Insulin Therapy

Question 1

What are the risks and contraindications of tight glucose control?

Answer 1

Risk: hypoglycaemia, in the elderly it can increase the risk of MI and stroke
Contraindication: hypoglycaemia unaware, elderly

Question 2

Name that type of insulin: Humalog (Lispro) and Novorapid (Aspart)

Answer 2

Humalog and Novorapid are very short acting analogues, “clear”, and are give as a bolus. The onset is within 5 min, it peaks at 1 hour and duration of action is 4 hours.

Question 3

Name that type of insulin: Humalin R and Novolin Toronto

Answer 3

Humalin R and Novolin Toronto are short acting “regular” and are given as a bolus. The onset is 30 min, it peaks at 3-4 hours and duration of action is 7-8 hours.

Question 4

Name that type of insulin: NPH and Human N

Answer 4

NPH and Humalin N are intermediate acting, and basal. The onset is 2 hours, peak is at 7-8 hours and duration of action is 12-16 hours.

Question 5

Name that type of insulin: Glargine and Determir

Answer 5

Glargine and Determir are long-acting, non-peaking basal insulin; “cloudy”. The duration of action is 18-24 hours.