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Flashcards in therapeutic use of insulin Deck (21)
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1
Q

what does insulin inhibit

A

liver glycogenolysis/gluconegensis, lipolysis.

adipocytes lipolysis

2
Q

what does insulin promote

A

glucose uptake in skeletal muscles and adipocytes

3
Q

what is the main differences between pancreas insulin and therapeutic insulin

A

injectable, no more c peptide, weight gain and not controlled endogenously there is a narrow therapuetic index, no portal peripheral gradient

4
Q

why is molecular size of insulin significant

A
Molecular size correlates with rate
of absorption from subcutaneous injection
sites,
 Molecular size correlates
with rate of absorption
5
Q

rapid acting insulin structures tend to be …

A

hexamers and monomers

6
Q

long acting insulin structures tend to be …

A

bound to other agents, attached to fatty acids, multi hexamers or pegylated insulin, acidic soloutions

7
Q

how man units are in a ml when prescribing insulin

A

100 units in a ml important!

8
Q

describe the basal bolus regimen of insulin

A

long acting insulin to maintain basal levels such as detemir and rapid acting analogues before meals to peak insulin. it aims to recreate how insulin is delivered in a non diabetic person.

9
Q

what are the rules around insulin dose adjustment

A

test pre meals and before bed, identify blood glucose targets, sort out hypos first. Identify biggest problem in blood glucose

10
Q

if a patient has a repeated problem with blood glucose concentration and the doctor wishes to adjust the insulin taken at this time how much should it be adjusted by

A

10-20%

11
Q

The doctor wishes to increase the patients pre bed long lasting insulin what should they check first

A

they should check the blood glucose at 3am

12
Q

if patient has blood glucose issue during pre evening meal where should insulin dose be adjusted

A

either long acting morning dose or pre lunch rapid acting

13
Q

if patient has blood glucose issue during pre brekfast meal where should insulin dose be adjusted

A

pre bed long acting insulin

14
Q

if patient has blood glucose issue pre bed where should dose insulin adjustment be made

A

pre evening fast acting insulin

15
Q

what is dafne

A

hcp passing on skills to patient to teach them how to replace insulin by matching it to Cho. adjusts insulin to lifestyle rather than the other way around

16
Q

what type of insulin does insulin pump therapy provide

A

continuous subcutaneous rapid acting insulin infusion

17
Q

why is type 2 diabetes seen as a progressive disease

A

because the b cell function gradually declines so less insulin and insulin sen sitivity can also decline

18
Q

what is twice daily mixed insulin

A

two injections each one is a mixture of rapid acting and more gradual insulin to achieve target BG

19
Q

name the two common times to administer insulin in twice daily mixed plan

A

pre brekfast mixed and pre evening mixed

20
Q

can you use insulin to treat type one and type two diabetes

A

yes but, Insulin is essential for the treatment of Type 1
and can be used in the treatment of Type 2
diabetes

21
Q

what are main side effects of insulin

A
Main side effects are:
– Hypoglycaemia
– Weight gain
– Very rarely allergies
• Properly used, it is very effective