Unit 5 - Diabetes 1 Flashcards

1
Q

What do all patients with type 1 diabetes need treatment with?

A

Insulin

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2
Q

How is insulin used to manage type 1 diabetes?

A
Prevent the development of severe hyperglycaemia
- ketosis
- ketoacidosis
- coma
- death
Decrease microvascular complications
- retinopathy
- nephropathy
- neuropathy
Avoid macrovascular complications in later life
- cardiovascular
- peripheral vascular problems
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3
Q

What is used to mimic the normal physiological secretion of insulin?

A

Exogenous insulin

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4
Q

What are the principle insulin types?

A
  • rapid acting
  • short acting
  • intermediate acting
  • long actingGIve
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5
Q

Give an example of an ultrarapid acting insulin

A

Insulin aspart

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6
Q

Describe the onset, timing and duration of insulin aspart

A

Onset - 5-10 minutes
Timing - 2 minutes before and up to 20 minutes after meals
Duration - 3-5 hours

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7
Q

Give three examples of rapid acting insulins

A

Insulin lispro
Insulin aspart
Insulin glulisine

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8
Q

Describe the onset, timing and duration of rapid acting insulins

A

Onset - 10-20 minutes
Timing - 0-15 minutes before or soon after meals
Duration - 2-5 hours

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9
Q

Give two examples of short acting insulins

A

Insulin soluble

Insulin porcine

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10
Q

Describe the onset, timing and duration of short acting insulins

A

Onset - 15-30 minutes
Timing - 15-30 minutes before meals
Duration - 6-12 hours

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11
Q

Give an example of an intermediate acting insulin

A

Isophane insulin

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12
Q

Describe the onset, timing and duration of intermediate acting insulins

A

Onset - 1-2 hours
Timing - once or twice daily
Duration - 10-12 hours

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13
Q

What are intermediate acting insulins complexed with?

A

Conventially, insoluble, cloudy suspensions of insulin complexed with either protamine (isophane or NPH insulin) or zinc (lente insulin)

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14
Q

Why do intermediate acting insulins take longer to work?

A

In order to be active, the insulin must dissociate from the protamine

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15
Q

What are the advantages of using intermediate acting insulins?

A

Do not need to be co-ordinated with meals

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16
Q

How are long acting insulins administered?

A

Basal-bolus regimes

17
Q

How are long acting insulins used?

A

Alongside rapid-acting insulin analogues in basal-bolus

18
Q

How are insulin glargine and insulin determir produced?

A

Using recombinant technology

19
Q

What is the duration of action of long acting insulins?

A

Around 24 hours

- a very flat PK profile

20
Q

What are the advantages of long acting insulins?

A

Limited peak/trough effects

Limited inter- or intra- patient variability

21
Q

Describe the onset, timing and duration of insulin detemir

A

Timing - once or twice daily
Onset - steady state after 2-3 doses
Duration - 24 hours

22
Q

Describe the onset, timing and duration of insulin glargine

A

Timing - once daily
Onset - 1.5-2 hours
Duration - 24 hours

23
Q

Give an example of ultralong acting insulin

A

Insulin degludec

24
Q

Describe the onset, timing and duration of insulin degludec

A

Timing - once daily
Onset - steady state after 2-3 hours
Duration - beyond 42 hours

25
Q

What is a combination insulin?

A

Combination of a short/rapid acting insulin with an intermediate acting insulin

26
Q

What is the role of insulin in the body ?

A

To help control glucose levels
When glucose levels are too high insulin is released which stimulates glucose uptake from the blood.
This lowers blood sugars

Glucose from the bloodstream enters liver cells, stimulating the action of several enzymes that convert the glucose to chains of glycogen—so long as both insulin and glucose remain plentiful.