Insulin/T1D

Question 1

What kind of molecule is insulin?

Answer 1

Peptide

Question 2

Insulin main action

Answer 2

Decrease blood glucose

Question 3

Insulin binds to an extracellular insulin receptor, activating an intracellular ____

Answer 3

Tyrosine kinase

Question 4

What effect does activation of tyrosine kinase by insulin have?

Answer 4

Glucose transporters (GLUT4) are translocated into the cell membrane to increase glucose uptake

Question 5

Efficacy of all insulins is equal; the differences among them is in their ______

Answer 5

Pharmacokinetics

Question 6

Regular insulin is ___-acting and ___ -acting

Answer 6

Rapid acting
Short acting

Question 7

Gold standard insulin

Answer 7

Regular insulin

Question 8

Most current insulins have a ____ pH

Answer 8

Neutral

Question 9

Isophane insulin suspension is also called

Answer 9

NPH

Question 10

Difference between regular insulin and NPH

Answer 10

NPH has slower onset and longer action than regular

Question 11

Unique physical characteristic of NPH

Answer 11

Cloudy (cannot give via IV)

Question 12

When is regular insulin usually used?

Answer 12

Before meals (1/2-1 hour before)

Question 13

NPH insulin is used for glucose control ___ and ___

Answer 13

Between meals
Overnight

Question 14

Rapid and short acting insulins

Answer 14

Lispro
Aspart
Glulisine

Question 15

Slow and long acting insulins

Answer 15

Glargine
Detemir
Degludec

Question 16

Insulin lispro peaks within __ minutes

Answer 16

30 minutes

Question 17

Timing of meal is __ critical with insulin lispro

Answer 17

Less critical (less risk of hypoglycemia from missed meal)

Question 18

When can insulin glulisine be injected?

Answer 18

Before meal
Immediately after meal

Question 19

Rapid acting synthetic insulins can be formulated with isophane/NP for ___

Answer 19

Between meal glucose control

Question 20

First ultra-long synthetic insulin

Answer 20

Insulin glargine

Question 21

When does insulin glargine peak?

Answer 21

Does not have a peak
Long, constant activity for 24+ hours

Question 22

When is insulin glargine administered?

Answer 22

Bedtime

Question 23

Differences between insulin glargine and detemir

Answer 23

Detemir has neutral pH, glargine is acidic
Detemir has 18 hour action, glargine is 24+

Question 24

Insulin with longest duration of action

Answer 24

Degludec (42+ hours)

Question 25

Why is insulin usually administered at bedtime?

Answer 25

Protects against nighttime glucose production by liver glycogen breakdown

Question 26

Insulin side effects

Answer 26

Hypoglycemia
Sympathoadrenal symptoms
CNS symptoms
Weight gain

Question 27

Treatment for severe hypoglycemia (unconscious)

Answer 27

Glucagon

Question 28

Insulin drug interactions

Answer 28

Tons of common drugs, especially propranolol and other B-blockers

Question 29

Non-insulin drug for T1D

Answer 29

Pramlintide

Question 30

Pramlintide is an analog of ____

Answer 30

Amylin (peptide hormone released with insulin from pancreatic beta cells)

Question 31

Effects of Pramlintide

Answer 31

Decreases post-prandial glucose
Decreases glucagon
Increases satiety/slows gastric emptying

Question 32

Downside to pramlintide

Answer 32

Increases number of injections