INSULIN

Question 1

Rapid-acting insulin;— is approved by the FDA for use in children aged >2 y with type 1 DM for SC daily injections and for SC continuous infusion by external insulin pump; however, it has not been studied in pediatric patients with type 2 DM; onset of action is 10-30 minutes, peak activity is 1-2 h, and duration of action is 3-6 h.

Answer 1

insulin aspart

Question 2

Rapid-acting insulin; the safety and effectiveness of SC injections of — have been established in pediatric patients (aged 4-17 y) with type 1 DM; however, it has not been studied in pediatric patients with type 2 DM; onset of action is 20-30 minutes, peak activity is 1 h, and duration of action is 5 h.

Answer 2

insulin glulisine

Question 3

Rapid-acting insulin; only lispro U-100 is approved by the FDA to improve glycemic control in children aged >3 y with type 1 DM; however, it has not been studied in children with type 2 DM; onset of action is 10-30 minutes, peak activity is 1-2 h, and duration of action is 2-4 h.

Answer 3

• Insulin lispro

Question 4

Short-acting insulin. Novolin R has been approved by the FDA to improve glycemic control in pediatric patients aged 2-18 y with type 1 DM; however, it has not been studied in pediatric patients with type 2 DM; Humulin R is indicated to improve glycemic control in pediatric patients with diabetes mellitus requiring more than 200 units of insulin per day; however, there are no well-controlled studies of use of concentrated Humulin R U-500 in children.

Answer 4

Regular insulin

Question 5

Intermediate-acting insulin; it is indicated to improve glycemic control in pediatric patients with type 1 diabetes mellitus; onset of action is 3-4 h, peak effect is in 8-14 h, and usual duration of action is 16-24 h.

Answer 5

• Insulin NPH

Question 6

Long-acting insulin; the safety and effectiveness of - U-100 have been established in pediatric patients (6-15 y) with type 1 DM; however, it has not been studied in pediatric patients with type 2 DM.

Answer 6

• Insulin glargine.

Question 7

Long-acting insulin. —- is indicated for once- or twice-daily SC administration for the treatment of pediatric patients (aged 6-17 years) with type 1 DM; however, — has not been studied in pediatric patients with type 2 DM; onset of action is 3-4 h, peak activity is 6-8 h, and duration of action ranges from 5.7 h (low dose) to 23.2 h (high dose).

Answer 7

Insulin detemir

Question 8

Ultra-long-acting insulin; — is approved by the FDA to improve glycemic control in pediatric patients aged >1 y with type 1 or type 2 DM; it usually takes 3-4 days for — to reach steady state, peak plasma time is 9 h and the durations of action is at least 42 h; it is highly protein bound, and following SC, the protein-binding provides a depot effect.

Answer 8

insulin degludec