Podcast
Questions and Answers
What is the primary trigger for the release of insulin from the pancreas?
What is the primary trigger for the release of insulin from the pancreas?
Which of the following is NOT a consequence of insulin deficiency?
Which of the following is NOT a consequence of insulin deficiency?
In which situation does the body require more insulin?
In which situation does the body require more insulin?
What role do beta cells in the pancreas play in managing diabetes?
What role do beta cells in the pancreas play in managing diabetes?
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What is the primary mechanism of action (MOA) for DPP 4 inhibitors?
What is the primary mechanism of action (MOA) for DPP 4 inhibitors?
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Which of the following medication classes is NOT an insulin type used for diabetes management?
Which of the following medication classes is NOT an insulin type used for diabetes management?
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Which side effect is commonly associated with GLP 1 receptor agonists?
Which side effect is commonly associated with GLP 1 receptor agonists?
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What is the most significant risk associated with incretin agents?
What is the most significant risk associated with incretin agents?
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Which of the following is NOT a side effect of DPP 4 inhibitors?
Which of the following is NOT a side effect of DPP 4 inhibitors?
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Which of the following medications is classified as a GLP 1 receptor agonist?
Which of the following medications is classified as a GLP 1 receptor agonist?
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What type of insulin is typically prescribed for basal insulin therapy?
What type of insulin is typically prescribed for basal insulin therapy?
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Which insulin should be added before meals to control postprandial glucose spikes?
Which insulin should be added before meals to control postprandial glucose spikes?
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For optimal effect, when should Insulin aspart be administered in relation to mealtimes?
For optimal effect, when should Insulin aspart be administered in relation to mealtimes?
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What nursing consideration is essential to teach Mrs. Johnson about her insulin therapy?
What nursing consideration is essential to teach Mrs. Johnson about her insulin therapy?
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Which of the following insulins is classified as long-acting?
Which of the following insulins is classified as long-acting?
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What is a characteristic of NPH insulin?
What is a characteristic of NPH insulin?
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Which insulin type is primarily used for IV insulin infusions?
Which insulin type is primarily used for IV insulin infusions?
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What is the action of rapid-acting insulin?
What is the action of rapid-acting insulin?
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What is the duration of action for Insulin lispro?
What is the duration of action for Insulin lispro?
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Which insulin type is commonly used as an IV route in acute care settings?
Which insulin type is commonly used as an IV route in acute care settings?
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How often should NPH insulin be administered?
How often should NPH insulin be administered?
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What is the onset time for Insulin degludec?
What is the onset time for Insulin degludec?
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Which of the following insulin types is described as 'cloudy insulin'?
Which of the following insulin types is described as 'cloudy insulin'?
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Insulin aspart should be injected how many minutes before meals?
Insulin aspart should be injected how many minutes before meals?
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What is the peak action time for 70% NPH insulin/30% regular insulin?
What is the peak action time for 70% NPH insulin/30% regular insulin?
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Which insulin type provides continuous glucose control primarily through a pump?
Which insulin type provides continuous glucose control primarily through a pump?
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How long can Insulin glargine effectively control blood sugar levels?
How long can Insulin glargine effectively control blood sugar levels?
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Which of the following statements about Insulin detemir is correct?
Which of the following statements about Insulin detemir is correct?
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What is the primary mechanism of action of Biguanides like Metformin?
What is the primary mechanism of action of Biguanides like Metformin?
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Which of the following medications is classified as a Thiazolidinedione (TZD)?
Which of the following medications is classified as a Thiazolidinedione (TZD)?
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What side effect is commonly associated with Thiazolidinediones (TZDs)?
What side effect is commonly associated with Thiazolidinediones (TZDs)?
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Which class of medications includes agents that stimulate insulin secretion?
Which class of medications includes agents that stimulate insulin secretion?
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What is a notable characteristic of SGLT 2 inhibitors?
What is a notable characteristic of SGLT 2 inhibitors?
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Which mechanism of action is NOT associated with Metformin?
Which mechanism of action is NOT associated with Metformin?
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Which of the following correctly matches a medication to its primary mechanism of action?
Which of the following correctly matches a medication to its primary mechanism of action?
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What mechanism of action do DPP-4 inhibitors like Sitagliptin share?
What mechanism of action do DPP-4 inhibitors like Sitagliptin share?
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Study Notes
Insulin and Diabetes: Review
- Insulin is synthesized by the pancreas' beta cells in the Islets of Langerhans.
- Insulin is released primarily when blood sugar levels increase, typically after meals rich in carbohydrates.
- Insulin deficiency is a common consequence of diabetes.
- Consequences of insulin deficiency include:
- Increased serum blood glucose levels.
- Decreased cellular glucose uptake.
- Increased glycogen breakdown.
- The body requires more insulin in situations such as:
- Infection.
- During periods of stress.
Insulin Types
-
Rapid acting insulin:
- Insulin lispro (Humalog) & Insulin aspart (Novolog) are examples.
- Onset: 15-30 minutes.
- Peak: 0.5-2.5 hours.
- Duration: 3-6 hours.
- Subcutaneous injections: 15 minutes before or immediately after meals.
