Insulin Flashcards
Diabetes
Hyperglycemia
Affects the ability of the pancreas to produce or respond to insulin
Insulin
Peptide hormone produced by beta cells of islets on Langerhans in the pancreas
Regulates the metabolism of carbohydrates, fats and protein by promoting insulin absorption into liver, fat and skeletal muscle cells.
Insulin function
Makes the level of glucose in the bloodstream go down by allowing glucose to enter cells in the body, serving as fuel
Insulin mechanism
binds a receptor on the cell allowing glucose to pass through the cell membrane
Type I diabetes
someone stole the key
Type II diabetes
Door will not fully open even with the key
Regular insulin
beef, pork, or human
Sterile aqueous solution
pH 2.8-3.5 originally, now neutral
short-acting
May be administered by IV route
hexameric
Hexameric insulin
regular insulin complexed with zinc
slower because zinc must dissociate and separate, monomers are much faster
Isophane insulin suspension
sterile suspension in aqueous vehicle buffered with dibasic sodium phosphate to neutral pH
Prepared from zinc-insulin crystals modified by the addition of protamine
Rod-shaped crystals about 30 micrometers in length
Immediate acting
Neutral Protamine Hagedorn–NPH
Isophane insulin suspension components
insulin-100 uts
Protamine- 1.25 mg
Zinc-0.2 mg
Glycerin-1.6%
Phenol-0.25%
Diabasic sodium phosphate-0.2%
water for injection qs 1 mL
Insulin storage
store extra supply in refrigerator
Keep unrefrigerated insulin as cool as possible and away from light
Never shake insulin hard
Keep it from becoming too cold or hot (don’t freeze)
animal insulin
more immunogenic than humans
fast acting insulin
Lispro (humalog)–fastest
Insulin Aspart
Regular
Semilente
0.25 h onset
Duration 6-8 h
Intermediate acting insulin
NPH
Humulin R/N
Lente
1-1.5 h onset
duration 24 h
Long acting insulin
Ultralente
Humulin U
Insulin glargine
Detemir insulin
2-4 h onset
24 h duration
Mixed insulins
70/30
75/25
50/50
0.5 h onset
24 h duration
Short acting insulin
human/animal insulin
0.5-1 h onset
8-12 h duration
SC route
patient must be instructed to rotate sites on a continual basis
Each square is a place to give a shot
Regular rotation pattern
(Fastest) abdomen–> arms–> legs–> buttocks (slowest)
lipohypertrophy
Lipohypertrophy
build up of avascular fibrous tissue after continual injections in the same spot
Insulin pump
fewer needle pricks
rotate sites
risk of skin infection
local skin reactions
2-day use of infusion sets
continuous glucose monitoring
blood draw-gold standard
No more finger pricks
CGM sensor and insulin pump
closed loop system
e.g. low-glucose suspend system
Insulin vial injection
maintain equal pressure
pinch up area of skin
insert at 90 degree angle
count to 5 after injecting
Insulin lispro
changed Lys and Pro
Insulin aspart
changed proline to aspartic acid
Insulin glargine
added 2 agrinines to the end and a glycine
Detamir insulin
added a 14 carbon chain
hexamer–>dihexamer–>loss phenol and zinc–>dimers–>monomers–>enter capillaries
