Short acting soluble insulin exampes

Answer 1

Actrapid and Human S

Question 2

Short acting soluble insulin onset

Answer 2

30-60mins

Question 3

Short acting soluble insulin peak

Answer 3

2-4hrs

Question 4

Short acting soluble insulin duration

Answer 4

6-8 hrs

Question 5

Short acting soluble insulin uses

Answer 5

Maintenance: 15-30mins before meals
DKA
Sliding scales

Question 6

Short acting insulin analogues examples

Answer 6

Aspart: Nonorapid
Lispro: Humalog

Question 7

Short acting insulin analogues onset

Answer 7

15 mins

Question 8

Short acting insulin analogues peak

Answer 8

1-3 hrs

Question 9

Short acting insulin analogues duration

Answer 9

2-5hrs

Question 10

Short acting insulin analogues uses

Answer 10

Maintenance: 15-30mins before meals
DKA
Sliding scales

Question 11

Intermediate and long acting insulin isophane insulin

Answer 11

Insulatard

Humulin I

Question 12

Intermediate and long acting insulin insulin analogues

Answer 12

Glargine: lantus
Determir: Levemir

Question 13

Intermediate and long acting insulin onset

Answer 13

1-3hrs

Question 14

Intermediate and long acting insulin peak

Answer 14

4-12hrs

Question 15

isophane insulin duration

Answer 15

12 hrs

Question 16

Glargine duration

Answer 16

24hrs

Question 17

Detemir duration

Answer 17

20 hrs

Question 18

Intermediate and long acting insulin uses

Answer 18

Glargine is given OD (noct) as basal therapy

Long acting analogues reduced nocturnal hypoglycaemia

Question 19

Effects of insulin in adipose tissue

Answer 19

increase lipoprotein lipase activity - reduced TGs
Increase GLUT-4 activity and raised glucose storage as fat
reduced lipolysis - reduce fatty acids released into circulation

Question 20

Insulin effects on liver

Answer 20

Reduced glycogenolysis
reduced gluconeogeneis
increased glcyoneogeneis
Inhibition of ketogenesis

Question 21

Insulin in muscles

Answer 21

reduced ptoelysis

Increased GLUT4 activity - increase glucose uptake

Question 22

Factors affecting absorption

Answer 22

Temperature
Excercise
Preparation: actrarapid vs. glargine
Delivery method problems:
IV:1 min peak conc
SC: 90min peak conc

Injectino site and depth

Question 23

Adminisitration

Answer 23

s/c: typical route
IVI:
1. DKA
2. Control in critical illness
3. Control in peri-operative period

Question 24

Side effects

Answer 24

Hypoglycaemia
Liphypertrophy
Wt. gain in T2DM

Question 25

Hypoglycaemia

Answer 25

At riskL EToH binge, beta lockers (mask symptoms), elderly

Question 26

Lipohypertrophy

Answer 26

Rotte injection site: abdomen and thighs

Question 27

Wt. gain in T2DM

Answer 27

reduced wt gain if insulin given with metformin

Question 28

Problems with actrarapid in the basal-bolus regime

Answer 28

1. absorbed over 3-4hrs: not physiological 2. Must give 15 mins before meal 3. Can - late post prandial hypoglycaemia 4. Immediate post-prandial hyperglycaemia may increase risk of DM complications

Question 29

Short acting insulin analogues

Answer 29

Fast onset and shorted duration Can be given just before start of meal Less chance of post-prandial hypoglycaemia