Insulin Types and Administration Quiz

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Questions and Answers

What is the onset time of Humulin R U-100 regular insulin?

  • 30 minutes (correct)
  • 12-20 minutes
  • 1.5 hours
  • 2.5-3 hours

How long does the duration of action last for Afrezza (inhalation) regular insulin?

  • 2.5-3 hours (correct)
  • 21 hours
  • 8 hours
  • 12-24 hours

What is the difference in the duration of action between Humulin R U-100 regular insulin and Humulin R U-500 concentrated regular insulin?

  • Humulin R U-500 lasts 3 hours longer
  • Humulin R U-100 lasts 3 hours longer
  • Humulin R U-500 lasts 13 hours longer (correct)
  • Humulin R U-100 lasts 13 hours longer

How often is Humulin N intermediate acting insulin administered?

<p>Twice daily (D)</p> Signup and view all the answers

Which type of insulin is recommended for injecting 30 minutes prior to a meal?

<p>Humulin R U-100 (regular insulin) (D)</p> Signup and view all the answers

What is the onset time for Humulin N intermediate acting insulin?

<p>1.5 hours (B)</p> Signup and view all the answers

Based on the information provided, what is the primary difference between Humulin R U-100 and Humulin R U-500?

<p>Humulin R U-500 has a much longer duration of action. (C)</p> Signup and view all the answers

What is the recommended time to administer Afrezza (inhalation) insulin?

<p>12-20 minutes prior to meals (C)</p> Signup and view all the answers

Which insulin type is most suitable for achieving 24 hours of basal insulin coverage?

<p>Humulin N (intermediate acting insulin) (D)</p> Signup and view all the answers

Which of these insulin types is most likely to be prescribed for a patient who requires a quick-acting insulin for managing post-meal blood sugar spikes?

<p>Afrezza (inhalation) (D)</p> Signup and view all the answers

Which insulin type requires twice daily injections to achieve a 24 hours basal insulin coverage?

<p>Novolin N (B)</p> Signup and view all the answers

Which insulin type has a mean duration of ~21 hours?

<p>Humalin U-500 (D)</p> Signup and view all the answers

Which insulin types are generally administered once daily but can be adjusted to twice daily for some patients?

<p>Lantus (Insulin glargine) and Basaglar (Insulin glargine) (B)</p> Signup and view all the answers

In general, for most patients, administering Novolin N twice daily is necessary to achieve what?

<p>To achieve 24 hours basal insulin coverage (B)</p> Signup and view all the answers

Administering Humulin U-500 twice daily is recommended to align with what?

<p>The individual's glucose coverage needs (B)</p> Signup and view all the answers

How long does the duration of the insulin action last for Novolin N?

<p>12-24 hours (C)</p> Signup and view all the answers

What is the recommended administration time for Novolin N?

<p>30 minutes before a meal (C)</p> Signup and view all the answers

What is the primary reason for checking glucose levels before administering insulin?

<p>To prevent insulin stacking (C)</p> Signup and view all the answers

What is the relationship between twice daily administration and the effects of Lantus or Basaglar?

<p>It may provide benefit for some patients. (A)</p> Signup and view all the answers

Which of the following statements about Novolin N is correct?

<p>It should be administered 30 minutes before a meal to ensure more consistent blood sugar control. (B)</p> Signup and view all the answers

Which insulin type would be most appropriate for a patient who needs to take their insulin right before or after a meal, but needs the insulin to work quickly?

<p>Rapid acting insulin (C)</p> Signup and view all the answers

Which insulin(s) should be administered subcutaneously into the abdomen, upper arm, thigh, or buttocks?

<p>All insulin types listed in the content (C)</p> Signup and view all the answers

Which insulin has the shortest onset time of action?

<p>Fiasp (C)</p> Signup and view all the answers

Which insulin has the longest duration of action?

<p>All insulins have the same duration of action (D)</p> Signup and view all the answers

A patient is experiencing a sudden spike in blood sugar levels after a meal. Which insulin is the best option for this situation?

<p>Fiasp (B)</p> Signup and view all the answers

Which insulin requires a dosage adjustment based on the time of administration relative to a meal?

<p>NovoLog (B)</p> Signup and view all the answers

What unique characteristic of Fiasp allows for faster absorption?

<p>It is formulated with niacinamide (B)</p> Signup and view all the answers

Which insulin can be taken up to 20 minutes after the start of a meal?

<p>Fiasp and Lyumjev (A)</p> Signup and view all the answers

A patient needs an insulin with a longer duration of action for overnight management. Which insulin would be the BEST choice for this patient?

