Insulins

Question 1

Rapid Insulins

Answer 1

novorapid, humalog, apidra, CSCI

pre/with meals; CHO count (10g = 1 unit)

onset 15m, peak 1h, duration 2-5h

Question 2

Short insulins

Answer 2

actrapid, humulin S; fixed/variable rate infusions

hyperglycaemia

onset 30-60m, peak 2-4h, duration 8h

Question 3

Intermediate insulins

Answer 3

Humulin I, insulatard

OD/BD, basal insulin

peak 4-8, duration 24h

Question 4

Long acting insulins

Answer 4

OD: Levemir, glargines (lantus, teageo), tresiban
BD: delemir

background insulin - control during food-free periods
glargine for elderly (fewer hypos)

onset 1-2h, small peak 4-12h, duration 16-24h

Question 5

Pre-mixed insulins

Answer 5

analogues: rapid + intermediate
(novamix 30, humalog 50)

human: short + intermediate
(Humulin M3, Insuman 15/25/50)

must be give with meals

Question 6

basal bolus regime

Answer 6

background insulin and short acting insulin (pre-meal boluses)

Question 7

adjustments

Answer 7

sick day rules: 2h ketones + BG; 10% extra insulin 2h

patterns, not single values
pre-meal hypo/hyper = adjust previous dose down/up

Question 8

complications

Answer 8

weight gain
injection site infection/abscess
lipohypertrophy/lipodystrophy
pain, lesions, scarring
insulin resistance (obesity/T2)
compliance