Insulin

Question 1

what is insulin used for?

Answer 1

1) Type 1 diabetes (due to lack of production)
2) Type 2 diabetes (when oral hypoglycaemic treatment is inadequate)
3) Given IV for diabetic emergenies eg. DKA and Hyperglycaemic Hyperosmolar syndrome.
4) Perioperative glycaemic control
5) alongide glucose to treate hyperkalaemia

Question 2

How does insulin work in the treatment of:

1) DM
2) Hyperkalaemia

Answer 2

DM:

• In diabetes mellitus exogenous insulin stimulats glucos uptake from blood into tissues.
• Insulin stimulates glycogen, lipid and protein synthesis - -inhibits gluconeogenesis and ketogenesis

Hyperkalaemia:
-insulin drives K+ into cells. (short term fix)

Question 3

What are the side effects of insulin?

Answer 3

hypoglycaemia

Question 4

In what patients is there a particular risk of hypoglycaemia?

Answer 4

In patients with renal impairment, insulin clearance is reduced so increased risk of hypoglycaemia.

Question 5

What are the drug interactions of insulin?

Answer 5

• other hypoglycaemic agents —> risk of hypoglycaemia

- systemic corticosteroids increases insulin requirements.

Question 6

what is the prescription of insulin for home users?

Answer 6

1) long acting insulin 2X day (e.g. insulin glargine)

2) rapid or short acting with meals. (e.g. insulin aspart)

Question 7

how is insulin treatment monitored?

Answer 7

• measure cap blood glucose regularly
• HbA1c annually
• K+ measured every 4 hours with IV infusions