Insulin Flashcards
Which is the only insulin that can be administered intravenously?
Short Acting Insulin
What is the goal of rapid acting insulin?
Minimise post-prandial blood sugar rise
What is the goal of short acting insulin?
It works like natural insulin. Increases overall bodily ability to absorb glucose
When is short acting insulin administered?
Pre-prandially
What is the goal of intermediate acting insulin?
To control post prandial blood sugar after eating.
Helps regulate sugars throughout the day
What type of insulin has a high risk of causing hypoglycaemia?
Intermediate acting insulin
What is the onset time of Rapid acting insulin?
15 mins
What is the peak time of rapid acting insulin?
1-3 hours
What is the duration of Rapid Acting Insulin?
3-5 hours
What is the onset of short acting insulin?
30-60 mins
What is the peak time of short acting insulin?
2-3 hours
What is the duration of action of short acting insulin?
5-7 hours
What is the onset of action time for intermediate acting insulin?
60-90 mins
What is the peak time for intermediate acting insulin?
8-12 hours
What is the duration of action for intermediate acting insulin?
18-24 hours
What is the onset of action for Long Acting insulin?
4-8 hours
What is the peak time of Long acting insulin?
10-30 hours
What is the duration of action of Long acting insulin?
36+ hours
What is the onset of action of insulin analogues?
1.1 hours
What is the duration of action of Insulin analogues?
24 hours
What is the peak serum time of insulin analogues?
None, they are designed to act uniformly
What type of hormone is insulin?
Peptide Hormone
As well as making cells permeable to Glucose, what other substances do cells become more permeable to in the presence of insulin?
Amino Acids
Fatty Acids
Electrolytes
In the presence of insulin, cells in which tissues become “permeable” to glucose?
Hepatic Skeletal Muscle Adipose Myocardial Uterine
Insulin affects a number of metabolic pathways involving which substances?
Carbohydrates
Fats
Protein
What is Glycogenolysis? Where does it occur?
Breakdown of Glycogen into sugars. Liver
What is Glycogenesis?
Formation of glycogen from glucose
Which processes relating to glycogen does insulin affect?
Increases glycogenesis
Inhibits glycogenolysis
What is the mechanism by which insulin promotes fat storage?
- It promotes absorption of glucose by adipocytes
- Glucose gets broken down into products including A-glycerophosphate
- A-glycerophosphate together with free fatty acids ultimately leads to formation of triglycerides
What is Lypolysis?
Triglycerides stored in fat cells break down into free fatty acids and glycerol and are released and transported to the liver to fuel certain metabolic pathways
What waste products are produced by lypolysis?
Ketone Bodies
Acetate
What advise should parents/carers/patients be given regarding insulin?
Trained to monitor blood glucose
Know signs of hypoglycaemia and how to rectify it
Driving precautions - may need to advise DVLA
What blood sugar levels should be maintained for those using insulin?
Adults - Maintain between 4-9 mmol/l most of the time
Aim for 4-7 mmol/l Pre-prandial
Aim for <9 mmol/l Post prandial
What is the goad of long acting insulin?
Consistent delivery of activity throughout the day; no peak in activity
What is the first line recommendation for insulin?
Patients with type 1 diabetes should be offered multiple daily injection basal-bolus insulin regimens as the first-line choice. Insulin Detemir (long acting analogue) recommended - Alternative Insulin Glargine (long acting analogue) Rapid acting insulin analogue for mealtime insulin
What is the second line recommendation for insulin?
Twice daily mixed insulin regime.
Short acting insulin or rapid acting insulin analogue mixed with intermediate acting or long acting insulin analogue once or twice daily (before meals).
Insulin Side Effects?
Fat hypertrophy at injection site;
local reactions at injection site;
transient oedema
