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Flashcards in Insulin therapy in DM Deck (14):
1

how is endogenous insulin catabolized?

60liver/ 40kidney

2

how is subQ insulin catabolized?

60kidney/40liver

3

remember in pts with CKD that what?

kidney bears the weight of catabolizing insulin
-decrease insulin dose b/c it is staying on board longer

4

when would you use a U500?

in cases of severe insulin resistance

5

how did they make the insulin fast/slow acting?

changed the amino acid structure to allow to either be more readily or more slowly absorbed

6

what should you consider when starting to treat DM II pts with insulin?

are you working to augment or replace insulin?
are they coming out post op? hospitalizes? illness? glucose toxicity?

7

what is the process for glargine (insulin augmentation) in the type II DM?

10units QHS and titrate up in 2 unit increments based on FBS (morning sugars)

8

what are the steps to calculate multiple daily injections?

Step 1 type 1 0.2-0.6u/kg, type 2 0.4-1.0 u/kg (gives you a TDD)
Step 2 TDD x 0.5 (gives you daily basal dose)
Step 3 TDD x 0.5 (divide this by 3 to get injection amount at each meal)

9

why do you need to give more insulin to type II DM?

they are resistant to insulin

10

how do you assign the pre-mix insulin dosing for type II diabetics?

60% of TDD in the am
40% of TDD in the pm

11

why would you want to adjust basal insulin levels with an insulin pump?

in the morning, the body releases cortisol and GH which causes glucose levels to go up

12

what are presenting sxs of type 1 DM?

polydipsia/polyuria
SOB
fruity breathe
visual blurring

13

what are presenting sxs of type 2 DM?

obese
polyuria
visual blurring
acanthosis nigrans
yeast/skin infections
neuropathy

14

what causes dehydration of type 1 DM?

osmotic diuresis

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