Week 141 Diabetes

Question 0

Long acting insulins?

Answer 0

Levemir - Insulin determir

Lantus - Insulin glargine

Question 1

Short acting Insulins?

Answer 1

Actrapid (trade name) -Soluble insulin

Question 2

What drug is Humalog?

Answer 2

Insulin Lispro

Question 3

What drug is Apidra?

Answer 3

Insulin Glulisine

Question 4

Rapid acting insulins?

Answer 4

Novorapid - Insulin Aspart
Apidra- Insulin glulisine
Humalog - Insulin lispro

Question 5

Intermediate acting insulin?

Answer 5

NPH (neutral protamine Hagedorn)

Isophane (Insulatard/humulin I)

Question 6

Which insulins can be provided as a continuous sub cut?

Answer 6

Novorapid

Actrapid (most common)

Question 7

How many times a day do you inject long acting insulin?

Answer 7

once per day

Question 8

How many times a day do you inject intermediate insulins?

Answer 8

Twice a day

Question 9

What type of insulin do you use with type 1 Diabetes?

Answer 9

Long/Intermediate with short/rapid with meals

Question 10

What type of insulin do you use with type 2 diabetes?

Answer 10

Can be treated with just long/intermediate.

Question 11

Which device would you use to deliver novorapid?

Answer 11

Novapen cartridge

Question 12

Which device would you use to deliver Lantus?

Answer 12

CliKstar Cartridge.

Question 13

When filling in an insulin prescription chart, what things must you copmlete?

Answer 13

Name
Hospital Number
Date
Initials
Bleep
Units & times
Name (caps)
Device for delivery (see BNF)
Signature

Question 14

A new patient advises you that they’re a diabetic on insulin. What do you ask?

Answer 14

Type
Units (how often included in this)
Times
Delivery Device

Question 15

What does protamine do?

Answer 15

Protamine is combined with a rapid acting insulin to form crystals which delay absorbtion, giving an intermediate acting insulin profile.

Question 16

Intermediate insulin peaks ___ hours after delivery.

Answer 16

5.5

Question 17

Short acting insulin peaks how many hours after injection?

Answer 17

2.5

Question 18

What does HLA mean?

Answer 18

Human Leukocyte antigen.

Question 19

Which HLA mutations occur in Type 1 Diabetes?

Answer 19

DR3 & DR4

Question 20

Which mutations occur in type 2 diabetes?

Answer 20

None. No HLA association.

Question 21

What is the cause of type 1 diabetes?

Answer 21

Autoimmune beta cell destruction (islets of langerhan in the pancreas).

Question 22

What is the cause of type 2 diabetes?

Answer 22

Beta cell destruction, insulin resistance.

Question 23

How does type 1 diabetes typically present?

Answer 23

Polyuria
Polydipsia (excessive thirst)
Weight loss
Ketosis

Question 24

What is Ketosis and what can cause it?

Answer 24

Elevated levels of ketone bodies in the blood. Formed by ketogenesis when glycogen stores in the liver are depleted. May result from fasting or switching to low carb diet.

Question 25

The three main types of ulcer in the foot?

Answer 25

Neuropathic Venous Arterial

Question 26

How often does NICE recommend eye tests for diabetics?

Answer 26

Once per 6/12. Usually more like once a year.

Question 27

Which two drugs would be good for a diabetic patient with cvd and hypertension?

Answer 27

Ramipril | Statin

Question 28

Name ELEVEN (11) Risk Factors for insulin resistance

Answer 28

Obesity, Age, Lack of exercise, Asian, Metabolic syndrome, Drugs, Pregnancy, Renal failure, Endocrine conditions (i.e. cushings) Cystic fibrosis PCOS (polycystic ovary syndrome)

Question 29

What THREE classes of microvascular injury are associated complications of Diabetes?

Answer 29

Nephropathy Retinopathy Neuropathy

Question 30

What FOUR classes of complications associated with Diabetes are MACROVASCULAR?

Answer 30

Stroke Renal Disease Peripheral Vascular Disease Heart Disease

Question 31

What is the normal glucose range (mmol/l)?

Answer 31

4-7

Question 32

Above ___ HbA1c levels are particularly dangerous...

Answer 32

100

Question 33

What is the normal Non-Diabetic range of HbA1c in mmol?

Answer 33

Approx 20-42

Question 34

When treating, what principles should you consider?

Answer 34

``` Holistic approach BP control Hyperlipidaemia Diet/Exercise/lifestyle/alcohol Surgery DVLA ```

Question 35

Which supplements are advisable for diabetic patients?

Answer 35

Cinnamon Vanadium Chromium

Question 36

What is the popular term for the drug Biguanide?

Answer 36

Metformin