Flashcards in Treatment of Diabetes – Insulin Deck (24):
How many units of insulin does the pancreas secrete normally?
30 units per day
Type 2 diabetics typically lose which phase of insulin secretion?
Which glucose channel is constitutively expressed in beta cells?
What percent of T2 diabetics are using insulin?
What are the brand names of the three fast-acting insulins?
What are the three long-acting insulins and their brand names?
The ______________ have no peak.
What is MDI?
Multiple daily injections (also called basal-bolus or intensive insulin therapy)
In a non-diabetic, meals should raise blood glucose by _______________.
30 to 50
Detemir needs to be given __________ daily, while glargine needs to be given __________ daily.
Insulin pumps secrete ______________.
rapid-acting insulin as a basal insulin
What stimulates second-phase insulin secretion?
Glucose that remains high after the initial rise
What concentrations are typically given in injectable insulin?
100 U/mL, 300 U/mL, or 500 U/mL
What are the peak times of fast-acting and intermediate-acting insulin?
Fast-acting: 1.5 hours
Intermediate-acting: 3-5 hours
How (chemically) does detemir last so long in the circulation?
It has an added fatty acid, so it binds to albumin.
Which insulin is dispensed as a cloudy solution?
Neutral protamine Hagedorn (think Hagedorn = Hazy)
What formula is used to estimate basal insulin needs per day?
0.2 U/kg/day (so a 70 kg person needs 14 U daily for basal levels)
What is the typical range for carbohydrate-to-insulin ratios?
8:1 to 20:1 (meaning an insulin-resistant person might need 1 unit of insulin for every 8 grams of carbohydrates, while an insulin-sensitive person might need 1 unit of insulin for every 20 grams of carbohydrates)
By how much does 1 unit of fast-acting insulin typically lower a person's blood glucose?
20 mg/dL to 50 mg/dL
What is the "dawn phenomenon"?
Growth hormone typically rises between 4 am and 8 am, thus inducing hyperglycemia; patients with T1DM usually need more insulin during this time.
_____________ channels are blocked in beta-cells to stimulate secretion of insulin.
What are some signs that a type-2 diabetic might need insulin?
- Random glucose greater than 300
- Fasting glucose greater than 250
- Weight loss
- HbA1c greater than 10%
- Hospital admission for DKA or hyperosmolar syndrome
What are lab goals for diabetics receiving insulin?
- A1c less than 7.5% in children and 7.0% in adults
- Fasting glucose 70 - 130
- Two hours post-meal less than 180