<p>None of the listed insulins would be appropriate for this patient (A)</p> Signup and view all the answers

Considering a patient's need for mealtime insulin, which of the following is TRUE about Lyumjev?

<p>Lyumjev can be taken either immediately before or up to 20 minutes after a meal, making it versatile for mealtime management (D)</p> Signup and view all the answers

Which insulin type, based on its administration guidelines, would be the most suitable option for a patient who frequently forgets to take their insulin before meals?

<p>Fiasp (C)</p> Signup and view all the answers

A patient needs a rapid-acting insulin that can be administered 15 minutes before a meal but also provides flexibility to be taken immediately after eating. Which insulin type would be the most suitable choice in this scenario?

<p>Humalog (A), Admelog (B)</p> Signup and view all the answers

A patient is experiencing a sudden, unexpected spike in blood sugar levels following a meal. Which insulin type, based on its onset time, would be the most appropriate to address this situation quickly?

<p>Fiasp (B)</p> Signup and view all the answers

From the provided list, which insulin type(s) would be considered the most appropriate for a patient aiming to achieve a rapid reduction in blood sugar levels following a meal, thus minimizing the risk of postprandial hyperglycemia?

<p>Fiasp (A), Lyumjev (C)</p> Signup and view all the answers

A patient needs to carefully manage their postprandial blood sugar levels and prefers a rapid-acting insulin that offers some flexibility in the administration time relative to a meal. Which insulin type would be best for this patient?

<p>Humalog (B), Apidra (D)</p> Signup and view all the answers

A patient requires an insulin with a relatively short duration of action, ideally suitable for managing blood sugar levels during a single meal. Which insulin type would be the most appropriate choice in this scenario?

<p>Fiasp (C)</p> Signup and view all the answers

A patient prefers an insulin that can be administered shortly before a meal, but they may not always be able to inject exactly 15 minutes beforehand. Which insulin type offers the most flexibility in this aspect?

<p>NovoLog (B), Apidra (C)</p> Signup and view all the answers

Which insulin type, based on its administration guidelines, would present the least flexibility for a patient who frequently needs to adjust their mealtimes?

<p>NovoLog (D)</p> Signup and view all the answers

A patient's blood sugar levels consistently spike after a meal, even when they administer insulin as prescribed. Which insulin type, based on its onset time, would be most likely to offer a more rapid response and potentially address the issue of postprandial hyperglycemia?

<p>Lyumjev (A)</p> Signup and view all the answers

A patient is considering switching to a rapid-acting insulin that can be administered within a timeframe that is relatively more flexible than traditional insulin types. Based on the provided information, which insulin type(s) would be suitable for this purpose?

<p>Humalog (A), Apidra (B), Fiasp (C)</p> Signup and view all the answers

Which insulin type, when concentrated, significantly extends its duration of action, exceeding the typical range for regular insulin?

<p>Humulin R U-500 (C)</p> Signup and view all the answers

Which insulin type is characterized by a rapid onset and a relatively brief duration of action, making it particularly suited for managing post-meal blood sugar spikes?

<p>Afrezza (inhalation) (A)</p> Signup and view all the answers

Which insulin type is typically administered twice daily to ensure consistent basal insulin coverage throughout the day?

<p>Humulin N (B)</p> Signup and view all the answers

Which insulin type requires a significant time window between administration and the beginning of a meal, aiming to achieve optimal glucose control?

<p>Humulin R U-100 (B)</p> Signup and view all the answers

Which insulin type is uniquely administered via inhalation, offering a convenient and rapid-acting option for managing blood sugar levels?

<p>Afrezza (inhalation) (C)</p> Signup and view all the answers

Which insulin type exhibits a prolonged onset time, taking 1.5 hours to reach its full effect, making it less suitable for immediate pre-meal adjustments?

<p>Humulin N (D)</p> Signup and view all the answers

Which insulin type, despite being classified as regular insulin, displays a significantly extended duration of action due to its concentrated formulation?

<p>Humulin R U-500 (D)</p> Signup and view all the answers

Which insulin type is typically recommended for patients requiring a prolonged basal insulin coverage, lasting for up to 24 hours, often necessitating twice daily administration?

<p>Humulin N (D)</p> Signup and view all the answers

Which insulin type is best suited for achieving a quick reduction in blood glucose levels, especially after a meal, due to its rapid onset and shorter duration of action?

<p>Afrezza (inhalation) (A)</p> Signup and view all the answers

Which insulin type, although a regular insulin, exhibits a substantially prolonged duration of action due to its concentrated formulation, surpassing the typical duration of standard regular insulin?

