Insulin and Diabetes Management
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Questions and Answers

What is the normal range for glycosylated hemoglobin levels (HbA1c)?

  • 7-9%
  • 6-8%
  • 5-7% (correct)
  • 4-6%

    • Which medication is known to have an adverse reaction of 'disulfiram (Antabuse) like reaction'?

  • Thiazolidinediones
  • Sulfonylureas (correct)
  • Incretin Mimetics
  • Alpha-Glucosidase inhibitors

    • Which drug is to be taken at the first bite of a meal?

  • Nateglinide (Starlix)
  • Pioglitazone (Actos)
  • Acarbose (Precose) (correct)
  • Metformin (Glucophage)

    • Which medication is associated with an increased risk of bladder cancer and has a black box warning?

    <p>Pioglitazone (Actos)</p> Signup and view all the answers

    Which drug has the adverse effect of increasing respiratory tract infections?

    <p>Sitagliptin (Januvia)</p> Signup and view all the answers

    Which medication slows the movement of food through the stomach and is indicated for adult Type 1 and 2 Diabetes that need blood sugar control?

    <p>Pramlintide Acetate (Symlin)</p> Signup and view all the answers

    Which drug blocks glucose reabsorption in the kidney and has adverse effects such as UTI, genital yeast infection, and hypotension?

    <p>Canagliflozin (Invokana)</p> Signup and view all the answers

    Which medication is specifically administered subcutaneously in the abdomen or upper thigh before major meals?

    <p>Pramlintide Acetate (Symlin)</p> Signup and view all the answers

    Which medication is known to decrease insulin resistance and increase insulin sensitivity?

    <p>Metformin (Glucophage)</p> Signup and view all the answers

    Which drug should be stored unopened in the fridge and given as a dose in mcg based on blood sugar?

    <p>Pramlintide Acetate (Symlin)</p> Signup and view all the answers

    Which medication specifically requires checking for allergy to sulfa before use?

    <p>Acarbose (Precose)</p> Signup and view all the answers

    Which drug has an adverse effect of URTI, rhinitis, bronchitis, back pain, headache, and needs monitoring for liver profile due to hepatotoxicity?

    <p>Pioglitazone (Actos)</p> Signup and view all the answers

    What is the function of insulin in the body?

    <p>Controls the use of glucose, protein, and fat</p> Signup and view all the answers

    What is the source of human insulin?

    <p>Synthetic and semi-synthetic</p> Signup and view all the answers

    What is the classification of insulin based on its duration of action?

    <p>Rapid acting, intermediate acting, and long acting</p> Signup and view all the answers

    What is the role of zinc in insulin?

    <p>Modifies the onset and duration</p> Signup and view all the answers

    What is the recommended treatment for hypoglycemia?

    <p>$10-15$ grams of simple CHO followed by complex CHO within 1 hour</p> Signup and view all the answers

    What are the potential signs and symptoms of hyperglycemia?

    <p>$BS&gt;200$, thirst, nausea, vomiting, abdominal pain, loss of appetite</p> Signup and view all the answers

    What is the onset of action for glucagon?

    <p>$1$, $10$, $20$ minutes</p> Signup and view all the answers

    What are the potential causes of diabetic ketoacidosis?

    <p>Too little insulin, missed dose, unregulated or extra meals</p> Signup and view all the answers

    What is the assessment recommendation for blood sugar levels?

    <p>$1⁄2$ hour before meals and HS</p> Signup and view all the answers

    What do signs and symptoms like irritability, hot flushed skin, fruity odor to breath indicate in diabetic patients?

    <p>Hyperglycemia (Diabetic Coma, Ketoacidosis)</p> Signup and view all the answers

    What is the function of glucagon in treating hypoglycemia?

    <p>Raises blood sugar levels by releasing glucose from the liver</p> Signup and view all the answers

    What is meant by 'Double check – insulin type & dose'?

    <p>Confirming the correct type of insulin and its dosage before administration</p> Signup and view all the answers

    What is the function of protein in insulin?

    <p>Decrease rate of absorption</p> Signup and view all the answers

    What does the acronym IVP stand for in the context of insulin administration?

    <p>Intravenous Push</p> Signup and view all the answers

    Which medication is used to treat hypoglycemia and acts by releasing glucose into the blood?

