Insulin

Question 1

Describe the primary advantage of insulin therapy.

Answer 1

Insulin therapy lowers glucose in a dose-dependent manner and can address almost any level of blood glucose.

Question 2

What are the challenges of insulin therapy?

Answer 2

Challenges of insulin therapy include weight gain, the need for education and titration for optimal efficacy, risk of hypoglycemia, the need for regular glucose monitoring, and cost.

Question 3

What are some advances in insulin therapy geared toward better mimicking physiological insulin release patterns?

Answer 3

Advances in therapy include numerous formulations of insulin and devices such as prefilled syringes, auto-injectors, and intranasal insufflators.

Question 4

How can the approval of biosimilar insulins impact treatment costs?

Answer 4

The approval of biosimilar insulins may improve accessibility at lower treatment costs.

Question 5

What are the important aspects of education when initiating and intensifying insulin therapy?

Answer 5

Comprehensive education on self-monitoring of blood glucose, diet, injection technique, self-titration of insulin, and prevention and adequate treatment of hypoglycemia.

Question 6

What are some novel formulations and devices available for administering glucagon in the setting of severe hypoglycemia?

Answer 6

Novel formulations and devices include prefilled syringes, auto-injectors, and intranasal insufflators.

Question 7

How are starting doses of basal insulin estimated?

Answer 7

Starting doses of basal insulin are estimated based on body weight (0.1–0.2 units/kg per day) and the degree of hyperglycemia.

Question 8

What is the advantage of basal insulin analogs over NPH insulin?

Answer 8

Basal insulin analogs have shown a modest but significant reduction in HbA1c and the risk of total and nocturnal hypoglycemia compared to NPH insulin.

Question 9

How are starting doses of basal insulin estimated?

Answer 9

Starting doses of basal insulin are estimated based on body weight (0.1–0.2 units/kg per day) and the degree of hyperglycemia.

Question 10

What is the advantage of basal insulin analogs over NPH insulin?

Answer 10

Basal insulin analogs have shown a modest but significant reduction in HbA1c and the risk of total and nocturnal hypoglycemia compared to NPH insulin.

Question 11

How are starting doses of basal insulin estimated?

Answer 11

Starting doses of basal insulin are estimated based on body weight (0.1–0.2 units/kg per day) and the degree of hyperglycemia.

Question 12

What is the advantage of basal insulin analogs over NPH insulin?

Answer 12

Basal insulin analogs have shown a modest but significant reduction in HbA1c and the risk of total and nocturnal hypoglycemia compared to NPH insulin.

Question 13

What is a consideration when using longer-acting basal insulin analogs?

Answer 13

Longer-acting basal insulin analogs have a lower risk of hypoglycemia but may cost more.

Question 14

What are premixed insulins?

Answer 14

Premixed insulins combine basal insulin with mealtime insulin (short- or rapid-acting) in the same vial or pen, retaining the pharmacokinetic properties of the individual components.

Question 15

What is a potential advantage of premixed insulin?

Answer 15

Premixed insulin offers convenience for some individuals.

Question 16

What is a potential advantage of premixed insulin?

Answer 16

Premixed insulin offers convenience for some individuals.

Question 17

How are rapid-acting insulin analogs formulated as premixes?

Answer 17

Rapid-acting insulin analogs are formulated as premixes, combining mixtures of the insulin with protamine suspension and the rapid-acting insulin.

Question 18

What is an important aspect of education when using mixed insulin?

Answer 18

Education on the impact of dietary nutrients on glucose levels to reduce the risk of hypoglycemia while using mixed insulin is important.

Question 19

What is an important aspect of education when using mixed insulin?

Answer 19

Education on the impact of dietary nutrients on glucose levels to reduce the risk of hypoglycemia while using mixed insulin is important.

Question 20

What are some different routes of administration for insulin?

Answer 20

Insulins with different routes of administration include inhaled insulin and bolus-only insulin delivery patch pump.

Question 21

What are the advantages of concentrated insulins?

Answer 21

Concentrated insulins allow injection of a reduced volume and can be beneficial for individuals who require higher insulin doses.

Question 22

What are the important considerations when using concentrated insulins?

Answer 22

Cost and access are important considerations and can contribute to treatment discontinuation.

Question 23

What are the cardiovascular safety findings for insulin glargine U100 and insulin degludec?

Answer 23

Both insulin glargine U100 and insulin degludec have demonstrated cardiovascular safety in dedicated CVOTs.

Question 24

What are the cardiovascular safety findings for insulin glargine U100 and insulin degludec?

Answer 24

Both insulin glargine U100 and insulin degludec have demonstrated cardiovascular safety in dedicated CVOTs.

Question 25

What is the importance of education and support in insulin therapy?

Answer 25

The efficacy and safety of insulin therapy are largely dependent on the education and support provided to facilitate self-management.

Question 26

What are some challenges of insulin therapy?

Answer 26

Challenges of insulin therapy include weight gain, the need for education and titration for optimal efficacy, risk of hypoglycemia, the need for regular glucose monitoring, and cost.

Question 27

What are some advances in insulin therapy?

Answer 27

Advances in therapy include numerous formulations of insulin and devices such as prefilled syringes, auto-injectors, and intranasal insufflators.

Question 28

What are the potential benefits of biosimilar insulins?

Answer 28

Biosimilar insulins may improve accessibility and lower treatment costs.

Question 29

What are some considerations when initiating and intensifying insulin therapy?

Answer 29

Comprehensive education on self-monitoring of blood glucose, diet, injection technique, self-titration of insulin, and prevention and adequate treatment of hypoglycemia are important.

Question 30

What are some novel formulations and devices available for administering glucagon in severe hypoglycemia?

Answer 30

Novel formulations and devices include prefilled syringes, auto-injectors, and intranasal insufflators.

Question 31

How are starting doses of basal insulin determined?

Answer 31

Starting doses of basal insulin are estimated based on body weight and the degree of hyperglycemia, with individualized titration as needed.

Question 32

What are some considerations when using longer-acting basal insulin analogs?

Answer 32

Longer-acting basal insulin analogs have a lower risk of hypoglycemia but may cost more.