Insulin

Question 1

Diabetes

Answer 1

Hyperglycemia
Affects the ability of the pancreas to produce or respond to insulin

Question 2

Insulin

Answer 2

Peptide hormone produced by beta cells of islets on Langerhans in the pancreas
Regulates the metabolism of carbohydrates, fats and protein by promoting insulin absorption into liver, fat and skeletal muscle cells.

Question 3

Insulin function

Answer 3

Makes the level of glucose in the bloodstream go down by allowing glucose to enter cells in the body, serving as fuel

Question 4

Insulin mechanism

Answer 4

binds a receptor on the cell allowing glucose to pass through the cell membrane

Question 5

Type I diabetes

Answer 5

someone stole the key

Question 6

Type II diabetes

Answer 6

Door will not fully open even with the key

Question 7

Regular insulin

Answer 7

beef, pork, or human
Sterile aqueous solution
pH 2.8-3.5 originally, now neutral
short-acting
May be administered by IV route
hexameric

Question 8

Hexameric insulin

Answer 8

regular insulin complexed with zinc
slower because zinc must dissociate and separate, monomers are much faster

Question 9

Isophane insulin suspension

Answer 9

sterile suspension in aqueous vehicle buffered with dibasic sodium phosphate to neutral pH
Prepared from zinc-insulin crystals modified by the addition of protamine
Rod-shaped crystals about 30 micrometers in length
Immediate acting
Neutral Protamine Hagedorn–NPH

Question 10

Isophane insulin suspension components

Answer 10

insulin-100 uts
Protamine- 1.25 mg
Zinc-0.2 mg
Glycerin-1.6%
Phenol-0.25%
Diabasic sodium phosphate-0.2%
water for injection qs 1 mL

Question 11

Insulin storage

Answer 11

store extra supply in refrigerator
Keep unrefrigerated insulin as cool as possible and away from light
Never shake insulin hard
Keep it from becoming too cold or hot (don’t freeze)

Question 12

animal insulin

Answer 12

more immunogenic than humans

Question 13

fast acting insulin

Answer 13

Lispro (humalog)–fastest
Insulin Aspart
Regular
Semilente
0.25 h onset
Duration 6-8 h

Question 14

Intermediate acting insulin

Answer 14

NPH
Humulin R/N
Lente
1-1.5 h onset
duration 24 h

Question 15

Long acting insulin

Answer 15

Ultralente
Humulin U
Insulin glargine
Detemir insulin
2-4 h onset
24 h duration

Question 16

Mixed insulins

Answer 16

70/30
75/25
50/50
0.5 h onset
24 h duration

Question 17

Short acting insulin

Answer 17

human/animal insulin
0.5-1 h onset
8-12 h duration

Question 18

SC route

Answer 18

patient must be instructed to rotate sites on a continual basis
Each square is a place to give a shot
Regular rotation pattern
(Fastest) abdomen–> arms–> legs–> buttocks (slowest)
lipohypertrophy

Question 19

Lipohypertrophy

Answer 19

build up of avascular fibrous tissue after continual injections in the same spot

Question 20

Insulin pump

Answer 20

fewer needle pricks
rotate sites
risk of skin infection
local skin reactions
2-day use of infusion sets

Question 21

continuous glucose monitoring

Answer 21

blood draw-gold standard
No more finger pricks

Question 22

CGM sensor and insulin pump

Answer 22

closed loop system
e.g. low-glucose suspend system

Question 23

Insulin vial injection

Answer 23

maintain equal pressure
pinch up area of skin
insert at 90 degree angle
count to 5 after injecting

Question 24

Insulin lispro

Answer 24

changed Lys and Pro

Question 25

Insulin aspart

Answer 25

changed proline to aspartic acid

Question 26

Insulin glargine

Answer 26

added 2 agrinines to the end and a glycine

Question 27

Detamir insulin

Answer 27

added a 14 carbon chain
hexamer–>dihexamer–>loss phenol and zinc–>dimers–>monomers–>enter capillaries