<p>Humulin R U-500 (B)</p> Signup and view all the answers

Which insulin type, with once daily administration, may necessitate a dosage adjustment based on the time of administration relative to a meal?

<p>Humulin U-500 (B)</p> Signup and view all the answers

Which of the following statements accurately reflects the recommended administration time for Humulin U-500?

<p>Administer 30 minutes prior to a meal, but assess the need for administration with every meal. (B)</p> Signup and view all the answers

In the context of insulin therapy, achieving '24 hours basal insulin coverage' refers to:

<p>Maintaining a steady, consistent level of insulin in the bloodstream throughout the day. (D)</p> Signup and view all the answers

Which of the following insulins has the longest duration of action in the context of the provided information?

<p>Lantus (C), Basaglar (D)</p> Signup and view all the answers

Which insulin type would be most appropriate for a patient who needs a quick-acting insulin for managing post-meal blood sugar spikes?

<p>Novolin N (B)</p> Signup and view all the answers

The recommendation to check glucose levels prior to administering insulin is primarily intended to prevent:

<p>Insulin stacking, which can lead to hypoglycemia. (D)</p> Signup and view all the answers

Which insulin type is most likely to be prescribed for a patient who requires a longer-lasting insulin to manage blood sugar overnight?

<p>Basaglar (A), Lantus (B)</p> Signup and view all the answers

The statement 'Twice daily dosing aligns better with glucose coverage needs' in the context of Humulin U-500 suggests that:

<p>Humulin U-500's duration of action is best matched to twice daily administration. (D)</p> Signup and view all the answers

If a patient requires a rapid-acting insulin to quickly manage a post-meal blood sugar spike, which option would be the most suitable?

<p>Novolin N (D)</p> Signup and view all the answers

A patient has been prescribed a medication that helps manage post-meal blood sugar spikes by increasing insulin secretion. Which of the following medication classes is MOST LIKELY to be prescribed?

<p>Sulfonylureas (B)</p> Signup and view all the answers

Which drug from the provided list would be MOST indicated for a patient needing to enhance insulin sensitivity, leading to improved glucose uptake by tissues?

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

A patient is experiencing frequent episodes of hyperglycemia despite taking a sulfonylurea medication. Which medication class, when added to the patient's regimen, could effectively address this situation by acting on a different mechanism to improve glucose control?

<p>Biguanides (A)</p> Signup and view all the answers

Which of the following drugs is NOT a member of the SGLT-2 inhibitor class?

<p>Saxagliptin (A)</p> Signup and view all the answers

A patient needs to adjust their medication regimen after experiencing persistent hyperglycemia. They are currently taking a DPP-4 inhibitor. Which of the following medication classes, when added to the regimen, can help control blood sugar levels through a different mechanism?

<p>Thiazolidinediones (TZDs) (B), SGLT-2 Inhibitors (C), GLP-1 Receptor Agonists (D)</p> Signup and view all the answers

Which drug classification for diabetes treatment includes the following: Glimepiride, Glyburide, and Glipizide?

<p>Sulfonylureas (A)</p> Signup and view all the answers

Which drug classification, typically prescribed for type 2 diabetes, works by increasing insulin sensitivity and decreasing glucose production by the liver?

<p>Thiazolidinediones (TZDs) (A)</p> Signup and view all the answers

Which drug classification works by blocking the reabsorption of glucose in the kidneys, leading to increased glucose excretion in the urine?

<p>SGLT-2 Inhibitors (B)</p> Signup and view all the answers

Which of the following generic names is NOT associated with the DPP-4 inhibitor class of medications?

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

A patient reports experiencing frequent episodes of post-meal hyperglycemia. Which drug classification, known for its quick onset and shorter duration of action, would be most appropriate for addressing this specific issue?

<p>GLP-1 Receptor Agonists (B)</p> Signup and view all the answers

Which drug class utilizes a mechanism of action that involves increasing insulin sensitivity in peripheral tissues?

<p>Thiazolidinediones (TZDs) (B)</p> Signup and view all the answers

Which of these drug classes directly stimulates the release of insulin from pancreatic beta cells?

<p>Sulfonylureas (C)</p> Signup and view all the answers

Which of these drug classes acts by inhibiting the breakdown of incretin hormones, thereby increasing their levels and enhancing insulin secretion?

<p>DPP-4 Inhibitors (B)</p> Signup and view all the answers

Which drug class works by blocking the reabsorption of glucose in the kidneys, leading to an increase in urinary glucose excretion?

<p>SGLT-2 Inhibitors (A)</p> Signup and view all the answers

Which of these drug classes is NOT directly involved in regulating insulin secretion or sensitivity?

