Week 141 Diabetes Flashcards
Long acting insulins?
Levemir - Insulin determir
Lantus - Insulin glargine
Short acting Insulins?
Actrapid (trade name) -Soluble insulin
What drug is Humalog?
Insulin Lispro
What drug is Apidra?
Insulin Glulisine
Rapid acting insulins?
Novorapid - Insulin Aspart
Apidra- Insulin glulisine
Humalog - Insulin lispro
Intermediate acting insulin?
NPH (neutral protamine Hagedorn)
Isophane (Insulatard/humulin I)
Which insulins can be provided as a continuous sub cut?
Novorapid
Actrapid (most common)
How many times a day do you inject long acting insulin?
once per day
How many times a day do you inject intermediate insulins?
Twice a day
What type of insulin do you use with type 1 Diabetes?
Long/Intermediate with short/rapid with meals
What type of insulin do you use with type 2 diabetes?
Can be treated with just long/intermediate.
Which device would you use to deliver novorapid?
Novapen cartridge
Which device would you use to deliver Lantus?
CliKstar Cartridge.
When filling in an insulin prescription chart, what things must you copmlete?
Name Hospital Number Date Initials Bleep Units & times Name (caps) Device for delivery (see BNF) Signature
A new patient advises you that they’re a diabetic on insulin. What do you ask?
Type
Units (how often included in this)
Times
Delivery Device
What does protamine do?
Protamine is combined with a rapid acting insulin to form crystals which delay absorbtion, giving an intermediate acting insulin profile.
Intermediate insulin peaks ___ hours after delivery.
5.5
Short acting insulin peaks how many hours after injection?
2.5
What does HLA mean?
Human Leukocyte antigen.
Which HLA mutations occur in Type 1 Diabetes?
DR3 & DR4
Which mutations occur in type 2 diabetes?
None. No HLA association.
What is the cause of type 1 diabetes?
Autoimmune beta cell destruction (islets of langerhan in the pancreas).
What is the cause of type 2 diabetes?
Beta cell destruction, insulin resistance.
How does type 1 diabetes typically present?
Polyuria
Polydipsia (excessive thirst)
Weight loss
Ketosis
What is Ketosis and what can cause it?
Elevated levels of ketone bodies in the blood.
Formed by ketogenesis when glycogen stores in the liver are depleted.
May result from fasting or switching to low carb diet.
The three main types of ulcer in the foot?
Neuropathic
Venous
Arterial
How often does NICE recommend eye tests for diabetics?
Once per 6/12. Usually more like once a year.
Which two drugs would be good for a diabetic patient with cvd and hypertension?
Ramipril
Statin
Name ELEVEN (11) Risk Factors for insulin resistance
Obesity, Age, Lack of exercise, Asian, Metabolic syndrome, Drugs, Pregnancy, Renal failure, Endocrine conditions (i.e. cushings)
Cystic fibrosis
PCOS (polycystic ovary syndrome)
What THREE classes of microvascular injury are associated complications of Diabetes?
Nephropathy
Retinopathy
Neuropathy
What FOUR classes of complications associated with Diabetes are MACROVASCULAR?
Stroke
Renal Disease
Peripheral Vascular Disease
Heart Disease
What is the normal glucose range (mmol/l)?
4-7
Above ___ HbA1c levels are particularly dangerous…
100
What is the normal Non-Diabetic range of HbA1c in mmol?
Approx 20-42
When treating, what principles should you consider?
Holistic approach BP control Hyperlipidaemia Diet/Exercise/lifestyle/alcohol Surgery DVLA
Which supplements are advisable for diabetic patients?
Cinnamon
Vanadium
Chromium
What is the popular term for the drug Biguanide?
Metformin
