Insulin

Question 1

insulin aspart

(NovolLog, Fiasp)

Answer 1

Rapid-acting

Peak: 1 - 3 hr

Meal: bedside, immediately, 5-10 min

Question 2

insulin lispro

Answer 2

rapid-acting

Peak: 30 min - 1 hr

Meal: now, bedside, 5-10 min

Question 3

insulin regular (Humulin R, Novolin R)

Answer 3

• clear
• Peak: 2 - 4 hrs
• want meal within 30 - 60 min of being given

Question 4

insulin isophane (NPH, Humulin N, Novolin N, ReliOn N)

Answer 4

insulin isophane (NPH, Humulin N, Novolin N, ReliOn N)

cloudy

Peak: 4 - 12 hr

30 - 60 min

snack

Question 5

insulin glargine

Answer 5

• insulin glargine (Lantus, Toujeo)
• long-acting
• does not have peak
• 24 hr duration
• eat when hungry/desire

Question 6

metformin

Answer 6

Class: biguanides

• metformin (Glucophage)
• Action: acts on the liver, not the pancreas
  
  • therefore no risk of hypoglycemia
• taken off metformin while in admitted in facilities because cannot be given with contrast dyes (2 days before and after)
  
  • insulin used while in facility
  • increased stress so likely higher than normal blood sugar

Question 7

sulfonylureas

Answer 7

Class: sulfonylureas

• glimepiride (Amaryl)
• glipizide (Glucotrol)
• glyburide (Micronase) - most common?
• Action: increase insulin production by pancreas
  
  • ​–> can cause hypoglycemia
    
    • take about 30 min before meal
• can cause photosensitivity (give precautions for this)

Question 8

Diagnosis - Diabetes Mellitus

Answer 8

• A1C 6.5% or higher
  
  • a measure of blood glucose levels over 3 months
• fasting plasma glucose of 126 or greater at least two diff occasions
• 2-hour plasma glucose level 200 mg/dL or greater

Question 9

s/s of hypoglycemia vs hyperglycemia

Answer 9

Hypoglycemia

• cool, pale, sweaty, clammy/moist skin/sweating
  
  • “cool, clammy, needs some candy”
• headache, dizziness, lightheadedness
• anxiety, trembling, tachycardia
• confusion, irritable
• weakness, drowsiness
• hunger

Hyperglycemia

• polyuria
• excessive urination
• polydipsia
• increased/excessive thirst
• polyphagia
• increased/excessive or extreme hunger