TY1M Flashcards
(30 cards)
Definition of type 1
Absolute insulin shortage in which there is little/ no endogenous insulin
Type 1 diabetic hb1ac target
48mmol/mol or below
Type 1 blood glucose concentration aims (waking, before meals, at least 90 mins after eating and when driving)
Waking- 5-7 mmol/L
Before meals - 4-7 mmol/L
90 mins after eating - 5-9 mmol/L
Driving - At least 5mmol/L
Multiple daily basal bolus
This regimen
allows you to customise insulin therapy based on the
carbohydrate content of each meal. Multiple bolus
injections of short-acting insulin before meals, as well
as intermediate-acting insulin or long-acting insulin
analogue as the basal insulin
Mixed biphasic regimen
Insulin preparations can either be mixed by the patient at the point of injection or used as a premixed preparation
Continuous SC insulin infusion (insulin pump)
A programmable pump and insulin storage reservoir give a regular or continuous dose of insulin (typically in the form of a rapid acting insulin analogue or soluble insulin)
First line option for TY1DM
Basal bolus
Rapid acting for bolus
Insulin detemir BD/ Insulin glargine OD for basal
Insulin dosage
The insulin dosage must be set specifically for each
patient, and it should be changed as needed based on
the results of routine blood-glucose monitoring. Physical
exercise, lower food consumption, compromised renal
function, and some endocrine diseases can all reduce
insulin needs (and hence raise hypoglycemia risk).
Infection, stress, and unintentional or surgical injuries
can all raise the insulin amount necessary.
Insulin and Hypoglycaemia
Insulin therapy causes hypoglycaemia, which is an
unavoidable side effect. Patients should be informed
about the warning signs and what they should do if they
see them.
If warning signs are lost, insulin regimens, dosages, and
blood-glucose objectives should all be continuously re-
evaluated. Continuous subcutaneous insulin infusion
treatment should be explored, as should real-time
continuous blood glucose monitoring. Patients should
be provided with structured education to ensure that
they are appropriately following the concepts of a
flexible insulin regimen.
Rapid acting insulin examples
Insulin Aspart (Novorapid, Fiasp)
Insulin Glulisine (Apidra)
Insulin Lispro (Humalog)
Rapid acting insulin onset of action
Within 15 minutes
Rapid acting Insulin peak action
1-2 hours
Rapid acting duration of action
2-5 hours
When to inject rapid acting insulin
Inject immediately before meals
Short acting insulins examples
All contain soluble insulin
Actrapid
Insuman Rapid
Humlin S
Short acting insulin when to inject
15-30 MINS BEFORE FOOD
Short acting insulin onset of action
30-60 mins
Short acting insulin peak action
1-4 hrs
Short acting insulin DURATION of action
5-8 hrs
Intermediate acting insulin examples
Insulatard, Humulin I, Insuman Basal
All contain isophane insulin or NPH insulin
Use of intermediate acting insulin
Can be a basal
Intermediate acting onset of action
1-2 hrs
Peak action of intermediate acting
3-12 hours
Intermediate acting insulin duration of action
11-24 hrs