<p>Biguanides (A)</p> Signup and view all the answers

Which statement accurately differentiates between Type 1 and Type 2 Diabetes Mellitus?

<p>Type 1 diabetes results from autoimmune destruction of β-cells, while Type 2 involves insulin resistance. (D)</p> Signup and view all the answers

What A1c level indicates a diagnosis of prediabetes?

<p>A1c of 5.7% to 6.4% (C)</p> Signup and view all the answers

Which symptom is specifically associated with high blood glucose levels in diabetes?

<p>Dehydration from excessive urination (D)</p> Signup and view all the answers

What is a common characteristic of Type 2 Diabetes Mellitus?

<p>Insulin resistance present (D)</p> Signup and view all the answers

Which symptom is NOT classic for individuals with undiagnosed diabetes?

<p>Increased energy levels (D)</p> Signup and view all the answers

In which age group is Type 1 Diabetes predominantly diagnosed?

<p>Mostly childhood/adolescence (B)</p> Signup and view all the answers

What is an unusual symptom of hyperglycemia that can occur in diabetes?

<p>Slow-healing wounds (D)</p> Signup and view all the answers

Which factor is NOT typically associated with Type 1 Diabetes Mellitus?

<p>Strong genetic predisposition (D)</p> Signup and view all the answers

What distinguishes the onset of Type 2 Diabetes from that of Type 1 Diabetes?

<p>Gradual onset primarily in adults (C)</p> Signup and view all the answers

What symptom manifests as a result of glucose not being properly utilized in the body?

<p>Excessive hunger (A)</p> Signup and view all the answers

What is a classic symptom associated with hyperglycemia in individuals with diabetes?

<p>Frequent urination (C)</p> Signup and view all the answers

Which of the following characteristics differentiates Type 1 Diabetes (T1DM) from Type 2 Diabetes (T2DM)?

<p>T1DM patients require insulin for survival (B)</p> Signup and view all the answers

Which of the following is NOT a common symptom of undiagnosed diabetes?

<p>Frequent headaches (A)</p> Signup and view all the answers

How does the age of onset differ between Type 1 and Type 2 Diabetes?

<p>Type 2 generally occurs in adults (C)</p> Signup and view all the answers

Which statement about insulin dependence is accurate?

<p>T1DM patients require insulin for survival (C)</p> Signup and view all the answers

What indicates an individual is prediabetic based on their A1c level?

<p>A1c 5.7–6.4% (D)</p> Signup and view all the answers

Which of the following symptoms is associated with Type 1 Diabetes and is considered a classic symptom of hyperglycemia?

<p>Unintentional weight loss (B)</p> Signup and view all the answers

What is true regarding the genetic component of Type 1 and Type 2 Diabetes?

<p>T2DM has a stronger family history component than T1DM (D)</p> Signup and view all the answers

Which option best describes the insulin resistance present in Type 2 Diabetes?

<p>It is a key feature of the disease (C)</p> Signup and view all the answers

What is the formula used to calculate estimated average glucose (eAG) from A1c levels?

<p>eAG = 28.7 x A1c - 46.7 (A)</p> Signup and view all the answers

When an individual's A1c is high (greater than 10%), what primarily affects the A1c level?

<p>Basal hyperglycemia (B)</p> Signup and view all the answers

What is the general A1c target for most individuals with diabetes?

<p>&lt; 7% (D)</p> Signup and view all the answers

As an individual's A1c approaches 7% to 7.5%, which type of hyperglycemia has a greater effect on A1c?

<p>Postprandial hyperglycemia (B)</p> Signup and view all the answers

How does the effect of basal and postprandial hyperglycemia on A1c depend on the A1c level?

<p>It varies with the A1c level (C)</p> Signup and view all the answers

What is the primary effect of insulin when it binds to its receptor?

<p>Promotes glucose uptake by cells (A)</p> Signup and view all the answers

Which key anatomical structure of the pancreas is primarily involved in releasing insulin?

<p>Islets of Langerhans (A)</p> Signup and view all the answers

What distinguishes type 1 diabetes mellitus from type 2 diabetes mellitus?

<p>Type 1 results from autoimmune destruction of beta cells. (D)</p> Signup and view all the answers

What is a major complication associated with uncontrolled diabetes mellitus?

<p>Macrovascular and microvascular complications (D)</p> Signup and view all the answers

How does glucagon primarily affect glucose metabolism?

<p>Stimulates glycogenolysis in the liver (B)</p> Signup and view all the answers

Which population is at the highest risk for developing type 2 diabetes mellitus?

