Insulin Therapy Flashcards
What are the 2 insulin secretion responses?
Prandial
Basal
What is the rate of basal insulin secretion?
0.25-1.5 units/hour
What are the biphasic insulin secretion responses?
Preformed readily releasable (5-10 mins) Mobilization phase (1-2 hours)
Where is insulin secreted in to?
Portal vein
Give an example of rapid acting analogue and its duration.
Humalog/ Novorapid
0-5hrs
Give an example of short acting insulin and duration.
Humulin S (soluble) 0-8hrs
Give an example of an intermediate acting insulin and duration.
Humulin I (isophane) 0-20hrs
Give an example of long acting analogue insulin and duration.
Lantus/Levemir
0-24hr
Give an example of Rapid acting analogue/intermediate mix.
Humalog 25/Novomix30
Give an example of a short acting/intermediate mix.
Humulin M3
Describe the basal bolus regime and why is it used?
4 injections
1 basal (pre bed)
3 prandial (pre meal)
Mimics normal insulin secretion
What is the target blood glucose a) pre meal b) 1-2hrs after meal?
a) 3.9-7.2
b) <10
Why should T1DM patients use analogue insulin?
avoid hypos
When is the peak action of a) analogue b) soluble insulin?
a) 60-90 mins
b) 2-4 hrs
How is dosage of insulin calculated?
0.3 u/kg
50% is basal
50% is prandial (over 3 injections)
What is a) DAFNE and b) TIM?
a) dose adjustment for normal eating
b) tayside insulin management
What factors can affect insulin absorption?
pen accuracy leakage lipohyphertrophy injection depth exercise
When may you need IV insulin?
DKA
Hyperosmolar Hyperglycaemic state
Acute illness
Fasting patients
What prevents lipohypertrophy?
rotate injection sites
What can affect dosage given?
Sepsis/Acute illness
steroid therapy
Should insulin be continued in hypoglycaemia?
YES
Treat hypo AND continue insulin
