Treatment of Diabetes - Insulins

Question 1

Name the 3 Rapid-acting insulins:

Answer 1

lispro (Humalog)
aspart (Novolog)
glulisine (Apidra

Question 2

What are the pharmacokinetics of rapid acting insulins:
lispro (Humalog)
aspart (Novolog)
glulisine (Apidra

Answer 2

Onset of action 5-15 min
Peak 1-1.5 hr
Duration 3-5 hr

Question 3

When should patients take rapid releasing insulins and what is the route of admission

Answer 3

Given just prior to a meal by SQ injection or insulin pump

Question 4

name the Rapid-acting insulin that is Inhaled

Answer 4

Afrezza

Question 5

name the 2 Short-acting: Regular Insulins

Answer 5

(Humulin R; Novolin R)

Question 6

what are the pharmacokinetics of Humulin R; Novolin R

Answer 6

Onset of action 30-60 min
Peak 2 hr
Duration 6-8 hr

Question 7

what are the routes of admission for Humulin R; Novolin R

Answer 7

SQ injection, IV infusion

Question 8

name the 2 Intermediate-acting: NPH Insulins

Answer 8

Humulin N; Novolin N

Question 9

what are the pharmacokinetics of Humulin N; Novolin N

Answer 9

Onset of action 1-3 hr
Peak 6-8 hr
Duration 12-16 hr

Question 10

what is the route of admission of Humulin N; Novolin N

Answer 10

SQ injection only,

twice daily for basal coverage

Question 11

name the 4 long acting insulins

Answer 11

glargine (Lantus).
detemir (Levemir).
degludec (Tresiba).
glargine U-300 (Toujeo)

Question 12

what are the pharmacokinetics of the long acting insulins:
glargine (Lantus).
detemir (Levemir).
degludec (Tresiba).			
glargine U-300 (Toujeo)

Answer 12

Onset of action 1-1.5 hr
No pronounced peak
Duration: 24 hr (glargine) 
	12-20 hr (detemir)
	42 hr (degludec)

Question 13

which insulins Cannot be mixed in the same syringe with any other insulins

Answer 13

ong acting insulins:
glargine (Lantus).
detemir (Levemir).
degludec (Tresiba).			
glargine U-300 (Toujeo)

Question 14

when are biphasic insulins used?

Answer 14

Used twice a day just before AM and PM meals

Question 15

what are biphasic insulins

Answer 15

Mixture of intermediate- and short- or rapid- acting insulins - for basal AND meal insulin needs

Question 16

Basal insulin: definition

Answer 16

Insulin taken to suppress hepatic glucose production and to maintain normal fasting blood glucose levels

Question 17

______ insulin is used to metabolize nutrients in a meal or snack, and cover the postprandial rise in glucose. The ____________and inhaled insulin can be used for this purpose

Answer 17

Prandial,

rapid-acting insulins lispro, aspart, glulisine, fiasp,

Question 18

basal insulin is used even when a patient is fasting. insulin are used for this purpose

Answer 18

Glargine, detemir, NPH, and degludec

Question 19

The three purposes for insulin therapy include coverage of basal, prandial, and correctional needs. Together, the prandial and correctional insulin doses make up “bolus” insulin. Patients on this type of regimen are on ______ therapy.

Answer 19

basal bolus

Question 20

When is insulin therapy instituted in individuals with type 2 diabetes

Answer 20

When lifestyle modifications and combinations of non-insulin glucose-lowering therapies are inadequate to achieve target blood glucose levels,

Question 21

In some instances, individuals with type 2 diabetes come to medical attention experiencing marked weight loss with fasting blood glucoses _____, random glucoses of ____, and/or hemoglobin A1c of _____. In this instance, insulin therapy is instituted immediately because of these signs of severe insulin deficiency

Answer 21

> 250 mg/dL,
300 mg/dL,
10%

Question 22

Another situation necessitating the use of insulin therapy in type 2 diabetes is hospital admission for ________

Answer 22

hyperglycemic hyperosmolar state or diabetic ketoacidosis

Question 23

what is the treatment target for fasting blood glucose levels in diabetics

Answer 23

80 - 130 mg/dl

Question 24

what is the target therapeutic level of a1c levels in diabetics

Answer 24

< 7% for most adults
(<6.5%* if low risk for hypoglecemia
or <8%** higher risk hypoglycemia)
<7.5% for children

Question 25

what is the “closed-loop” system or “artificial pancreas

Answer 25

This a combination insulin pump and continuous glucose monitor that delivers insulin in a manner that requires less intervention and decision-making by the patient