Insulin - Considerations

Question 1

Considerations if there is poor control on insulin;

?-? to treatment.
Poor ? ?.
Non-? of injection ?.
Inappropriate dose ?.
Psychosocial issues.
Organic causes, including ?

Answer 1

non-adherence
injection technique
rotation site
titration
CKD

Question 2

Complications of Insulin Therapy.
General.
o ? ?: avoided by DAFNE.
o Insulin ? can develop.

Answer 2

weight gain

resistance

Question 3

At the injection site.
o ?, redness/ ?.
o Injection site ?
0 ?: can result in erratic insulin absorption

Answer 3

pain
swelling
abscesses
Lipohypertrophy

Question 4

Patients are asked to take ? finger pick glucose readings on ? days each week.

Optimal targets are;
Fasting plasma glucose level of ?-? mmol/L on ?.
Plasma glucose level of ?-? mmol/L ? meals at other times of the day.
Plasma glucose level of ?-? mmol/L ? minutes after eating.

Answer 4

4
2
5-7
waking
4-7
before
5-9
90

Question 5

The ‘? ? Rules’ were devised to help patients deal with ? illnesses, which can be dangerous if not managed effectively;

Do not stop their ? therapy.
o Seek ? from their diabetes team on how to adjust insulin doses.

Answer 5

sick day
intercurrent
insulin
advice

Question 6

Sick Day Rules

Monitor their blood ? more frequently.
o Every ?-? hours, including ?
.
Consider blood / urine ? monitoring.
o If ?, contact GP/diabetic service immediately

Answer 6

glucose
3-4
overnight
ketone
raised

Question 7

Sick Day Rules

Maintain their normal ? pattern where possible.
o Replace meals with ? ? if appetite reduced.
Drink at least ?L of fluid per day.
o Seek advice if unable to do this due to ?/?.
o ? ? may be required.
Once better, continue to control blood glucose carefully until it returns to
normal.

Answer 7

meal
sugary drinks
3
n,v
iv fluids

Question 8

Patients are required to notify the ? if;

They have had ? episodes of severe ? within the last ? months.
They have reduced ? of hypoglycaemic episodes.
They are on ? therapy.
—o If on insulin, they must test their blood glucose every ? hours on ? journeys, and also carry appropriate ? stores in case of
hypoglycaemic events.

Answer 8

dvla
2
hypo
12
awareness
insulin
2 long
glucose