T5 Diabetes PPT

Question 1

What is the typical concentration of U-100 insulin?

Answer 1

100 units/mL (~3.6 mg/mL).

Question 2

Which insulin concentration is used for patients with high insulin requirements?

Answer 2

U-500, which is 500 units/mL.

Question 3

What are the different types of insulin formulations based on their duration of action?

Answer 3

Rapid-acting, short-acting, intermediate-acting, long-acting, and ultra-long-acting.

Question 4

What is the onset time for regular insulin (Humulin R, Novolin R)?

Answer 4

Effects begin after ~30 minutes.

Question 5

What is the peak time for regular insulin?

Answer 5

Between 2 and 3 hours.

Question 6

What is the duration of action for regular insulin?

Answer 6

5-8 hours.

Question 7

What are some examples of rapid-acting insulin analogs?

Answer 7

Aspart, Glulisine, Lispro.

Question 8

When should rapid-acting insulin be administered?

Answer 8

15 minutes or less before a meal.

Question 9

How does insulin lispro differ from regular human insulin?

Answer 9

Two residues are reversed to prevent self-association and allow quicker absorption.

Question 10

What is the duration of action for rapid-acting insulin?

Answer 10

Approximately 3-6 hours.

Question 11

What are examples of long-acting insulin?

Answer 11

Insulin glargine (Lantus), Insulin detemir (Levemir).

Question 12

What is the duration of action for insulin glargine?

Answer 12

11-24 hours.

Question 13

What modification allows insulin detemir to have a longer duration of action?

Answer 13

Addition of myristic acid, which increases reversible binding to albumin.

Question 14

What is insulin degludec (Tresiba) known for?

Answer 14

Ultra-long-acting insulin with a half-life of 25 hours.

Question 15

What are the symptoms of mild hypoglycemia?

Answer 15

Sweating, palpitations, tremor, anxiety.

Question 16

What are the symptoms of severe hypoglycemia?

Answer 16

Difficulty concentrating, confusion, weakness, drowsiness, blurred vision.

Question 17

How should mild hypoglycemia be treated?

Answer 17

Dextrose tablets, glucose gel, or any sugar-containing food.

Question 18

What is the treatment for severe hypoglycemia in unconscious patients?

Answer 18

1 mg of glucagon injected SC or IM, or 50% glucose IV infusion.

Question 19

What is diabetic ketoacidosis (DKA)?

Answer 19

A life-threatening complication of untreated diabetes involving a lack of insulin and excessive ketone production.

Question 20

What are the key features of DKA?

Answer 20

Severe hyperglycemia, ketosis, and acidosis.

Question 21

What is the primary treatment for DKA?

Answer 21

IV insulin administration, IV fluids, and electrolyte replacement.

Question 22

What is the difference between DKA and hyperglycemic hyperosmolar state (HHS)?

Answer 22

HHS involves hyperglycemia without ketosis, primarily in type 2 diabetes.

Question 23

What are the glucose levels in HHS?

Answer 23

Glucose levels >600 mg/dL.

Question 24

How is HHS treated?

Answer 24

IV insulin, IV fluids, and electrolyte replacement.

Question 25

What is the onset of action for rapid-acting insulin analogs like insulin lispro?

Answer 25

Onset within 15 minutes.

Question 26

What is the duration of action for intermediate-acting insulin (NPH)?

Answer 26

10-16 hours.

Question 27

How often should long-acting insulin like glargine be administered?

Answer 27

Once daily.

Question 28

What is a basal-bolus insulin regimen?

Answer 28

A regimen using long-acting insulin for basal control and rapid-acting insulin for meal coverage.

Question 29

What percentage of total daily insulin dose is typically given as basal insulin in a basal-bolus regimen?

Answer 29

Approximately 50%.

Question 30

What are the benefits of basal-bolus insulin regimens?

Answer 30

Improved postprandial glucose control and greater flexibility with meals.

Question 31

What is continuous subcutaneous insulin infusion (CSII)?

