Therapeutic use of Insulin Flashcards
What is C peptide and what may the difference be with regards to this between someone who synthesises pancreatic insulin vs those who inject due to T1DM?
Molecule cleaved off insulin precursor molecule
No C peptide present in those who inject
Explain the loss of portal:peripheral gradient that is present in insulin therapy.
If pancreas synthesises insulin, portal system usually sees it first in high conc.
This is lost when insulin source is exogenous
What differentiates the length of action of different types of insulin and how does this work?
Molecular size
As it increases, takes longer for absorption from sub cut sites
Name some rapidly acting insulin types?
Actrapid
Novorapid
Huamalog
What is U100 insulin?
100 units/ml
What is U200 insulin?
200 units/ml
What is a basal bolus regime?
Once or twice daily long actin insulin to replace bodies regular background insulin release
Raid acting insulin before each meal to account for post-prandial glucose rises
When should people take their blood glucose?
When they are at a steady state (e.g. glucose not rising or falling)
Before meals
Before sleeping
What is important to do before increasing pre-bed long acting insulin?
Why?
Check 3am BM
To make sure BM isn’t dropping then rising again in middle of night
What is a continuous subcut insulin infusion regime and how does this differ to basal bolus?
What type of insulin is this?
What is the acronym for this method of glycaemic control?
Insulin pump administering varying rapid acting insulin dosages
CSII
What other insulin regimens are there apart from BBR and CSII?
Explain this regimen.
Twice daily mixed insulin regimen
Twice daily injection of a mix of long and rapid acting insulin
Name 2 aide effects of insulin therapy.
Hypoglycaemia
Weight gain
What are the CBG targets for a T1DM?
4-8mmol/L
When must diabetics inform the DVLA?
If insulin treated at any time due to the risk of hypos
What should BM be for diabetics pre-driving?
“Above 5 to drive”
