Insulin Types for Type 1 Diabetes
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Questions and Answers

What type of diabetes is Rapid Acting insulin used for?

  • Juvenile diabetes
  • Type 1 (correct)
  • Type 2
  • Gestational diabetes

    • What is the peak time for Intermediate acting insulin?

  • 1 hour
  • 12 hours
  • 24 hours
  • 8 hours (correct)

    • What is the main consideration for patients using insulin pumps?

  • Monitoring blood glucose levels hourly (correct)
  • Checking for low blood pressure
  • Confirming insulin doses with a healthcare provider
  • All of the above

    • What is the correct order for mixing insulin?

    <p>Clear then cloudy</p> Signup and view all the answers

    What is the normal range for fasting blood glucose?

    <p>80-100 mg/dL</p> Signup and view all the answers

    What type of insulin is used as a basal insulin?

    <p>Long Duration</p> Signup and view all the answers

    What is the purpose of sliding scale insulin monitoring?

    <p>To adjust insulin doses based on blood glucose levels</p> Signup and view all the answers

    What is the effect of insulin on potassium levels?

    <p>Insulin stores potassium in cells</p> Signup and view all the answers

    What is the MOA of Biguanide?

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

    What is a common side effect of Metformin?

    <p>All of the above</p> Signup and view all the answers

    What is a rare but dangerous side effect of this medication?

    <p>Lactic acidosis</p> Signup and view all the answers

    Why is it important to monitor kidney function during treatment?

    <p>Because the medication can affect kidney function</p> Signup and view all the answers

    What is a common side effect of this medication that can be uncomfortable but is not serious?

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

    Why is it important to stop taking this medication 48 hours before a CT scan?

    <p>To allow the contrast dye to work effectively</p> Signup and view all the answers

    What is a benefit of this medication for people with polycystic ovary syndrome (PCOS)?

    <p>It reduces androgen levels</p> Signup and view all the answers

    Why is it important for people with kidney disease to use caution when taking this medication?

    <p>Because it can worsen existing kidney disease</p> Signup and view all the answers

    What is a potential interaction to be aware of when taking this medication?

    <p>It can interact with alcohol</p> Signup and view all the answers

    What is a severe side effect of this medication that requires immediate medical attention?

    <p>All of the above</p> Signup and view all the answers

    Why is this medication used to treat people with pre-diabetes?

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

    What is a contraindication for this medication?

    <p>Severe infections</p> Signup and view all the answers

    What is the mechanism of action of Sulfonylureas?

    <p>Increased insulin secretion by stimulating pancreatic B cells</p> Signup and view all the answers

    What is a common side effect of Thiazolidinediones?

    <p>Weight gain</p> Signup and view all the answers

    What is the mechanism of action of GLP-1 Agonists?

    <p>Mimicking the action of incretin hormones</p> Signup and view all the answers

    What is a common side effect of DPP-4 Inhibitors?

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

    What is the mechanism of action of SGLT-2 Inhibitors?

    <p>Inhibition of sodium-glucose cotransporters in the kidney</p> Signup and view all the answers

    What is a rare but serious side effect of GLP-1 Agonists?

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

    What laboratory values would be elevated if the liver is not functioning well?

    <p>AST and ALT</p> Signup and view all the answers

    What is the effect of Meglitinides on the body?

    <p>Increased insulin secretion by stimulating pancreatic B cells</p> Signup and view all the answers

    What is a common side effect of Thiazolidinediones in patients with heart failure?

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

    What is the mechanism of action of Empagliflozin?

    <p>Inhibition of sodium-glucose cotransporters in the kidney</p> Signup and view all the answers

    What is the primary characteristic that distinguishes Rapid Acting insulin from other types of insulin?

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

    Which type of insulin is typically used as a basel insulin?

    <p>Long Duration</p> Signup and view all the answers

    What is the significance of the cloudy appearance of Intermediate Acting insulin?

    <p>It requires agitation before administration</p> Signup and view all the answers

    What is the primary purpose of sliding scale insulin monitoring?

    <p>To adjust insulin doses based on blood glucose levels</p> Signup and view all the answers

    What is the relationship between insulin and potassium levels?

    <p>Insulin stores potassium in cells</p> Signup and view all the answers

    What is the primary action of Biguanides, such as Metformin?

    <p>Decreasing insulin resistance</p> Signup and view all the answers

    What is the significance of the SQ route of administration for insulin?

    <p>It is a subcutaneous route of administration</p> Signup and view all the answers

    What is the primary consideration for patients using insulin pumps?

    <p>Monitoring blood glucose levels hourly</p> Signup and view all the answers

    What is the primary benefit of using insulin pumps?