<p>Individuals with a sedentary lifestyle and obesity (C)</p> Signup and view all the answers

What role does amylin play in glucose metabolism?

<p>Inhibits glucagon release (D)</p> Signup and view all the answers

What is a common process that regulates insulin release?

<p>Increased blood glucose concentrations (A)</p> Signup and view all the answers

What is the mechanism of action of GLP-1 receptor agonists in managing type 2 diabetes?

<p>They stimulate insulin secretion from pancreatic beta-cells and suppress glucagon secretion from alpha-cells. (C)</p> Signup and view all the answers

Which of the following DPP-4 inhibitors has the longest duration of action?

<p>Linagliptin (A)</p> Signup and view all the answers

Which of these statements accurately reflects the role of SGLT2 inhibitors in managing type 2 diabetes?

<p>They inhibit the reabsorption of glucose in the kidneys, increasing urinary glucose excretion. (B)</p> Signup and view all the answers

What is a potential side effect associated with the use of thiazolidinediones (TZDs) for the treatment of type 2 diabetes?

<p>Increased risk of heart failure (C)</p> Signup and view all the answers

Which class of medications can improve glycemic control in patients with type 2 diabetes by increasing insulin sensitivity and suppressing hepatic glucose production?

<p>Biguanides (B)</p> Signup and view all the answers

What is the primary mechanism of action of alpha-glucosidase inhibitors in managing type 2 diabetes?

<p>Inhibiting the breakdown of carbohydrates in the small intestine (C)</p> Signup and view all the answers

Which of the following medications is a GLP-1 receptor agonist that is administered once weekly?

<p>Semaglutide (D)</p> Signup and view all the answers

Which of the following medications is a SGLT2 inhibitor that is available in both oral and intravenous formulations?

<p>Empagliflozin (B)</p> Signup and view all the answers

What is the primary effect of insulin on glucose metabolism?

<p>Stimulates glycogen synthesis (B)</p> Signup and view all the answers

Which metabolic pathway is responsible for the synthesis of glucose from non-carbohydrate precursors?

<p>Gluconeogenesis (D)</p> Signup and view all the answers

What distinguishes glucokinase from hexokinase in glucose metabolism?

<p>Glucokinase is regulated by blood glucose levels and acts as a glucose sensor. (B)</p> Signup and view all the answers

In which state does the liver primarily utilize glucose for energy production?

<p>Absorptive state (B)</p> Signup and view all the answers

What is the primary role of GLP-1 in glucose homeostasis?

<p>Stimulates insulin secretion from pancreatic beta cells. (C), Inhibits glucagon secretion from alpha cells. (D)</p> Signup and view all the answers

What is a major consequence of insulin resistance on glucose metabolism?

<p>Elevated levels of blood glucose (B)</p> Signup and view all the answers

Which of the following best describes the balance between catabolic and anabolic pathways in cellular respiration?

<p>Catabolic pathways generate ATP and reduce power, while anabolic pathways use ATP to synthesize compounds. (A)</p> Signup and view all the answers

What determines the conversion of pyruvate into acetyl CoA?

<p>Presence of oxygen (D)</p> Signup and view all the answers

What is the equation used to convert A1c values to estimated average glucose (eAG)?

<p>eAG = 28.7 x A1c - 46.7 (A)</p> Signup and view all the answers

How does postprandial hyperglycemia influence A1c levels when the A1c is near the goal range?

<p>It has a relatively greater impact compared to basal hyperglycemia. (C)</p> Signup and view all the answers

At what A1c level does basal hyperglycemia start to have a greater impact on A1c compared to postprandial hyperglycemia?

<p>Greater than 10% (D)</p> Signup and view all the answers

What is the ideal A1c goal for most individuals with diabetes?

<p>&lt; 7% (B)</p> Signup and view all the answers

Which of the following statements is true regarding the relationship between A1c levels and the effects of hyperglycemia?

<p>Both forms of hyperglycemia affect A1c differently based on actual glucose levels. (C)</p> Signup and view all the answers

What is the primary difference between type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM)?

<p>T1DM patients usually require lifelong insulin therapy, while T2DM may be managed through lifestyle changes or oral medications. (D)</p> Signup and view all the answers

Which mechanism underlies insulin resistance contributing to type 2 diabetes mellitus?

<p>Impairment of insulin receptor signaling pathways. (D)</p> Signup and view all the answers

What are the classic symptoms of undiagnosed diabetes?

<p>Polyuria, polydipsia, and unexplained weight loss. (B)</p> Signup and view all the answers

What is the role of advanced glycation end products (AGEs) in diabetes?

