OnlineMedEd: Endocrinology - "Insulin Management" Flashcards

1
Q

Why do you give a basal insulin rate?

A

Physiologically the body has a static amount of insulin. The basal rate replaces that.

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2
Q

You’re supposed to give the rapid-acting insulin ____________.

A

before meals

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3
Q

The long-acting insulins both start with _____.

A

L (at least the trade names do)

Levemir
Lantus

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4
Q

What’s the difference between Humalin and Humalog?

A

Humalog is rapid-acting insulin. Humalin is a mixture of rapid-acting and long-acting (usually written as 70/30 or 50/50).

Same applies to Novolog/Novolin.

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5
Q

It’s recommended that diabetics use the long-acting insulin when?

A

Before bed

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6
Q

How should you add insulin to a type II diabetic’s medication regimen?

A
  • First, start with 0.1 U/kg of long-acting
  • Second, if their A1c is not in the desired range, then add a bolus for the biggest meal of the day.
  • Third/fourth, if the A1c is still not less than 7%, then add boluses for lunch and breakfast.
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7
Q

Go through the recommendation for how patients should check their blood glucose, give insulin, and eat.

A
  • First, they should check their blood glucose.
  • Second, they should bolus insulin.
  • Last, they should eat.

If they don’t eat they should not give insulin!!

Note: the blood glucose is a reflection of what they last ate and how effective the previous dose of insulin was at controlling their blood glucose.

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8
Q

What is the formula for doing total daily insulin (TDI) in the hospital?

A
  • First, calculate total requirements in 0.5 U/kg
  • Second, give half as basal QHS.
  • Third, give half as a bolus, divided into three before each meal.
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9
Q

Describe sliding scale.

A

Sliding scale is the method of checking blood glucose and then giving insulin based on how high it is. It’s not ideal because it’s reactive rather than proactive.

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