    <p>Improved glycemic control</p> Signup and view all the answers

    What is the primary storage requirement for insulin?

    <p>Refrigeration at 2-8°C</p> Signup and view all the answers

    What is the primary reason to monitor kidney function during treatment with Metformin?

    <p>To prevent lactic acidosis</p> Signup and view all the answers

    What is a common side effect of Metformin that can be uncomfortable but is not serious?

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

    Why is it important to stop taking Metformin 48 hours before a CT scan?

    <p>To prevent the CT dye from interacting with the medication</p> Signup and view all the answers

    What is a rare but dangerous side effect of Metformin?

    <p>Lactic acidosis</p> Signup and view all the answers

    What is a benefit of Metformin for people with polycystic ovary syndrome (PCOS)?

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

    Why is it important for people with kidney disease to use caution when taking Metformin?

    <p>Because it can worsen kidney disease</p> Signup and view all the answers

    What is a contraindication for Metformin?

    <p>All of the above</p> Signup and view all the answers

    What is the primary mechanism of action of Metformin?

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

    Why is Metformin used to treat people with pre-diabetes?

    <p>To prevent type 2 diabetes</p> Signup and view all the answers

    What is a severe side effect of Metformin that requires immediate medical attention?

    <p>Lactic acidosis</p> Signup and view all the answers

    Which of the following medications increases insulin responsiveness by stimulating PPAR?

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

    What is a common side effect of GLP-1 Agonists that can be uncomfortable but is not serious?

    <p>Gastrointestinal upset</p> Signup and view all the answers

    Which of the following laboratory values would be elevated if the liver is not functioning well?

    <p>AST and ALT</p> Signup and view all the answers

    What is the mechanism of action of Sulfonylureas?

    <p>Stimulating pancreatic beta cells to release more insulin</p> Signup and view all the answers

    What is a rare but serious side effect of GLP-1 Agonists?

    <p>Thyroid tumors</p> Signup and view all the answers

    What is the mechanism of action of SGLT-2 Inhibitors?

    <p>Blocking the reabsorption of glucose in the kidneys</p> Signup and view all the answers

    What is a common side effect of Thiazolidinediones in patients with heart failure?

    <p>Fluid retention</p> Signup and view all the answers

    What is the effect of Meglitinides on the body?

    <p>Increases insulin secretion</p> Signup and view all the answers

    What is the mechanism of action of DPP-4 Inhibitors?

    <p>Inhibiting DPP-4 to increase insulin secretion</p> Signup and view all the answers

    What is a common side effect of Empagliflozin?

    <p>Genital mycotic infections</p> Signup and view all the answers

    Study Notes

    Insulin Types and Characteristics

    • Rapid-acting insulin:
      • Onset: 15 minutes
      • Peak: 1-3 hours
      • Duration: 3-5 hours
      • Route: SQ
      • Side effects: hypoglycemia, weight gain
    • Short-acting insulin:
      • Onset: 30 minutes
      • Peak: 1-5 hours
      • Duration: 6-10 hours
      • Route: SQ, IV
      • Side effects: hypoglycemia, weight gain
    • Intermediate-acting insulin (basal insulin):
      • Onset: 60 minutes
      • Peak: 8 hours
      • Duration: 24 hours
      • Route: SQ
      • Side effects: hypoglycemia, weight gain
    • Long-duration insulin (basal insulin):
      • Onset: 70 minutes
      • Peak: n/a
      • Duration: 24 hours
      • Route: SQ
      • Side effects: hypoglycemia, weight gain

    Insulin Storage and Administration

    • Insulin storage: 2-8°C, do not freeze
    • Insulin pump: for type 1 diabetes, self-controlled insulin administration, requires hourly blood glucose checks
    • Mixing insulin: clear insulin should be added to cloudy insulin, and cloudy insulin requires agitation

