Oral Glycemics 3 Flashcards
What is the general strategy of the “split-mixed” insulin treatment program?
- Regular insulin at breakfast and dinner
- NPH at breakfast and dinner
What is an important point to make to your patient when suggesting the classic “split-mixed” insulin treatment program?
The patient must be careful to not overdose on NPH insulin at dinner because it can result in fatal nocturnal hypoglycemia
Why is the “Split-mixed” insulin treatment program with bedtime intermediate insulin preferred to the classical SPTP?
There is a less likelihood for nocturnal hypoglycemia
What two insulins are recommended for patients on a budget?
Regular insulin and NPH
What is the overall goal of insulin treatment?
To mimic normal insulin secretory patterns
Describe the Basal/Bolus Insulin strategy using regular and NPH insulin
- Regular insulin at all meals
- NPH insulin at bed time
Describe the Basal/Bolus Treatment program with rapid-acting and long-acting analogs
- Either Aspart or Lispro at every meal
- Glargine or (high dose) Detemir once a day before bed
Major side effects of insulin?
- Hypoglycemia
- Weight Gain
- Local/systemic allergic reactions
- Lipoatrophy/hypertrophy
What types of insulin are used in pumps?
Rapid-acting insulins
Bobby is very good about checking his glucose, which he does 4 times a day. Although he is very diligent, what are possible downsides to his glucose-reading regimen?
- The 4 readings are only a “snapshot” view of blood glucose and does not indicate glucose rise or fall
George has an A1C of 6.7%. Although he has reached is goal of < 7%, his glycemic control quality may not be desirable. How?
He may have extreme highs and lows throughout his day which average to a low A1C.
Why is continuous glucose monitoring beneficial?
It not only shows glucose levels, but it shows trends/rates of glucose rise and fall
