therapeutic use of insulin

Question 1

what does insulin inhibit

Answer 1

liver glycogenolysis/gluconegensis, lipolysis.

adipocytes lipolysis

Question 2

what does insulin promote

Answer 2

glucose uptake in skeletal muscles and adipocytes

Question 3

what is the main differences between pancreas insulin and therapeutic insulin

Answer 3

injectable, no more c peptide, weight gain and not controlled endogenously there is a narrow therapuetic index, no portal peripheral gradient

Question 4

why is molecular size of insulin significant

Answer 4

Molecular size correlates with rate
of absorption from subcutaneous injection
sites,
 Molecular size correlates
with rate of absorption

Question 5

rapid acting insulin structures tend to be …

Answer 5

hexamers and monomers

Question 6

long acting insulin structures tend to be …

Answer 6

bound to other agents, attached to fatty acids, multi hexamers or pegylated insulin, acidic soloutions

Question 7

how man units are in a ml when prescribing insulin

Answer 7

100 units in a ml important!

Question 8

describe the basal bolus regimen of insulin

Answer 8

long acting insulin to maintain basal levels such as detemir and rapid acting analogues before meals to peak insulin. it aims to recreate how insulin is delivered in a non diabetic person.

Question 9

what are the rules around insulin dose adjustment

Answer 9

test pre meals and before bed, identify blood glucose targets, sort out hypos first. Identify biggest problem in blood glucose

Question 10

if a patient has a repeated problem with blood glucose concentration and the doctor wishes to adjust the insulin taken at this time how much should it be adjusted by

Answer 10

10-20%

Question 11

The doctor wishes to increase the patients pre bed long lasting insulin what should they check first

Answer 11

they should check the blood glucose at 3am

Question 12

if patient has blood glucose issue during pre evening meal where should insulin dose be adjusted

Answer 12

either long acting morning dose or pre lunch rapid acting

Question 13

if patient has blood glucose issue during pre brekfast meal where should insulin dose be adjusted

Answer 13

pre bed long acting insulin

Question 14

if patient has blood glucose issue pre bed where should dose insulin adjustment be made

Answer 14

pre evening fast acting insulin

Question 15

what is dafne

Answer 15

hcp passing on skills to patient to teach them how to replace insulin by matching it to Cho. adjusts insulin to lifestyle rather than the other way around

Question 16

what type of insulin does insulin pump therapy provide

Answer 16

continuous subcutaneous rapid acting insulin infusion

Question 17

why is type 2 diabetes seen as a progressive disease

Answer 17

because the b cell function gradually declines so less insulin and insulin sen sitivity can also decline

Question 18

what is twice daily mixed insulin

Answer 18

two injections each one is a mixture of rapid acting and more gradual insulin to achieve target BG

Question 19

name the two common times to administer insulin in twice daily mixed plan

Answer 19

pre brekfast mixed and pre evening mixed

Question 20

can you use insulin to treat type one and type two diabetes

Answer 20

yes but, Insulin is essential for the treatment of Type 1
and can be used in the treatment of Type 2
diabetes

Question 21

what are main side effects of insulin

Answer 21

Main side effects are:
– Hypoglycaemia
– Weight gain
– Very rarely allergies
• Properly used, it is very effective