Insulin/T1D Flashcards
What kind of molecule is insulin?
Peptide
Insulin main action
Decrease blood glucose
Insulin binds to an extracellular insulin receptor, activating an intracellular ____
Tyrosine kinase
What effect does activation of tyrosine kinase by insulin have?
Glucose transporters (GLUT4) are translocated into the cell membrane to increase glucose uptake
Efficacy of all insulins is equal; the differences among them is in their ______
Pharmacokinetics
Regular insulin is ___-acting and ___ -acting
Rapid acting
Short acting
Gold standard insulin
Regular insulin
Most current insulins have a ____ pH
Neutral
Isophane insulin suspension is also called
NPH
Difference between regular insulin and NPH
NPH has slower onset and longer action than regular
Unique physical characteristic of NPH
Cloudy (cannot give via IV)
When is regular insulin usually used?
Before meals (1/2-1 hour before)
NPH insulin is used for glucose control ___ and ___
Between meals
Overnight
Rapid and short acting insulins
Lispro
Aspart
Glulisine
Slow and long acting insulins
Glargine
Detemir
Degludec
Insulin lispro peaks within __ minutes
30 minutes
Timing of meal is __ critical with insulin lispro
Less critical (less risk of hypoglycemia from missed meal)
When can insulin glulisine be injected?
Before meal
Immediately after meal
Rapid acting synthetic insulins can be formulated with isophane/NP for ___
Between meal glucose control
First ultra-long synthetic insulin
Insulin glargine
When does insulin glargine peak?
Does not have a peak
Long, constant activity for 24+ hours
When is insulin glargine administered?
Bedtime
Differences between insulin glargine and detemir
Detemir has neutral pH, glargine is acidic
Detemir has 18 hour action, glargine is 24+
Insulin with longest duration of action
Degludec (42+ hours)
Why is insulin usually administered at bedtime?
Protects against nighttime glucose production by liver glycogen breakdown
Insulin side effects
Hypoglycemia
Sympathoadrenal symptoms
CNS symptoms
Weight gain
Treatment for severe hypoglycemia (unconscious)
Glucagon
Insulin drug interactions
Tons of common drugs, especially propranolol and other B-blockers
Non-insulin drug for T1D
Pramlintide
Pramlintide is an analog of ____
Amylin (peptide hormone released with insulin from pancreatic beta cells)
Effects of Pramlintide
Decreases post-prandial glucose
Decreases glucagon
Increases satiety/slows gastric emptying
Downside to pramlintide
Increases number of injections