<p>AGEs contribute to inflammation and damage associated with diabetes complications. (D)</p> Signup and view all the answers

What defines the balance between catabolic and anabolic pathways in cellular respiration?

<p>Catabolic pathways produce energy by breaking down molecules, while anabolic pathways use energy to build larger molecules. (B)</p> Signup and view all the answers

Which compounds are involved in key metabolic pathways of glucose after its absorption?

<p>Glucose-6-phosphate, pyruvate, and acetyl CoA. (A)</p> Signup and view all the answers

What factors contribute to the development of insulin resistance?

<p>High levels of circulating free fatty acids and chronic inflammation. (A)</p> Signup and view all the answers

Which statement accurately compares the acute and chronic complications of diabetes?

<p>Acute complications affect immediate metabolic control, whereas chronic complications typically involve long-term damage to organs. (A)</p> Signup and view all the answers

Flashcards

Fiasp

Ultra-rapid acting insulin that starts working in about 5-10 minutes.

Lyumjev

An ultra-rapid insulin similar to lispro, acting in ~15 minutes.

Admelog

Rapid acting insulin; take 15 minutes before or after meals.

Humalog

A rapid acting insulin that works within 15-30 minutes.

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NovoLog

Rapid acting insulin acting in 10-20 minutes before meals.

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Apidra

Rapid acting insulin effective 20 minutes around meals.

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Onset

The time it takes for insulin to start working.

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Duration

The length of time insulin remains effective in lowering blood sugar.

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Administration

The method of delivering insulin (usually subcutaneously).

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Subcutaneous

Means administering insulin under the skin.

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Short Acting Insulin

Insulin that begins to work quickly, typically within 30 minutes.

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Humalin R U-100

Regular insulin, short acting, needs injection 30 minutes before meals.

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Novolin R U-100

Another brand of regular insulin, with similar properties to Humalin R.

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Afrezza

Inhalation insulin that works quickly, with onset in 12-20 minutes.

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Duration of Action (Regular Insulin)

Regular insulin typically lasts about 8 hours after injection.

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Humulin R U-500

Concentrated regular insulin, with longer duration of action (up to 21 hours).

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Intermediate Acting Insulin

Insulin that covers basal needs for 12-24 hours; injected 1-2 times daily.

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Humulin N

Intermediate acting insulin that begins working in 1.5 hours and lasts 12-24 hours.

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Onset of Insulin

The time it takes for insulin to start lowering blood sugar levels after injection.

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Administration Before Meals

Short acting insulins should be injected 30 minutes before meals for optimal effect.

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Novolin N

A type of insulin with an onset of 1.5 hours and duration of 12-24 hours.

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Humalin U-500

Insulin with a ~30 minutes onset and duration range of 13-24 hours.

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Long Acting Insulin

Insulin designed for once daily injection to provide extended blood sugar control.

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Lantus

A long-acting insulin that usually requires once-daily administration.

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Basaglar

Another long-acting insulin like Lantus, used once daily.

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Dosing Frequency

Refers to how often insulin should be injected, typically once or twice daily.

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Insulin Stacking

When insulin is injected before previous doses have worn off, risking low blood sugar.

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Injection Timing

The recommended time to inject insulin before meals, often around 30 minutes.

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Basal Insulin

Insulin that maintains blood sugar levels during fasting periods.

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Glucose Coverage

The ability of insulin to manage glucose levels in the body.

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Fiasp Administration

Inject Fiasp at meal start or within 20 minutes after.

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Lyumjev Onset

Lyumjev starts working in approximately 15 minutes.

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Admelog Injection Timing

Inject Admelog 15 minutes before or immediately after meals.

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Humalog Use

Humalog should be injected 15 minutes before meals or right after.

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NovoLog Administration

NovoLog is injected 5-10 minutes before a meal.

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Apidra Timing

Apidra is injected 20 minutes before or within 20 minutes after meals.

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Ultra-Rapid Insulin

Types include Fiasp and Lyumjev, acting within 5-15 minutes.

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Rapid Acting Insulin

Includes Admelog, Humalog, NovoLog, Apidra, lasting around 3-5 hours.

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Insulin Onset Variation

Ultra-rapid insulins have onset times of 5-20 minutes.

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Subcutaneous Injection

Common method for administering many insulins, including ultra-rapid.

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Twice Daily Insulin Dosing

Recommended for certain insulins like Novolin N to achieve adequate glucose coverage throughout the day.

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Basal Insulin Coverage

Insulin needed to maintain blood sugar levels during fasting times, crucial for diabetes management.

