Session 2

Question 1

Rapid Acting Insulins

Answer 1

Aspart, Lispro, Glulisine

Question 2

Aspart

Answer 2

Novolog (rapid acting)

Question 3

Lispro

Answer 3

Humalog (rapid acting)

Question 4

Glulisine

Answer 4

Apidra (rapid acting)

Question 5

Onset/duration of rapid acting insulin

Answer 5

15 min/ 3-5 hr

Question 6

Regular Insulin

Answer 6

Humulin R and Novolin R

Question 7

Onset/Duration/Peak regular insulin

Answer 7

30-60min/4-6hr/2-3hr

Question 8

NPH Insulin

Answer 8

Humulin N and Novolin N

Question 9

NPH Insulin onset/duration/peak

Answer 9

1-4hr/10-16hr/6-10hr

Question 10

Basal Insulin

Answer 10

Glargine and Detemir

Question 11

Glargine

Answer 11

Lantus (Basal)

Question 12

Detemir

Answer 12

Levemir (Basal)

Question 13

Basal O/D/P

Answer 13

1hr/ up to 24 hr/ none, slight at 6-8hr (detemir)

Question 14

Pt. was on 60 units once daily NPH. Convert to Glargine.

Answer 14

1:1 so 60 units.

Question 15

Pt. was on 50 units NPH BID. Convert to Glargine.

Answer 15

reduce by 20% so 80 Units Glargine. (Lantus). Give 40 units BID. (Because dose is over 60 Units)

Question 16

Converting from Detemir to Glargine

Answer 16

Reduce dose by 20%

Question 17

Converting from NPH insulin to Detemir

Answer 17

1:1

Question 18

U 500 dosing

Answer 18

BID or TID

Question 19

Guidelines for Using U-500

Answer 19

> 200 units/day, compliant and reliable, insurance coverage, pt can recognize hypoglycemia

Question 20

A1C goal Normal

Answer 20

7.0

Question 21

Preprandial goal

Answer 21

70-130

Question 22

Postprandial goal

Answer 22

<180

Question 23

A1C goal for young healthy person

Answer 23

6.0-6.5

Question 24

A1C goal for older person or person prone to hypoglycemia

Answer 24

7.5-8.0

Question 25

% of people who die 1 year after they break a hip

Answer 25

50%

Question 26

Insulin Lispro AA changes

Answer 26

B28 Pro and B29 Lys flipped

Question 27

Aspart AA changes

Answer 27

B28 pro to asp

Question 28

Glulisine AA changes

Answer 28

B3 asn to lys and B29 lys to glu

Question 29

Why are rapid acting insulin rapid acting?

Answer 29

Exists as a hexamir in vial but changes to AA structure cause it to dissasociate more quickly.

Question 30

This insulin is longer acting because it forms a microprecipitate in tissues.

Answer 30

Glargine (Lantus)

Question 31

This insulin is longer acting because it forms bond with Albumin and slowly disassociates.

Answer 31

Detemir (Levemir)

Question 32

This insulin is longer acting because it forms a precipitate in the vial.

Answer 32

NPH (Humulin N and Novolin N)