    <p>Glucagon</p> Signup and view all the answers

    What is the recommended initial treatment for hypoglycemia?

    <p>10 - 15 grams of simple carbohydrate</p> Signup and view all the answers

    Which signs and symptoms indicate diabetic ketoacidosis?

    <p>Fruity odor to breath</p> Signup and view all the answers

    What is the main objective of insulin resistance?

    <p>Increase insulin sensitivity</p> Signup and view all the answers

    Which medication has a risk of allergic reaction, especially with animal insulin?

    <p>Humulin</p> Signup and view all the answers

    What is the adverse effect associated with lipodystrophy?

    <p>Destruction of fat tissue</p> Signup and view all the answers

    What is the assessment recommendation for blood sugar levels?

    <p>1⁄2 hour before meals and HS</p> Signup and view all the answers

    What does 'Double check – insulin type & dose' mean?

    <p>Draw up: clear before cloudy (short / fast acting before intermediate acting)</p> Signup and view all the answers

    What is the onset of action for regular insulin?

    <p>10 minutes</p> Signup and view all the answers

    What does lipodystrophy cause at the injection site?

    <p>Destruction of fat tissue</p> Signup and view all the answers

    What is the recommended storage for unopened pre-filled syringes?

    <p>Room temperature for up to 1 month</p> Signup and view all the answers

    At what age can children self-administer medication according to the text?

    <p>8 to 9 years</p> Signup and view all the answers

    Which medication can cause a 'disulfiram (Antabuse) like reaction' as an adverse reaction?

    <p>Sulfonylureas</p> Signup and view all the answers

    What is the normal percentage range for glycosylated hemoglobin levels (HbA1c)?

    <p>&lt; 5.7%</p> Signup and view all the answers

    Which medication, when used during pregnancy, is not recommended according to the text?

    <p>Thiazolidinediones</p> Signup and view all the answers

    Which drug decreases insulin resistance, increases insulin sensitivity, and has a rare adverse effect of lactic acidosis?

    <p>Metformin</p> Signup and view all the answers

    Which medication has the adverse effect of hypoglycemia and requires caution in individuals with liver and bowel disease?

    <p>Acarbose</p> Signup and view all the answers

    Which drug is specifically administered subcutaneously and increases insulin secretions from beta cells?

    <p>Exenatide</p> Signup and view all the answers

    "Duetact" is a combination drug composed of which two medications?

    <p>(Pioglitazone, Glimepiride)</p> Signup and view all the answers

    "Invokana", "Farxiga", and "Jardiance" are drugs that collectively belong to which class of medications?

    <p>(SGLT2 inhibitors)</p> Signup and view all the answers

    "Januvia" and "Onglyza" are drugs that specifically inhibit the breakdown of which hormones?

    <p>(Incretin hormones)</p> Signup and view all the answers

    What is the action of "Pramlintide Acetate (Symlin)" according to the text?

    <p>(Slow the movement of food through the stomach)</p> Signup and view all the answers

    What is the recommended storage for opened pre-filled syringes?

    <p>At room temperature for 1 month</p> Signup and view all the answers

    At what age is it recommended for children to self-administer medication?

    <p>By age 8 to 9</p> Signup and view all the answers

    Which drug has the adverse effect of a 'disulfiram (Antabuse) like reaction'?

    <p>Glyburide</p> Signup and view all the answers

    What is the main objective of 'Incretin Mimetics'?

    <p>Stimulate beta cells to release insulin</p> Signup and view all the answers

    Which medication requires caution in individuals with liver and bowel disease?

    <p>Acarbose</p> Signup and view all the answers

    What is the action of 'Canagliflozin'?

    <p>Blocks glucose reabsorption in the kidney</p> Signup and view all the answers

    Which drug specifically inhibits the breakdown of incretin hormones?

    <p>Sitagliptin</p> Signup and view all the answers

    What is the adverse effect associated with 'Pramlintide Acetate (Symlin)'?

    <p>Nausea and vomiting, severe hypoglycemia</p> Signup and view all the answers

    'Invokana', 'Farxiga', and 'Jardiance' collectively belong to which class of medications?

    <p><code>Sodium-glucose cotransporter 2 (SGLT2) inhibitors</code></p> Signup and view all the answers

    'Pioglitazone' is used in combination with which other drug as 'Actoplus met'?