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Glucose Coverage Needs

Refers to insulin's ability to manage blood glucose levels effectively throughout the day.

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Afrezza Administration

Inhalation insulin that should be inhaled at the beginning of a meal for effective use.

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Duration of Humulin N

The duration of Humulin N is 12-24 hours, providing basal insulin coverage.

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Short Acting Insulin Timing

Short acting insulin should be injected 30 minutes before meals for optimal effect.

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Humulin N Onset

Humulin N begins working in about 1.5 hours after injection.

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Insulin Concentration Effect

Higher concentrations of insulin can lead to a prolonged duration of action.

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Afrezza Onset

Afrezza has an onset of 12-20 minutes, making it faster than regular insulin.

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Regular Insulin Duration

Regular insulin typically lasts about 8 hours after injection.

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Humulin N Administration Frequency

Humulin N is usually injected once to twice daily for effective coverage.

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Biguanides

A class of medications that improve insulin sensitivity and lower hepatic glucose output; Metformin is the primary agent.

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Sulfonylureas

Medications that stimulate the pancreas to release more insulin; common examples include Glimepiride, Glyburide, and Glipizide.

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DPP-4 Inhibitors

Medications that increase incretin levels, leading to increased insulin secretion and decreased glucagon; examples include Sitagliptin and Saxagliptin.

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SGLT-2 Inhibitors

A class of drugs that prevent glucose reabsorption in the kidneys, leading to increased glucose excretion; Canagliflozin and Dapagliflozin are examples.

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GLP-1 Receptor Agonists

Drugs that mimic GLP-1, enhancing glucose-dependent insulin secretion; Semaglutide and Dulaglutide are notable examples.

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Three P’s of Diabetes Symptoms

Classic symptoms include Polyuria, Polydipsia, and Polyphagia, which indicate high blood glucose levels.

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Polyuria

Frequent urination caused by excess glucose in urine leading to osmotic diuresis.

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Polydipsia

Excessive thirst resulting from dehydration due to frequent urination.

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Polyphagia

Excessive hunger caused by the body's inability to utilize glucose effectively.

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Type 1 Diabetes (T1DM)

An autoimmune condition where the body destroys insulin-producing beta cells, characterized by sudden onset.

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Type 2 Diabetes (T2DM)

Develops gradually with insulin resistance, mostly in adults and often associated with obesity.

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A1c Criteria for Diabetes

A1c of 6.5% or higher indicates diabetes; 5.7% to 6.4% indicates prediabetes.

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Symptoms of High Blood Sugar

Includes fatigue, blurred vision, weight loss, slow-healing wounds, and skin issues.

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Impaired Immune Function in Diabetes

Diabetes can lead to slow-healing wounds and frequent infections due to reduced immune response.

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Diabetes Neuropathy Symptoms

Numbness or tingling in extremities due to nerve damage from high glucose levels.

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Classic Symptoms of Diabetes

Symptoms include Polyuria, Polydipsia, and Polyphagia, indicating high blood glucose.

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Type 1 Diabetes (T1DM) Characteristics

Sudden onset diabetes primarily in children, requiring insulin for survival.

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Type 2 Diabetes (T2DM) Characteristics

Gradual onset diabetes associated with insulin resistance, mostly in adults, often linked to obesity.

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A1c for Diabetes Diagnosis

A1c of 6.5% or higher indicates diabetes, 5.7% to 6.4% indicates prediabetes.

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A1c

A blood test that measures average blood glucose levels over the past 2-3 months.

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Estimated Average Glucose (eAG)

A translation of A1c results into an average glucose level, calculated using the formula: eAG = 28.7 x A1c – 46.7.

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Postprandial Hyperglycemia

High blood sugar levels that occur after eating a meal.

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Basal Hyperglycemia

Consistently elevated blood sugar levels, typically when fasting.

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A1c Goal for Diabetes Management

The typical A1c target for most individuals with diabetes is < 7%.

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Diabetes Mellitus

A chronic condition characterized by high blood sugar levels due to insulin production or action issues.

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Gestational Diabetes

Diabetes that develops during pregnancy, often resolving after giving birth, but increases risk for T2DM later.

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Macrovascular Complications

Serious health issues caused by diabetes affecting large blood vessels, leading to heart disease or stroke.

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Microvascular Complications

Health problems caused by diabetes affecting small blood vessels, often leading to kidney or eye issues.

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Insulin Release Regulation

Processes that control how insulin is secreted from the pancreas, influenced by blood glucose levels.

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Epinephrine Effects on Glucose

Stimulates glucose release for energy during stress, countering insulin's effects.

