Insulin

Question 1

Which is the only insulin that can be administered intravenously?

Answer 1

Short Acting Insulin

Question 2

What is the goal of rapid acting insulin?

Answer 2

Minimise post-prandial blood sugar rise

Question 3

What is the goal of short acting insulin?

Answer 3

It works like natural insulin. Increases overall bodily ability to absorb glucose

Question 4

When is short acting insulin administered?

Answer 4

Pre-prandially

Question 5

What is the goal of intermediate acting insulin?

Answer 5

To control post prandial blood sugar after eating.

Helps regulate sugars throughout the day

Question 6

What type of insulin has a high risk of causing hypoglycaemia?

Answer 6

Intermediate acting insulin

Question 7

What is the onset time of Rapid acting insulin?

Answer 7

15 mins

Question 8

What is the peak time of rapid acting insulin?

Answer 8

1-3 hours

Question 9

What is the duration of Rapid Acting Insulin?

Answer 9

3-5 hours

Question 10

What is the onset of short acting insulin?

Answer 10

30-60 mins

Question 11

What is the peak time of short acting insulin?

Answer 11

2-3 hours

Question 12

What is the duration of action of short acting insulin?

Answer 12

5-7 hours

Question 13

What is the onset of action time for intermediate acting insulin?

Answer 13

60-90 mins

Question 14

What is the peak time for intermediate acting insulin?

Answer 14

8-12 hours

Question 15

What is the duration of action for intermediate acting insulin?

Answer 15

18-24 hours

Question 16

What is the onset of action for Long Acting insulin?

Answer 16

4-8 hours

Question 17

What is the peak time of Long acting insulin?

Answer 17

10-30 hours

Question 18

What is the duration of action of Long acting insulin?

Answer 18

36+ hours

Question 19

What is the onset of action of insulin analogues?

Answer 19

1.1 hours

Question 20

What is the duration of action of Insulin analogues?

Answer 20

24 hours

Question 21

What is the peak serum time of insulin analogues?

Answer 21

None, they are designed to act uniformly

Question 22

What type of hormone is insulin?

Answer 22

Peptide Hormone

Question 23

As well as making cells permeable to Glucose, what other substances do cells become more permeable to in the presence of insulin?

Answer 23

Amino Acids
Fatty Acids
Electrolytes

Question 24

In the presence of insulin, cells in which tissues become “permeable” to glucose?

Answer 24

Hepatic
Skeletal Muscle
Adipose
Myocardial
Uterine

Question 25

Insulin affects a number of metabolic pathways involving which substances?

Answer 25

Carbohydrates Fats Protein

Question 26

What is Glycogenolysis? Where does it occur?

Answer 26

Breakdown of Glycogen into sugars. Liver

Question 27

What is Glycogenesis?

Answer 27

Formation of glycogen from glucose

Question 28

Which processes relating to glycogen does insulin affect?

Answer 28

Increases glycogenesis | Inhibits glycogenolysis

Question 29

What is the mechanism by which insulin promotes fat storage?

Answer 29

1. It promotes absorption of glucose by adipocytes 2. Glucose gets broken down into products including A-glycerophosphate 3. A-glycerophosphate together with free fatty acids ultimately leads to formation of triglycerides

Question 30

What is Lypolysis?

Answer 30

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

Question 31

What waste products are produced by lypolysis?

Answer 31

Ketone Bodies | Acetate

Question 32

What advise should parents/carers/patients be given regarding insulin?

Answer 32

Trained to monitor blood glucose Know signs of hypoglycaemia and how to rectify it Driving precautions - may need to advise DVLA

Question 33

What blood sugar levels should be maintained for those using insulin?

Answer 33

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

Question 34

What is the goad of long acting insulin?

Answer 34

Consistent delivery of activity throughout the day; no peak in activity

Question 35

What is the first line recommendation for insulin?

Answer 35

``` 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 ```

Question 36

What is the second line recommendation for insulin?

Answer 36

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).

Question 37

Insulin Side Effects?

Answer 37

Fat hypertrophy at injection site; local reactions at injection site; transient oedema