    <p><code>Metformin</code></p> Signup and view all the answers

    What is a potential adverse effect of Thiazolidinediones?

    <p>Fetal abnormality, disulfiram (Antabuse) like reaction, hepatotoxicity, photosensitivity</p> Signup and view all the answers

    Which drug specifically delays carbohydrate digestion and absorption?

    <p>Acarbose</p> Signup and view all the answers

    What is the role of protein in insulin?

    <p>To decrease the rate of absorption</p> Signup and view all the answers

    Which medication can cause a 'disulfiram (Antabuse) like reaction' as an adverse reaction?

    <p>Januvia</p> Signup and view all the answers

    At what age can children self-administer medication according to the text?

    <p>10 years old</p> Signup and view all the answers

    What is the function of zinc in insulin?

    <p>To modify onset and duration</p> Signup and view all the answers

    What does lipodystrophy cause at the injection site?

    <p>Destruction of fat tissue</p> Signup and view all the answers

    Which drug should be stored unopened in the fridge and given as a dose in mcg based on blood sugar?

    <p>Pramlintide Acetate</p> Signup and view all the answers

    What is the normal percentage range for glycosylated hemoglobin levels (HbA1c)?

    <p>&lt; 8%</p> Signup and view all the answers

    What is the recommended storage for unopened pre-filled syringes?

    <p>+2°C to +8°C</p> Signup and view all the answers

    Study Notes

    • Hormone produced by beta cells of pancreas: controls use of glucose, protein, and fat, stimulates glucose transportation, inhibits glucose release by liver
    • Insulin sources: animal (beef, pork), human (synthetic/semi-synthetic: Humulin, Novolin)
    • Insulin types and administration: U100/U300/U500, SQ, IVP, IV infusion, inhalation, classified as rapid acting, short acting, intermediate acting, long acting, mixed insulins
    • Insulin properties: protein (decrease rate of absorption), zinc (modify onset and duration)
    • Insulin dosage determination: HCP based on blood sugar and urine glucose levels
    • Insulin frequency: rapid/short - AC & HS, intermediate - once or twice/day, long - daily (usually HS)
    • Insulin coverage: AC & HS use regular insulin, 71-350 mg/dL requires increasing units
    • Causes of high insulin: too much insulin/wrong type, delay/omission of food, too much exercise, illness, diarrhea, vomiting, excessive alcohol
    • Signs and symptoms of high insulin: N&V, diarrhea, hunger, inability to concentrate, confusion, nervousness, anxiety, tremors, tachycardia, pale, cold and clammy skin, tired, drowsy, lethargy, coma
    • Findings in high insulin: BS < 60, negative urine sugar and ketones
    • Treatment for high insulin:Simple carbohydrates, complex carbohydrates, glucagon, correct fluids and electrolytes
    • Causes of low insulin: too little insulin/missed dose, unregulated or extra meals, stress, alcohol, diarrhea, infection
    • Signs and symptoms of low insulin: N&V, abdominal pain, distension, anorexia, dry mouth, irritability, hot, flushed skin, fruity odor to breath, Kussmaul’s respiration
    • Findings in low insulin: BS > 150, positive urine sugar and ketones, fluid and electrolyte imbalance
    • Treatment for low insulin: Regular insulin, correct fluids and electrolytes
    • Insulin adverse effects: hypoglycemia, allergic reaction, lipodystrophy, insulin resistance, adverse reactions to specific drugs (hypoglycemia, anorexia, N&V, heartburn, weight gain, weakness, numbness of extremities, heart and blood vessel disease, fetal abnormality, disulfiram-like reaction, hepatotoxicity, photosensitivity)
    • Insulin administration: 30 min before breakfast, check allergy to sulfa, long acting glipizide in stool, recognize hypoglycemia and treatment, not for use during pregnancy, stimulate insulin release from pancreas, monitor liver profile, delay carbohydrate digestion and absorption, reduce hepatic glucose production, increase insulin sensitivity, decrease insulin resistance, increase insulin secretions from beta cells, suppress glucagon secretion, slow gastric emptying, inhibit glucose reabsorption in the kidney, block glucose reabsorption in the kidney, take at first bite of meal.

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    Description

    Test your knowledge on insulin, a hormone produced by the beta cells of the pancreas. Learn about its functions in controlling the use of glucose, protein, and fat, as well as its various forms, strengths, and administration techniques.

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