insulin treatment Flashcards
Why do Type 1 diabetics need insulin therapy?
Destruction of pancreatic beta cells requires insulin replacement.
When do Type 2 diabetics need insulin therapy?
When diet, exercise, and oral antidiabetic medications are not enough.
Why is it important to know the peak action time of insulin?
Peak times indicate when insulin is most effective and when hypoglycemia risk is highest.
What does U-100 insulin mean?
1 mL of insulin contains 100 units.
Who typically uses U-500 insulin?
Patients requiring large insulin doses.
What devices can be used to administer insulin?
Syringe, pen injector, jet injector, pump, IV.
How should unopened insulin be stored?
In the refrigerator, not frozen, until expiration date.
How long can opened insulin be stored at room temperature?
Up to 1 month or until expiration date, whichever comes first.
How should insulin be stored to prevent damage?
Keep out of direct sunlight and extreme heat.
How long can insulin mixtures be stored?
1 month at room temp, 3 months in refrigerator.
How long can prefilled insulin syringes be stored?
1-2 weeks in the refrigerator.
Why store prefilled syringes with the needle pointing up?
Prevent insulin from clogging the needle.
What are the common insulin therapy schedules?
BID premixed regimen, intensive basal/bolus strategy, continuous subcutaneous infusion.
What blood glucose level defines hypoglycemia?
Less than 70 mg/dL.
How should hypoglycemia be treated in a conscious person?
15 g fast-acting carbohydrate (glucose tabs, juice, milk, soda, honey).
Why is chocolate not recommended for hypoglycemia?
Milk fats delay glucose absorption.
How should hypoglycemia be treated in an unconscious person?
IV glucose or parenteral glucagon (SQ/IM).
What is lipohypertrophy?
Subcutaneous fat deposits from repeated insulin injections at the same site.
How does insulin affect potassium levels?
It lowers blood potassium by promoting cellular uptake.
What drugs can cause additive hypoglycemia with insulin?
Sulfonylureas, meglitinides, beta-blockers, alcohol (EtOH).
What drugs counteract insulin by raising blood glucose?
Thiazide diuretics, glucocorticoids.
How do beta-blockers affect hypoglycemia symptoms?
They mask signs of hypoglycemia.
Why might pregnant/lactating women need insulin adjustments?
Increased calorie intake, infection, stress, growth spurts, 2nd/3rd trimesters require more insulin.
What insulin should never be mixed or used IV?
Long-acting and ultra-long-acting insulin.
How should insulin suspensions be mixed?
Gently rotate vials, never shake.
What insulin is used for IV therapy?
Regular insulin most commonly; aspart, glulisine, lispro may be used.
What is the typical IV insulin concentration?
100 units in 100 mL of 0.9% NS (1 unit/mL).
Why should 50 mL be wasted when priming IV tubing with insulin?
Prevent insulin adsorption to tubing.
Are oral antidiabetic medications effective for Type 1 diabetes?
No, they are only used for Type 2 diabetes.
What happens if a patient fails two oral antidiabetic medications?
Insulin is added to their regimen.
Name three sulfonylureas.
Glipizide, Glyburide, Glimepiride.
Name two meglitinides.
Repaglinide, Nateglinide.
What is the most common biguanide?
Metformin.
Name two thiazolidinediones (TZDs).
Pioglitazone, Rosiglitazone.
Name two alpha-glucosidase inhibitors.
Acarbose, Miglitol.
Name four DPP-4 inhibitors (gliptins).
Sitagliptin, Saxagliptin, Linagliptin, Alogliptin.
Name three SGLT-2 inhibitors.
Canagliflozin, Dapagliflozin, Empagliflozin.
Name a GLP-1 receptor agonist.
Semaglutide.
