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EBR MCQ > Insulin resistance and HI TDD > Flashcards

Insulin resistance and HI TDD Flashcards

1
Q

What condition is indicated by poor responsiveness to >200 units/day of U100 insulin?

A

Insulin resistance

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2
Q

What are the symptoms of the patient described?

A

Markedly uncontrolled, symptomatic hyperglycemia

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3
Q

What issues arise from high insulin doses?

A

Large-volume insulin injections cause discomfort and poor absorption

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4
Q

How many daily injections are typically required with U100 insulin?

A

4-5 daily injections

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5
Q

What is recommended for patients with severe insulin resistance?

A

Consider U500 regular insulin

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6
Q

What is unique about U500 regular insulin compared to regular insulin?

A

Longer duration of action (13-24 hours)

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7
Q

How many injections per day does U500 regular insulin allow?

A

2-3 injections per day

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8
Q

What type of delivery devices are available for U500 regular insulin?

A

U500 regular insulin pens

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9
Q

What guidelines are used for converting U100 doses to U500 doses?

A

Baseline U100 doses and hemoglobin A1c levels

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10
Q

If A1c is >8.0%, what percentage of the U100 dose should be used for conversion to U500?

A

100% of U100 dose

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11
Q

If A1c is ≤8.0%, what percentage of the U100 dose should be used for conversion to U500?

A

80% of U100 dose

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12
Q

What is one option for split dosing U500 regular insulin?

A

Twice daily (60% before breakfast, 40% before dinner)

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13
Q

What is another option for split dosing U500 regular insulin?

A

Three times daily (40% before breakfast, 30% before lunch, 30% before dinner)

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14
Q

Does switching from insulin glargine to insulin degludec significantly differ in A1c control?

A

No significant difference in A1c control

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15
Q

What is the effect of increasing the insulin dose by 20%?

A

Unlikely to improve glycemic control or address multiple daily injections

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16
Q

Are SGLT-2 inhibitors effective in lowering A1c to goal with low eGFR?

A

Ineffective in lowering A1c to goal

17
Q

Is adding Dulaglutide effective for this patient already on a GLP-1 receptor agonist?

A

Redundant as patient is already on a GLP-1 receptor agonist

EBR MCQ (7 decks)

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