Type 1 Diabetes

Question 1

Classification of Type 1 diabetes

Answer 1

B-cell destruction usually leading to absolute insulin deficiency

Question 2

Function of Insulin

Answer 2

Regulates glucose metabolism

Question 3

Effects of Insulin

Answer 3

Inhibits Glucagon release
Incr. lipogenesis
Decr. Lipolysis
Incr. AA transport into cells=Incr. Protein Synthesis
Decr. blood levels of glucose, FFA and ketones: decr. gluconeogenesis

Question 4

Which are the Ultra-fast acting Insulins

Answer 4

Lispro
Aspart
Glulisine

Question 5

PK of Ultra-fast acting insulins

Answer 5

Clear solution
Weak hexamers thus they dissociate into their monomers very rapidly

Question 6

Onst of action of the Ultra-fast acting Insulins

Answer 6

10-15 mins
Thus need to be taken 10-15mins prior

Question 7

DOA of Ultra-fast acting Insulins

Answer 7

3-5hrs

Question 8

Admin of Ultra-fast acting Insulins

Answer 8

SC

Question 9

Peak action of Ultra-fast acting Insulins

Answer 9

45-90mins

Question 10

What are the Short-acting Insulin

Answer 10

They are regular, soluble human insulin
Insulin that are formulated with soluble Zn complex which holds the monomers together–> dissociate slower

Question 11

When are the Short-acting Insulins used

Answer 11

Only in Emergency and they are administered via IV

Question 12

Onset of action of Short-acting Insulin

Answer 12

30 mins
thus 30mins prior and no skipping of meals

Question 13

DOA of Short-acting Insulin

Answer 13

6-8hrs

Question 14

What happens if a Short-acting Insulin is administered to a patient in Ketoacidosis

Answer 14

The IV infusion would cause disintegration of the monomers within seconds after administration

Question 15

What is an Intermediate-acting Insulin

Answer 15

Its an insulin Formulated with Zn or Protamine which causes the monomers of the insulin to be tightly held together thus their dissociation rate is much slower
*Cloudy solution-crystal formulation

Question 16

Onset of action of Intermediate-acting Insulin

Answer 16

1-3 hrs

Question 17

DOA of Intermediate-acting Insulin

Answer 17

18-20 hrs

Question 18

What is a Premixed insulin

Answer 18

Its a combination of short and intermediate acting insulins

Question 19

Onset of action of Premixed insulin

Answer 19

30 mins

Question 20

DOA of Premixed insulin

Answer 20

24 hrs

Question 21

Which are the Long-acting insulins

Answer 21

Glargine
Detemir
Degludec

Question 22

Glargine is conjugated with

Answer 22

Zn molecules

Question 23

Onset of action of Long acting insulins

Answer 23

G: 1 hr
D: 1-2 hrs
D: 30-90 mins

Question 24

DOA of Long-acting insulins

Answer 24

G: 24 hrs
D: 20 hrs
D: >24 hrs

Question 25

Admin of Long-acting insulins

Answer 25

Once daily SC injection

Question 26

Can Long-acting insulins be mixed with other insulins

Answer 26

Nope

Question 27

When are Long-acting insulins used

Answer 27

As alternatives to Intermediate insulins as they can provide Basal Levels of insulin

Question 28

Drugs that cause Hyperglycemic Effects (DIs)

Answer 28

Glucocorticosteroids
Estrogens
Glucagon
Diuretics
Overall: decr. glucose tolerance and Incr. Insulin requirements)

Question 29

Drugs that cause Hypoglycemic Effects (DIs)

Answer 29

Alcohol
Slaicylates (aspirin)
B-Blockers
ACE inhibitors (eg. Captopril)
Sulpher antibiotics
Overall: decr blood sugar levels thus decr. insulin

Question 30

Drugs that mask Hypoglycemia

Answer 30

B-Blockers such as:
Propranolol
Carvedilol

Question 31

How do B-blockers mask hypoglycameia

Answer 31

mask low blood sugar levels by causing Bradycardia and Sedation but they CANT mask SWEATING