- Suitable for subcutaneous pump therapy for continuous glucose control.
- Commonly used in sliding scale insulin therapy.
-
Short acting insulin:
- Regular insulin (Humulin R, Novolin R) is an example.
- Onset: 30-60 minutes.
- Peak: 1-5 hours.
- Duration: 6-10 hours.
- Subcutaneous injection: 30 minutes pre-meal for postprandial control.
- Subcutaneous pumps can be used for continuous glucose control.
- May be used in sliding scale insulin therapy.
- Can be given intravenously in acute care settings.
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Intermediate acting insulin:
- NPH insulin (Humulin N, Novolin N) is an example.
- Onset: 1-2 hours.
- Peak: 6-14 hours.
- Duration: 16-24 hours.
- Usually administered subcutaneously twice daily at the same times each day.
- Requires agitation before use due to its cloudy appearance.
- Can be mixed with rapid or short-acting insulins.
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Long acting insulin:
- Insulin glargine (Lantus) and Insulin detemir (Levemir) are common examples.
- Onset: ~ 1 hour for Lantus, 1-2 hours for Levemir.
- Peak: None.
- Duration: 18-24 hours.
- Typically administered subcutaneously once daily at the same time.
- Both are clear insulins.
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Ultra long acting insulin:
- Insulin degludec (Tresiba) is an example.
- Onset: 30-90 minutes.
- Peak: None.
- Duration: >24 hours.
- Administered once daily at the same time.
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Combination insulins:
- 70% NPH insulin/30% regular insulin (Humulin 70/30, Novolin 70/30) is an example.
- Onset: 30-60 minutes for the regular component.
- Peak: 2-12 hours for the NPH component.
- Duration: 10-16 hours.
-
Nursing implications for insulin therapy:
- Patient education about the different types of insulin and appropriate administration is crucial.
- Close monitoring of blood glucose levels is essential.
- Importance of consistent meal planning and regular exercise.
- Hypoglycemia awareness and management are important.
- Understanding of potential side effects, including hypoglycemia.
Non-insulin Diabetic Medications:
-
Insulin sensitizers:
-
Biguanides:
- Metformin (Glucophage) is the most commonly used.
-
Mechanism of Action (MOA):
- Reduces hepatic glucose production.
- Decreases insulin resistance in muscle and fat cells.
- Slightly reduces glucose absorption in the gut.
-
Side Effects:
- Gastrointestinal upset.
- Lactic acidosis (rare but serious).
-
Thiazolidinediones (TZDs):
- Rosiglitazone (Avandia) is an example.
-
MOA:
- Improves insulin sensitivity in muscle and fat cells.
- Reduces hepatic glucose production.
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Side Effects:
- Most commonly: Upper respiratory tract infections, headache, sinusitis, myalgia.
- Increased risk of heart failure, especially in patients with pre-existing heart conditions.
-
Biguanides:
-
Incretin Agents:
-
GLP 1 Receptor Agonists:
- Liraglutide (Victoza) is an example.
-
MOA:
- Activates receptors for GLP-1, promoting insulin secretion and reducing glucagon secretion.
- Slows gastric emptying, reducing postprandial glucose spikes.
-
Side Effects:
- Gastrointestinal upset.
- Allergic reactions.
- Pancreatitis.
- Thyroid cancer (although rare).
-
DPP 4 Inhibitors:
- Sitagliptin (Januvia) is an example.
-
MOA:
- Inhibits dipeptidyl peptidase-4 (DPP-4), which breaks down incretin hormones like GLP-1.
- Increases GLP-1 levels, leading to improved insulin secretion and reduced glucagon secretion.
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Side Effects:
- Pancreatitis.
- Allergic reactions.
-
GLP 1 Receptor Agonists:
-
Insulin Secretagogues:
-
Sulfonylureas:
- Glyclazide is an example.
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MOA:
- Stimulate insulin release from pancreatic beta cells.
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Side Effects:
- Hypoglycemia.
- Weight gain.
- Allergic reactions.
-
Meglitinides:
- Repaglinide is an example.
-
MOA:
- Similar to sulfonylureas, stimulate insulin release from beta cells.
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Side Effects:
- Hypoglycemia.
- Weight gain.
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Sulfonylureas:
-
Miscellaneous:
-
SGLT 2 Inhibitors:
- Canagliflozin is an example.
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MOA:
- Block the reabsorption of glucose in the kidneys, promoting its excretion in urine.
-
Side Effects:
- Urinary tract infections.
- Genital yeast infections.
- Dehydration.
-
Alpha-glucosidase Inhibitors:
- Acarbose is an example.
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MOA:
- Slow the breakdown of complex carbohydrates in the small intestine, reducing postprandial glucose absorption.
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Side Effects:
- Gastrointestinal upset.
- Flatulence.
- Diarrhea.
-
SGLT 2 Inhibitors:
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Description
This quiz covers the synthesis, function, and types of insulin, emphasizing its role in diabetes management. Key concepts include insulin secretion, deficiencies, and the different types of insulin used in treatment. Test your knowledge on how these factors influence blood sugar levels and overall health.
