Insulin Therapy Flashcards
Proinsulin is stored in
golgi apparatus of beta cells
Glucose stimulates insulin release by increasing intracellular
calcium
Endogenous insulin is 60% metabolized by the __ and 40% by the
liver; kidneys
The portal insulin concentration is __ x the peripheral blood concentration
3
_____ insulin is the exact opposite metabolism mechanism vs ___ insulin
exogenous; endogenous
Insulin has __ effect on tissues
anabolic
Insulin is used in ___ type II diabetes and as a bridge before ___ meds
uncontrolled; oral
Standard insulin is packaged at __ units and the fast acting high insulin is at __ units/ml
100; 500
Aspart, lispro, and glulisine are __ __ human analogs of insulin
fast actings
Three categories of insulin acting
rapid; short; long
Regular human insulin takes __ minutes to act and lasts __ hours while rapid acting takes __ minutes and lasts ___ hours
30-60; 6-10; 5-15; 4-6
Rapid acting insulins have AA subs which disrupt __ interaction and disrupt __ formation
monomer-monomer; hexamer
The only difference between rapid insulin and regular is in the ____: the rest is the same
pharmacokinetics
Basal insulin is used in the ___ state and is often administered at __
fasting; night
The intermediate basal acting insulin is and it lasts
NPH; 10-20 hours
The addition of ____ slows the breakdown of NPH
protamine
A dangerous side effect of NPH is __ due to the peak level of its activity
hypoglycemia
Detemir binds __ and slowly gets dissociated from it all day
albumin
Glarine is stored in an ___ pH of _ solution and forms a _____ in the blood
acidic; 4; micro precipitate
Unlike NPH, Glargine and Detemir have ___ peaks and last about _ hours
flat; 24
Split mixed regimens are __% intermediate lasting and __% short acting (not __)
70/30 (long)
What is the dawn phenomenon
The early morning fall of tissue insulin sensitivity
The multiple injection therapy uses rapid acting insulin ___ and long acting ____
before each meal; once daily
The ___ __ insulin concept mimics natural insulin peaks
basal-bolus
Does the insulin pump measure blood sugar?
No
The insulin pump is not ___-___ and cannot pump insulin based on ___
self-regulated; glucose levels
Must __ insulin dose after exercise because of its ___ effects
lower; sensitizing
This complication of insulin therapy occurs during insulin peak
hypoglycemia
Insulin ___ is localized loss of __ at injection sites (localized swelling can occur- known as ___)
lipoatrophy; subq fat (lipohypertrophy)
