Part A DM Insulin (Lecture 2)

Question 1

When does basal insulin lower glucose?

Answer 1

Between meals and over night (fasting)

Question 2

Basal insulin account ____% of daily insulin needs

Answer 2

50%

Question 3

Which insulins are basal insulin products?

Answer 3

*NPH &DGD
-NPH
-Degludec (LA)
- Glargine (LA)
- Detemir (LA)

Question 4

Basal insulin has a _____ onset

Answer 4

Slow (11-24 hours/longer)

Question 5

Basal insulin color?

Answer 5

Clear solution

Question 6

Is basal insulin peakless?

Answer 6

YES

Question 7

Bolus insulin has a ____ onset & _____ DOA

Answer 7

Rapid & Shorter

Question 8

When does bolus insulin lower glucose?

Answer 8

During and after meals (post prandial hyperglycemia)

Question 9

Bolus insulin accounts for ______% of total daily insulin requirements at each meal

Answer 9

10-20%

Question 10

Which are rapid acting mealtime bolus insulins?

Answer 10

*GAL
-Glulisine
- Aspart
- Lispro

Question 11

Which are short acting mealtime bolus insulins?

Answer 11

*SR
-Regular insulin

Question 12

For Type 1 DM what does insulin replace?

Answer 12

Replaces normal pancreatic hormone production

Question 13

In Type 2 DM how is insulin utilized?

Answer 13

Insulin complements other oral drugs/ and or to supplement endogenous insulin release

Question 14

Insulin component of Humilin/Novolin 70/30

Answer 14

70% NPH & 30 regular

Question 15

Insulin component of Humilin 50/50

Answer 15

50 NPH & 50 Regular

Question 16

Insulin component of Humalog 75/25

Answer 16

75 Lispro protamine & 25 Lispro

Question 17

Insulin component of Humalog 50/50

Answer 17

50 Lispro protamine & 50 Lispro

Question 18

Insulin component of Novolog 70/30

Answer 18

70 Aspart protamine & 30 aspart

Question 19

What are the 2 premixed insulins with GLP-1RA?

Answer 19

• Glargine/ lixisenatide
• Degludec/ Liraglutide

Question 20

How do you initiate basal insulin for DM?

Answer 20

Begin with a single insulin dose @ bedtime (10-20 units). Use *Degludec, Glargine, Detemir, or NPH

Question 21

What should we target to correct first?

Answer 21

Fix fasting blood sugars first!

Question 22

Adjust and increase insulin dose every ______ days as needed to target FBG goal

Answer 22

3-4 days

Question 23

What is the FBG glucose goal?

Answer 23

80-100

Question 24

Titrate basal insulin dose by 2 units if FBG are between ______?

Answer 24

100-120 mg/dL

Question 25

Titrate basal insulin dose by 4 units if FBG are between ______?

Answer 25

121-140 mg/dL

Question 26

Titrate basal insulin dose by 6 units if FBG are between ______?

Answer 26

141-180 mg/dL

Question 27

Titrate basal insulin dose by 8 units if FBG are______?

Answer 27

> 180 mg/dL

Question 28

Type 1 Dosing formula

Answer 28

0.5 units/kg/d

Question 29

Type 2 dosing formula

Answer 29

0.7-1.0 units/kg/d

Question 30

1800 Rule

Answer 30

1800/TDD
*For RAPID ACTING insulin

Question 31

1500 Rule

Answer 31

• for SHORT ACTING insulin
  1500/TDD