Insulin regimes-Table 1

Question 1

When should insulin be initiated?

Answer 1

All type 1 diabetes, DM pts with A1C>=9%, and symptoms of complications, pts who fail maximal anti-hyperglycemic therapy

Question 2

insulin types

Answer 2

short acting-regular(human- 70/30 humulin humalog novolog), rapid acting (aspart,glulisine,lispro), intermediate-acting (NPH-non-proteated hagodorn-crystalizes), basal long acting(detemir,glargine)

Question 3

basal bolus ‘prandial” insulin regimes

Answer 3

long acting in am, then rapid acting insulin before each meal

Question 4

Sliding scale insulin regime

Answer 4

Used in hospitals, short acting insulin given at scheduled times base on blood glucose levels at that time

Question 5

Once-daily insulin regime

Answer 5

PO DPP4 inhibitor or GLP1 with 10 U detemir or glargine at night

Question 6

Twice daily insulin regime

Answer 6

Short acting insulin(70/30=regular/NPH and 50/50), rule is get 0.5U/Kg/day, 2/3 in am, 1/3 in evening

Question 7

Basal-bolus “Prandial” insulin regime

Answer 7

2x daily long acting insulin and rapid acting insulin before each meal - Long acting(10U detemir) rapid acting .1-.3 U/Kg of insulin lispro

Question 8

Sliding scale insuline regime

Answer 8

short acting insulin given q6h,q4h based on glucose levels, good during active inflammatory process or infection