Principles of Insulin Management Flashcards
Humalog
Rapid acting
Humalog
Rapid acting
NovoRapid
Rapid acting
Apidra
Rapid acting
Actrapid
Short acting
Insuman rapid
Short acting
Insulatard
Intermediate acting
Once daily insulin regime, when do you take your injection?
At night
Twice daily insulin regime, when do you take your injections?
Before breakfast and before dinner
Basal bolus insulin regime, when do you take your injections?
Long acting before bed and rapid acting before each meal (breakfast/lunch/dinner)
Factors affecting insulin absorption/action
Temperature
Injection site
Injection depth
Exercise
Why should you alternate injection sites?
Lipohypertrophy
Where can you inject?
Thighs, tummy, bum, upper arms
How to check you blood glucose control?
Home blood glucose monitoring kit
Urine testing
Glycated haemoglobin
Continuous monitor
Which trial is type 1 diabetes evidence based on?
DCCT!
Pre-prandial blood glucose target
4-7 mmol
Post meal blood glucose target
How should you adjust insulin if BG
Decrease insulin by 4 units
How should you adjust insulin if BG is 4-7 mmol/l?
Don’t, this is optimal
How should you adjust insulin if your BG is 8-14 mmol/l?
Increase insulin by 2 units
How should you adjust insulin if BG is >15 mmol/l?
Increase insulin by 4 units
When would you give IV insulin?
DKA
HHS
Acute illness
Fasting/patients who are unable to tolerate oral intake
Target BG if you are on IV insulin (i.e. ill)
5-12 mmol/L
Measurements you must do if on IV insulin
Hourly blood glucose (BG) monitoring Aim for BG 5 -12 mmol/L Free of hypoglycaemia Check ketones if BG > 12 mmol/L Check U & E’s at least daily Safe transition from IV to SC insulin
