Treatment of Diabetes – Insulin Flashcards
How many units of insulin does the pancreas secrete normally?
30 units per day
Type 2 diabetics typically lose which phase of insulin secretion?
Phase 1
Which glucose channel is constitutively expressed in beta cells?
GLUT2
What percent of T2 diabetics are using insulin?
50 percent
What are the brand names of the three fast-acting insulins?
Humalog (lispro)
Novolog (aspart)
Apidra (glulisine)
What are the three long-acting insulins and their brand names?
Detemir (Levemir)
Glargine (Lantus)
Degludec (Tresiba)
The ______________ have no peak.
long-acting insulins
What is MDI?
Multiple daily injections (also called basal-bolus or intensive insulin therapy)
In a non-diabetic, meals should raise blood glucose by _______________.
30 to 50
Detemir needs to be given __________ daily, while glargine needs to be given __________ daily.
twice; once
Insulin pumps secrete ______________.
rapid-acting insulin as a basal insulin
What stimulates second-phase insulin secretion?
Glucose that remains high after the initial rise
What concentrations are typically given in injectable insulin?
100 U/mL, 300 U/mL, or 500 U/mL
What are the peak times of fast-acting and intermediate-acting insulin?
Fast-acting: 1.5 hours
Intermediate-acting: 3-5 hours
How (chemically) does detemir last so long in the circulation?
It has an added fatty acid, so it binds to albumin.
Which insulin is dispensed as a cloudy solution?
Neutral protamine Hagedorn (think Hagedorn = Hazy)
What formula is used to estimate basal insulin needs per day?
0.2 U/kg/day (so a 70 kg person needs 14 U daily for basal levels)
What is the typical range for carbohydrate-to-insulin ratios?
8:1 to 20:1 (meaning an insulin-resistant person might need 1 unit of insulin for every 8 grams of carbohydrates, while an insulin-sensitive person might need 1 unit of insulin for every 20 grams of carbohydrates)
By how much does 1 unit of fast-acting insulin typically lower a person’s blood glucose?
20 mg/dL to 50 mg/dL
What is the “dawn phenomenon”?
Growth hormone typically rises between 4 am and 8 am, thus inducing hyperglycemia; patients with T1DM usually need more insulin during this time.
_____________ channels are blocked in beta-cells to stimulate secretion of insulin.
ATP-sensitive potassium
What are some signs that a type-2 diabetic might need insulin?
- Random glucose greater than 300
- Fasting glucose greater than 250
- Weight loss
- HbA1c greater than 10%
- Hospital admission for DKA or hyperosmolar syndrome
What are lab goals for diabetics receiving insulin?
- A1c less than 7.5% in children and 7.0% in adults
- Fasting glucose 70 - 130
- Two hours post-meal less than 180
If a diabetic is admitted to the hospital, stop _______________.
all non-insulin glucose-lowering agents
