Insulin therapy Flashcards
What is blood glucose lowered by?
Insulin
What is blood glucose raised by?
Glucagon
Adrenalin
Growth hormone
Cortisol
What is the difference in type 1 and type 2 diabetes?
Type 1 - the pancreas does not make insulin, because the body’s immune system attacks the islet cells in the pancreas that make insulin.
Type 2 - the pancreas makes less insulin than used to, and your body becomes resistant to insulin. Occurs because blood glucose is too high due to obesity, being overweight, inactivity.
Signs and symptoms of diabetes type 1
Thirst
Urinating more frequently
Feeling tired
Weight loss
Loss of muscle
Itchiness around genitals
Regular bouts of thrush
Blurred vision
Signs and symptoms of diabetes type 2
Urinating more frequently at night time
Feeling thirsty
Feeling tired
Weight loss
Cuts or wounds that heal slowly
Increased hunger
What are the principles of insulin therapy?
To maintain stable BGL that avoids hyperglycemia and hypoglycemia
What do insulin formulations differ in?
Time of onset
Peak effect
Duration of action
Why are there different formulations?
To enable more individualised optimisation of BGL and reduce incidence of fluctuations in BGL
Type 1 diabetes will use a combination of formulations to maintain BGL over a 24 hour period
What is a basal bolus regime?
Is a bolus of short acting plus either intermediate or long-acting. Mimics the body’s natural insulin release. Bolus covers post prandial rise and basal covers between meals and overnight.
What are the different formulations of insulin?
Rapid acting - rapid onset and short duration of action
Short acting - quick onset and moderate duration of action
Intermediate acting - longer onset of action and longer duration
Long acting - longest onset of action and longest duration
Insulin administration education
Rotating the site to avoid lipohypertrophy
Needle insterted at 90o angle
Ensure appropriate needle size
Safe disposal of sharps
IV - only in acute situations
Subcut - prefilled cartridge pens, insulin pumps
What are some safe storage for insulin?
Avoid extreme temps
Avoid exposure to sunlight
Keep unopened insulin in the fridge
Keep insulin currently in use at room temp
Use within 1 month
Never shake insulin, gently roll and invert
Adverse drug reactions to insulin
Hypoglycemia
Weight gain
Lipohypertrophy
Patient education for a patient who is experiencing a hypo
Give quick acting carbohydrate (e.g. 6 Jelly beans)
Recheck BGL in 10 mins - if still low repeat above
When BGL above 4mmol/L have a complex carbohydrate snack
If blood glucose not responding seek medical help
Avoid driving or operating machinery if having a hypo
Let GP or diabetes nurse if having regular hypos
If person is unconscious, ABCD and give glucagon injection
