OnlineMedEd: Endocrinology - "Insulin Management" Flashcards
Why do you give a basal insulin rate?
Physiologically the body has a static amount of insulin. The basal rate replaces that.
You’re supposed to give the rapid-acting insulin ____________.
before meals
The long-acting insulins both start with _____.
L (at least the trade names do)
Levemir
Lantus
What’s the difference between Humalin and Humalog?
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.
It’s recommended that diabetics use the long-acting insulin when?
Before bed
How should you add insulin to a type II diabetic’s medication regimen?
- 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.
Go through the recommendation for how patients should check their blood glucose, give insulin, and eat.
- 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.
What is the formula for doing total daily insulin (TDI) in the hospital?
- 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.
Describe sliding scale.
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.