Insulin Flashcards
What are common indications for insulin therapy?
- Type 1 and type 2 diabetes
- DKA
- HHS
- Hyperkalaemia
What is the mechanism of action of insulin?
- Increases glucose uptake by insulin-sensitive tissues (e.g. adipose, muscle)
- Increases glycogen synthesis in muscle and liver
- Increases amino acid uptake into muscle
- Increases protein synthesis
- Increases triacylglycerol synthesis in adipocytes and liver i.e. stimulates lipogenesis and inhibits lipolysis
- Inhibits the enzymes of gluconeogenesis in the liver
- Promotes K+ ion entry into cells
What are examples rapid acting insulins?
- Novorapid
- Apidra
- Humalog
When are do you need to be cautious with insulins?
- Renal impairment
- Hepatic impairment
- Pregnancy and breastfeeding
What are examples of intermediate acting Insulins?
- Novomix 30
- Humalog Mix25
- Humulin I
- Insulatard
What are examples of long acting insulins?
- Lantus
- Levemir
What are examples of short-acting insulins?
- Actrapid
- Humulin S
When is the peak effect of novorapid?
Within 10-20 minutes of administration
When is the peak effect of humalog?
15 minutes of administration
When is the peak effect of actrapid?
2-4 hours
When is the peak effect of humulin S?
30 minutes to 2.5 hours
When is the peak effect of insulatard?
45 mins - 12 hours
When is the peak action of Humulin I?
45 mins - 8 hours
When is the peak effect of humulin mix 25?
20 minutes - 2.5 hours
What type of insulin are novorapid 30 and humilin mix25?
Biphasic insulin - rapid + intermediate acting
When should analogue mixtures be administered?
Just before/during/after food
When should rapid acting insulins be administered?
Just before/during/after meals
When should short acting insulins be administered?
20-45 mins before food
When should long-acting insulins be administered?
Once/Twice a day, at the same time every day
What is a three times daily regimen?
Mix of short and intermediate acting before breakfast, short acting before lunch, and intermediate at bedtime
What is a basal bolus regimen?
Long acting mix once daily with short acting insulin before meals
What is a twice daily regimen?
Mix of short and intermediate acting given before breakfast and tea
What insulins are used in a twice daily regimen?
Premixed e.g. Novomix 30 or Humalog mix25
What is the normal daily requirement of insulin?
30-50 units - varies substantially between individuals