Answer 31

An insulin pump delivering rapid-acting insulin continuously.

Question 32

How often should the infusion set of an insulin pump be changed?

Answer 32

Every 2-3 days.

Question 33

What is the main advantage of insulin pumps over multiple daily injections?

Answer 33

Better control of glucose levels with fewer hypoglycemic episodes.

Question 34

When should insulin be initiated in patients with type 2 diabetes?

Answer 34

When oral medications fail to achieve target A1C.

Question 35

What is the typical starting dose of basal insulin for type 2 diabetes?

Answer 35

0.1-0.2 units/kg per day.

Question 36

What is the primary goal of basal insulin in type 2 diabetes?

Answer 36

To control fasting blood glucose levels.

Question 37

What is the Somogyi effect?

Answer 37

Rebound hyperglycemia following an episode of nocturnal hypoglycemia.

Question 38

What is the Dawn phenomenon?

Answer 38

An early morning rise in blood glucose due to increased insulin resistance.

Question 39

How can the risk of hypoglycemia be minimized in patients on insulin therapy?

Answer 39

By adjusting insulin doses, timing meals, and monitoring blood glucose levels.

Question 40

How should basal insulin doses be adjusted?

Answer 40

Increase the dose by 2-4 units every 3-4 days until fasting glucose is within the target range.

Question 41

When should prandial insulin doses be adjusted?

Answer 41

Based on postprandial glucose levels or carbohydrate intake.

Question 42

What is insulin resistance?

Answer 42

Reduced sensitivity to insulin, requiring higher doses to achieve glucose control.

Question 43

What are common causes of insulin resistance?

Answer 43

Obesity, sedentary lifestyle, and certain medications like steroids.

Question 44

How is insulin resistance managed in patients with diabetes?

Answer 44

By increasing insulin doses or using insulin-sensitizing agents like metformin.

Question 45

What is the main difference between insulin pens and vials?

Answer 45

Pens are pre-filled and easier to use, while vials require syringes.

Question 46

What is the benefit of using insulin pens?

Answer 46

Convenience, more accurate dosing, and portability.

Question 47

What are the storage requirements for insulin pens?

Answer 47

Store unopened pens in the refrigerator, and opened pens at room temperature for up to 28 days.

Question 48

How should rapid-acting insulin be titrated?

Answer 48

Increase dose by 1-2 units based on postprandial glucose levels.

Question 49

What factors should be considered when titrating insulin doses?

Answer 49

Carbohydrate intake, physical activity, and blood glucose levels.

Question 50

What are common complications of insulin therapy?

Answer 50

Hypoglycemia, weight gain, and lipodystrophy.

Question 51

What is lipodystrophy in insulin therapy?

Answer 51

Abnormal distribution of fat at injection sites due to repeated insulin injections.

Question 52

How can lipodystrophy be prevented?

Answer 52

By rotating injection sites and avoiding repeated injections in the same area.

Question 53

What is the role of insulin degludec in diabetes management?

Answer 53

It provides ultra-long-acting basal insulin coverage with a half-life of 25 hours.

Question 54

How often is insulin degludec administered?

Answer 54

Once daily, regardless of the timing of meals.

Question 55

What are key clinical considerations when initiating insulin therapy?

Answer 55

Patient education on proper injection techniques, glucose monitoring, and hypoglycemia management.

Question 56

What are the signs of insulin overdose?

Answer 56

Severe hypoglycemia, confusion, seizures, and coma.

Question 57

How is insulin overdose treated?

Answer 57

Administration of glucagon or intravenous glucose.

Question 58

What is the role of metformin in insulin therapy?

Answer 58

It reduces insulin resistance and may allow for lower insulin doses.

Question 59

How does physical activity affect insulin sensitivity?

Answer 59

Exercise increases insulin sensitivity and may reduce the need for insulin.

Question 60

What is the effect of stress on blood glucose levels in patients with diabetes?

Answer 60

Stress increases cortisol and adrenaline levels, leading to higher blood glucose.