Insulin Flashcards

1
Q

Name the intermediate basal insulin

A

NPH

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2
Q

Name the 3 long acting basal insulins

A
  1. Glargine
  2. Detemir
  3. Delgludec
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3
Q

What is the insulin starting regimen for Type 1 DM

A

basal-bolus

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4
Q

What is the starting regimen for most Type II DM

A

Metformin (+/- GLP-1) and basal insulin

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5
Q

Which insulins come from an animal source (pork)?

A

Short acting: Humulin R, Novolin R

NPH: Humulin N, Novolin N

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6
Q

Rapid Acting Insulins: onset

A

15-30minutes

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7
Q

Short acting insulins: onset

A

30min-1 hour

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8
Q

Intermediate active insulins: onset:

A

2-4 hours

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9
Q

Long Acting insulins: onset

A

1, 2, 4-5 hours

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10
Q

How much will 1 unit of insulin cover?

A

15g of carbohydrates

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11
Q

Storing insulin opened versus unopened bottles

A

opened: keep at room temperature
unopened: refrigerate

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12
Q

How much will one unit of insulin lower blood sugar in Type II DM?

A

30 mg/dL

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13
Q

How much will one unit of insulin lower blood sugar in Type I DM?

A

50 mg/dL

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14
Q

When choosing to add Prandial insulin, when and how much should you add?

A

begin prandial insulin before largest meal

10% of basal dose, or 5 units

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15
Q

If post prandial glucose is consistently >140mg/dL how much should you increase prandial insulin dose?

A

1-2 units

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16
Q

How do you calculate Total Daily Dose of insulin?

A

TDD (units) = weight in pounds /4

or

0.55*Weight in Kilograms

17
Q

If your patient’s blood sugar is >180mg/dL how much should you increase insulin dose?

A

increase by 20%

A. increase by 1 unit a day until FBS is between 80-120mg/dL

or

B. increase long acting by 1 unit every 2-3 days until FBS is at goal of 80-120mg/dL

18
Q

What is the ideal fasting blood sugar?

A

100

19
Q

What is the premeal ideal blood glucose?

A

<110

20
Q

What is the post meal target for blood sugar?

A

20-40mg/dL rise

<140mg/dL (<180 according to ADA)

21
Q

Bolus mealtime insulin is self-adjusted based on what?

A

carbs you are going to consume + correction of blood sugar higher than >110 premeal

22
Q

What calculation can be used to determine bolus dose?

A

Rule of 500:

500/total daily insulin dose= # of carbs that 1 unit of insulin will cover

23
Q

What is the correction factor used for?

A

Correction factor helps you determine how much 1 unit of short-acting insulin will lower the plasma glucose

24
Q

Correction factor (“Rule of 1800”)/ Insulin Sensitivity Factor (ISF) calculation

A

1800/TDD = how much 1 unit of insulin will lower the BG

25
Q

“Correction dose” for premeal high blood sugar

A

Actual BS - Target BS (110) / correction factor

26
Q

Total Mealtime dose

A

Total Mealtime Dose = CHO insulin dose + high blood sugar correction insulin dose

(ex. 6 units for meal CHO + 3 units for premeal BS correction = 9 units)

27
Q

IF your total daily insulin is 60 units how much is given in the morning?

A

2/3 or 40 units in this case

28
Q

Traditional insulins: Of the 40 units in the morning dose what is the ratio of NPH (intermediate) to Regular?

A

2/3 is NPH and 1/3 is Regular

NPH = 26 units
R= 13 units
29
Q

If your patient’s blood sugars are all messed up - which blood sugar do you fix first?

A

Fasting blood sugar

30
Q

What drug can be given for asymptomatic erratic gastric emptying?

A

Pramlintide (synthetic amylin)