Flashcards in Diabetes - Treatment Deck (84)
What type of insulin (i.e. human or analogue) is most commonly used by type 1 diabetics and why?
Analogue, because it has a lower risk of hypoglycaemia
What is an example of a short-acting human insulin?
What is an example of a long-acting human insulin?
What are 2 examples of short-acting analogue insulins?
Novorapid (insulin aspart) and Humalog (insulin lispro)
What are 2 examples of long-acting analogue insulins?
Lantus (insulin glargine) and Levemir (insulin determir)
Which has a shorter duration of action- human or analogue insulin?
Patients with type 1 diabetes should be given an insulin to carbohydrate ratio and should be educated to match their prandial insulin dose to what 3 things?
Carbohydrate intake, pre-meal glucose and anticipated exercise
Do fingerprick blood glucose levels taken before meals inform about the long or short acting insulin dose?
Do fingerprick blood glucose levels taken after meals inform about the long or short acting insulin dose?
Explain what is meant by the basal bolus regimen of giving insulin?
A long-acting insulin is given before bed, and short-acting insulin doses are given with each meal
In a bi-daily insulin regimen, what type of insulin is given at the two daily doses?
A mixture of short and intermediate acting insulin
How fast acting is isophane insulin?
What type of insulin is given in a once daily insulin regimen? When should this dose be given?
An intermediate-long acting insulin is given before breakfast
When is a once daily insulin regimen used?
In type 2 diabetics, in conjunction with oral hypoglycaemic agents
Explain what is meant by continuous SC insulin infusion?
A rapid acting insulin is infused continuously, boluses are given with meals
When is IV insulin used?
In acute illness and fasting patients
If a patient is being given IV insulin and their blood glucose is > 12mmol/L, what should be checked?
What effect does insulin therapy have on weight?
What is the name for a lump of fat which accumulates under the skin at the site of many SC injections of insulin? How can this complication be avoided?
Lipohypertrophy, this can be avoided by regularly changing the injection site and using new needles daily
What is the major potential risk of insulin treatment?
What gets replaced in a pancreas transplant for type 1 diabetes?
Pancreatic islet cells
Which oral hypoglycaemic agent has the following mechanism of action: helps to increase insulin sensitivity and decrease hepatic gluconeogenesis?
Metformin is the first line pharmacological treatment for type 2 diabetes because it does not cause what two things?
Weight gain and hypoglycaemia
What is the most common side effect of metformin?
Which oral hypoglycaemic agent can cause a metallic taste in the mouth as a side effect?
Why should metformin be avoided in those with severe liver disease or renal failure?
Risk of lactic acidosis
What are the contraindications to the use of metformin?
CKD, and periods of time where there is tissue hypoxia (e.g. post-MI)
It is recommended that metformin should be stopped if the creatinine is greater than what, or the eGFR is less than what?
Creatinine > 150 / eGFR < 30
Is metformin safe to use during pregnancy and breastfeeding?