Insulin Therapy

Question 1

What are the 2 insulin secretion responses?

Answer 1

Prandial

Basal

Question 2

What is the rate of basal insulin secretion?

Answer 2

0.25-1.5 units/hour

Question 3

What are the biphasic insulin secretion responses?

Answer 3

Preformed readily releasable (5-10 mins)
Mobilization phase (1-2 hours)

Question 4

Where is insulin secreted in to?

Answer 4

Portal vein

Question 5

Give an example of rapid acting analogue and its duration.

Answer 5

Humalog/ Novorapid

0-5hrs

Question 6

Give an example of short acting insulin and duration.

Answer 6

Humulin S (soluble)
0-8hrs

Question 7

Give an example of an intermediate acting insulin and duration.

Answer 7

Humulin I (isophane)
0-20hrs

Question 8

Give an example of long acting analogue insulin and duration.

Answer 8

Lantus/Levemir

0-24hr

Question 9

Give an example of Rapid acting analogue/intermediate mix.

Answer 9

Humalog 25/Novomix30

Question 10

Give an example of a short acting/intermediate mix.

Answer 10

Humulin M3

Question 11

Describe the basal bolus regime and why is it used?

Answer 11

4 injections
1 basal (pre bed)
3 prandial (pre meal)
Mimics normal insulin secretion

Question 12

What is the target blood glucose a) pre meal b) 1-2hrs after meal?

Answer 12

a) 3.9-7.2

b) <10

Question 13

Why should T1DM patients use analogue insulin?

Answer 13

avoid hypos

Question 14

When is the peak action of a) analogue b) soluble insulin?

Answer 14

a) 60-90 mins

b) 2-4 hrs

Question 15

How is dosage of insulin calculated?

Answer 15

0.3 u/kg
50% is basal
50% is prandial (over 3 injections)

Question 16

What is a) DAFNE and b) TIM?

Answer 16

a) dose adjustment for normal eating

b) tayside insulin management

Question 17

What factors can affect insulin absorption?

Answer 17

pen accuracy
leakage
lipohyphertrophy
injection depth
exercise

Question 18

When may you need IV insulin?

Answer 18

DKA
Hyperosmolar Hyperglycaemic state
Acute illness
Fasting patients

Question 19

What prevents lipohypertrophy?

Answer 19

rotate injection sites

Question 20

What can affect dosage given?

Answer 20

Sepsis/Acute illness

steroid therapy

Question 21

Should insulin be continued in hypoglycaemia?

Answer 21

YES

Treat hypo AND continue insulin