Insulin

Question 1

Type 1 diabetes

Answer 1

• No insulin
• Develops abruptly during childbirth
• Cannot be reversed w/ lifestyle modifications
• Lifelong insulin replacement
• Destruction of pancreas beta cells

Question 2

Type 2 diabetes

Answer 2

• Cellular resistance to insulin/impaired insulin action
• Most common
• Can be reversed w/weight loss & dietary changes

Question 3

Hyperinsulinemia

Answer 3

• Insulin resistance develops
• Type 2 diabetes

Question 4

Range for normal fasting blood glucose

Answer 4

74-106 mg/dl

Question 5

Range for before meals blood glucose

Answer 5

70-130 mg/dl

Question 6

Range for before sleep blood glucose

Answer 6

100-140 mg/dl

Question 7

Indication of insulin in type 1 diabetes

Answer 7

Need insulin to survive and require multiple injections daily

Question 8

Indication of insulin in type 2 diabetes

Answer 8

May need insulin depending on blood sugar levels & when under extreme stress

Question 9

Rapid acting insulin names

Answer 9

Aspart, Gluilsine

Question 10

Intermediate acting insulin name

Answer 10

NPH

Question 11

Long acting insulin names

Answer 11

Glagrine, detemir, degludec

Question 12

Therapeutic action of insulin

Answer 12

Promote the use of glucose by cells and promote storage of glucose as glycogen in the muscles

Question 13

Contraindications of insulin

Answer 13

• Hypersensitivity to the protein added during production
• Hypoglycemia
• Concurrent use of Rosiglitazone (oral diabetic)

Question 14

Side effects of insulin

Answer 14

• Headache
• Injection site reaction
• Lipodystrophy

Question 15

Lipodystrophy

Answer 15

Direct anabolic effect of insulin on local skin leading to fat and protein synthesis

Question 16

Adverse reactions to insulin

Answer 16

• Hypoglycemia
• Somogyi effect
• Hypokalemia
• Insulin shock
• Anaphylaxis

Question 17

Somogyi Effect

Answer 17

Wake up in middle of the night with low blood sugar levels that leads to high blood sugars in the morning

Question 18

Rapid acting insulin types

Answer 18

Insulin lispro (Humalog)
Insulin aspart (Novolog)

Question 19

Rapid acting insulin onset

Answer 19

10-30 minutes

Question 20

Rapid acting insulin peak

Answer 20

30 minutes-hour and a half

Question 21

Rapid acting insulin duration

Answer 21

3-5 hours

Question 22

Rapid acting considerations

Answer 22

Can be injected at the start of a meal

Question 23

Short acting insulin types

Answer 23

Humulin - Regular insulin
Novolin - Regular insulin

Question 24

Short acting onset

Answer 24

30 minutes

Question 25

Short acting peak

Answer 25

1-3.5 hours

Question 26

Short acting duration

Answer 26

4-12 hours

Question 27

Short acting considerations

Answer 27

-Usually injected 15-30 minutes before a meal - Clear solution

Question 28

Intermediate insulin types

Answer 28

- Humulin (NPH) - Novolin (NPH)

Question 29

Intermediate insulin onset

Answer 29

90 minutes

Question 30

Intermediate insulin peak

Answer 30

4-12 hours

Question 31

Intermediate insulin duration

Answer 31

14-24 hours

Question 32

Intermediate insulin considerations

Answer 32

- Used to control glucose levels between meals - Can be combined with short-acting insulin

Question 33

Long acting insulin types

Answer 33

- Insulin Glargine (Lantus) - Insulin Detemir (Levimir) - Insulin Degludec

Question 34

Long acting onset

Answer 34

60-120 minutes

Question 35

Long acting peak

Answer 35

0-12 hours

Question 36

Long acting duration

Answer 36

24-42 hours

Question 37

Long acting insulin considerations

Answer 37

Usually taken daily

Question 38

Hypoglycemia

Answer 38

Low blood sugars

Question 39

Cold and clammy - need some candy!

Answer 39

Hypoglycemia

Question 40

Symptoms of hypoglycemia

Answer 40

- Shaking - Sweating - Anxious/irritable - Dizzy/weak/fatigue - Hungry - Headache - Fast heart rate - Blurry vision

Question 41

Hypoglycemia blood sugar range

Answer 41

<70 mg/dl

Question 42

What kind of treatment for hypoglycemia?

Answer 42

- Rapid treatment: fast acting-oral sugar - IV glucose or parenteral glucagon

Question 43

Complications of nonadherence

Answer 43

Hyperglycemia

Question 44

Hyperglycemia

Answer 44

High blood sugars

Question 45

Hot and dry - sugar high

Answer 45

Hyperglycemia

Question 46

Causes of hyperglycemia in diabetics

Answer 46

- Illness/infection - Too much food - Inactivity - Too little or no diabetes meds - Physical or emotional stress

Question 47

Symptoms of hyperglycemia

Answer 47

- Extreme thirst - Dry skin - Sleepy - Hungry - Slow-healing wounds - Frequent urination - Blurry vision