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Renal Sodium-Glucose Cotransporters

Transport proteins in kidneys that reabsorb glucose with sodium.

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GLP-1

A hormone that stimulates insulin secretion and inhibits glucagon release.

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GIP

A hormone released in response to food intake, aiding in insulin release.

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Glycolysis

The metabolic pathway that converts glucose into pyruvate, producing ATP.

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Tricarboxylic Acid Cycle

Cycle that processes acetyl CoA, generating NADH and FADH2 for energy production.

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Gluconeogenesis

The formation of glucose from non-carbohydrate sources, important during fasting.

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Pentose Phosphate Pathway

A metabolic pathway parallel to glycolysis that generates NADPH and ribose-5-phosphate.

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Glycogenesis vs. Glycogenolysis

Glycogenesis: converting glucose to glycogen; Glycogenolysis: breaking down glycogen to glucose.

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Role of Renal Sodium-Glucose Cotransporters

Transport proteins in the kidneys that reabsorb glucose along with sodium, crucial in glucose homeostasis.

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GLP-1 Function

A hormone that stimulates insulin secretion and inhibits glucagon release, aiding in glucose regulation.

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GIP Role

A hormone released after eating that promotes insulin secretion from pancreatic cells.

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Glycolysis Process

The metabolic pathway that converts glucose to pyruvate, resulting in ATP production.

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Glucose Phosphorylation Role

The process of adding a phosphate group to glucose, making it more reactive for metabolism.

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Gluconeogenesis Function

The formation of glucose from non-carbohydrate sources, essential during fasting states.

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Diabetes Mellitus (DM)

A chronic condition characterized by high blood sugar levels due to insulin production or action issues.

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Impact of A1c Levels

High A1c indicates more basal hyperglycemia; lower A1c shows more postprandial influence.

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Study Notes

Insulin Types and Actions

  • Ultra-rapid acting insulins: Faster onset and shorter duration of action.
    • Fiasp (insulin aspart): Onset ~5-10 minutes, duration 3-5 hours. Formulated with niacinamide for faster absorption. Administered at mealtime or within 20 minutes of meal
    • Lyumjev (insulin lispro-aabc): Onset ~15 minutes, duration 3-5 hours. Administered at mealtime or within 20 minutes of meal
  • Rapid acting insulins: Faster onset and shorter duration than intermediate insulins.
    • Admelog (insulin lispro): Onset 15-30 minutes, duration 3-5 hours. Administered 15 minutes before meals, or immediately after.
    • Humalog (insulin lispro): Onset 15-30 minutes, duration 3-5 hours. Administered 15 minutes before meals, or immediately after.
    • NovoLog (insulin aspart): Onset 10-20 minutes, duration 3-5 hours. Administered 5-10 minutes before meals.
    • Apidra (insulin glulisine): Onset 20 minutes, duration 3-5 hours. Administered within 15 minutes before meals, or within 20 minutes after starting a meal.

Short-acting insulins (Regular insulin):

  • Humulin R U-100 (regular insulin): Onset 30 minutes, duration 8 hours. Administered 30 minutes prior to meals.
  • Novolin R U-100 (regular insulin): Onset 30 minutes, duration 8 hours. Administered 30 minutes prior to meals.
  • Afrezza (inhalation): Onset 12-20 minutes, duration 2.5-3 hours. Inhaled at mealtime
  • Humulin R U-500 (concentrated regular insulin): Onset 30 minutes; duration ~21 hours. Higher concentration leads to longer duration.

Intermediate-acting insulins:

  • Humulin N: Onset 1.5 hours, Duration 12-24 hours. Administered once or twice daily; Twice daily dosing is more common.
  • Novolin N: Onset 1.5 hours, Duration 12-24 hours. Administered once or twice daily; Twice daily dosing is more common.

Long-acting insulins:

  • Lantus (insulin glargine): Onset 1.5 hours, Duration ~24 hours. Administered once daily, or twice daily in some cases.
  • Basaglar (insulin glargine): Onset 1.5 hours, Duration ~24 hours. Administered once daily, or twice daily in some cases.
  • Semglee (insulin glargine-yfgn): Onset 1.5 hours, Duration ~24 hours. Administered once daily.
  • Rezvoglar (Insulin glargine-aglr): Onset 1.5 hours, Duration ~24 hours. Administered once daily.
  • Toujeo (insulin glargine): Onset ~1 hour, Duration 24-36 hours. Administered once daily.

Ultra-long-acting insulin:

  • Tresiba (insulin degludec): Onset 1.5 hours, Duration 36-42 hours. Administered once daily.

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