Type 1 Diabetes - Insulin

Question 1

What are the different types of insulin, based on their duration of action?
Give examples where relevant

Answer 1

• Rapid acting - e.g. Novorapid
• Short acting - e.g. Humulin S, Actrapid
• Intermediate acting - Humulin I
• Long acting - e.g. Insulin glargine
• Very long acting
  (Some come in mixed preparations)

Question 2

Rapid-acting insulin:

• When is it injected?
• How long is the onset of action?
• Peak?
• Duration?

Answer 2

• Injected immediately before eating
• Starts working within 5 - 15 minutes
• Peaks at 30 - 90 minutes
• Duration = 4 - 6 hours

Question 3

Short-acting insulin:

• Onset? Therefore when injected?
• Duration?

Answer 3

• Onset 30 - 60 minutes, so injected 15 - 30 mins before meal
• Duration - 8 - 10 hours

Question 4

What is intermediate insulin good for given its onset and duration?
Which other preparations can do this too?

Answer 4

Basal/overnight control

Long/very long acting

Question 5

List 3 ADRs of insulin therapy

Answer 5

Hypoglycaemia
Pain at injection site
Lipohypertrophy at injection site - insulin anabolic

Question 6

When might type 1 diabetics who are also asthmatic need to increase their insulin?

Answer 6

During exacerbations being treated with corticosteroids