Type I Diabetes - Insulin Flashcards
Whats C Peptide
Cleaved out from endogenous proinsulin to give insulin
How is insulin released from beta cells
Glucose GLUT 2 - low affinity high Kc
Glucose then ATP then close K+ channel, open Ca channel - insulin release
Insulin bind to RTK and increases GLUT4 - muscle adipose
GLUT 1245
1: all
2: liver kidney pancreas
4: muscle, adipose
5: fructose intestine
What are the 2 target insulin secretions that Insulin drugs need to cover
Basal + Prandial
What are the short classes of meal insulins [2]
Rapid Acting {LAG}
- Insulin Lispro/Aspart/Glulisine (lysine and Glutamic acid added)
[modified to increase propensity to maintain monomers]
JAB at meal times, Short duration of action lower risk of hypo
Short Acting - 30 mins prior
- Human Insulins
What is human insulin IV used for
DKA
Intermediate
NPH Neutral Protamine Hageborn
- human insulin plus that protamine - CLOUDY
Risk
- high px variability
- long peak effect - 4-8 hrs
Long Acting
Insulin Glargine/Detemir - prolonged action
- no peak, 24 hr action
- do not mix - clear, made at acidic pH
Ultra Long
Insulin Degludec - 42 hrs at physiological pH
Gimme 2 Insulin jab patterns
Morning take
- insulin glargine
- at each meals jab Rapid acting
Wake up
- each meal take rapid acting (w overlap durations)
- after dinner take NPH - but must eat Supper
2 AE of insulin medicine
Hypoglycaemia
Lipodystrophy (due to subcutaneous injection)