    Oral Diabetes Medications

    • Biguanides (Metformin):
      • Mechanism of action: increases insulin sensitivity, decreases glucose production in liver, increases peripheral glucose uptake
      • Side effects: GI upset, anorexia, flatulence, B12 deficiency
      • Contraindications: severe infections, sepsis, shock, kidney disease
    • Sulfonylureas:
      • Mechanism of action: stimulate pancreatic beta cells to release insulin
      • Side effects: hypoglycemia, weight gain
      • Contraindications: type 1 diabetes, pregnancy, breastfeeding
    • Meglitinides:
      • Mechanism of action: stimulate pancreatic beta cells to release insulin
      • Side effects: hypoglycemia, weight gain
      • Contraindications: type 1 diabetes
    • Thiazolidinediones (TZDs):
      • Mechanism of action: increase insulin sensitivity, decrease insulin resistance
      • Side effects: weight gain, edema, heart failure
      • Contraindications: heart failure, liver disease
    • GLP-1 Agonists (Incretin Mimetics):
      • Mechanism of action: mimic incretin action, stimulate pancreatic beta cells to release insulin
      • Side effects: GI upset, pancreatitis, thyroid tumors
      • Contraindications: type 1 diabetes, severe gastrointestinal disease
    • DPP-4 Inhibitors:
      • Mechanism of action: inhibit DPP-4 enzyme, increase GLP-1 levels
      • Side effects: headache, pancreatitis, joint pain
    • SGLT-2 Inhibitors:
      • Mechanism of action: inhibit sodium-glucose contransporters, increase glucose excretion in urine
      • Side effects: genital mycotic infections, urinary tract infections, Fournier's gangrene

    Monitoring and Contraindications

    • Liver function tests: AST and ALT levels increase with liver damage
    • Renal function tests: BUN and creatinine levels increase with renal damage
    • Contraindications: type 1 diabetes, pregnancy, breastfeeding, severe infections, sepsis, shock, kidney disease, liver disease, heart failure

    Insulin Types

    • Rapid-Acting Insulin: Onset in 15 minutes, peak in 1-3 hours, and duration of 3-5 hours; administered through subcutaneous (SQ) injection; may cause hypoglycemia and weight gain.
    • Short-Acting Insulin: Onset in 30 minutes, peak in 1-5 hours, and duration of 6-10 hours; administered through SQ or IV injection; may cause hypoglycemia and weight gain.
    • Intermediate-Acting Insulin: Onset in 60 minutes, peak in 8 hours, and duration of 24 hours; administered through SQ injection; may cause hypoglycemia and weight gain.
    • Long-Acting Insulin: Onset in 70 minutes, with no peak and a duration of 24 hours; administered through SQ injection; may cause hypoglycemia and weight gain.

    Insulin Administration and Precautions

    • Insulin should be stored at 2-8°C and should not be frozen or exposed to extreme temperatures.
    • Insulin pumps are only for type 1 diabetes and require self-monitoring of blood glucose levels every 2-3 hours.
    • Mix insulin should be injected with clear insulin first, followed by cloudy insulin, and cloudy insulin should be agitated before injection.

    Oral Diabetes Medications

    Biguanide - Metformin

    • Mechanism of action: decreases glucose production, increases insulin sensitivity, and decreases glucose absorption.
    • Metabolism: excreted by the kidneys.
    • Side effects: GI upset, anorexia, flatulence, abdominal cramps, lactic acidosis (rare), and vitamin B12 deficiency.
    • Nursing considerations: monitor renal function, start with a small dose and gradually increase, and avoid taking with alcohol.

    Sulfonylureas - Glyburide and Glipizide

    • Mechanism of action: stimulates pancreatic beta cells to release insulin.
    • Side effects: weight gain, hypoglycemia, and disulfiram-like reaction with alcohol.
    • Nursing considerations: monitor hepatic laboratory tests, avoid taking with alcohol, and skip meals may cause hypoglycemia.

    Meglitinides - Repaglinide and Nateglinide

    • Mechanism of action: stimulates pancreatic beta cells to release insulin.
    • Side effects: weight gain, hypoglycemia, and GI upset.
    • Nursing considerations: primarily used for type 2 diabetes, cannot skip meals, and may cause hypoglycemia.

    Thiazolidinediones - Rosiglitazone and Pioglitazone

    • Mechanism of action: increases insulin sensitivity through PPAR-gamma.
    • Side effects: weight gain, edema, and increased risk of heart failure.
    • Nursing considerations: monitor for heart failure, cannot be used in patients with heart failure, and primarily used for type 2 diabetes.

    GLP-1 Agonists - Semaglutide and Incretin Mimetics

    • Mechanism of action: mimics incretin.
    • Side effects: GI upset, severe abdominal pain, and rare cases of thyroid tumors.
    • Nursing considerations: primarily used for type 2 diabetes, cannot skip meals, and may cause hypoglycemia.

    DPP-4 Inhibitors - Sitagliptin and Januvia

    • Mechanism of action: blocks DPP-4 to stimulate insulin release and suppress glucagon release.
    • Side effects: headache, joint pain, and rare cases of pancreatitis.
    • Nursing considerations: primarily used for type 2 diabetes, monitor for pancreatitis, and may cause hypoglycemia.

    SGLT-2 Inhibitors - Empagliflozin and Januvia

    • Mechanism of action: blocks SGLT-2 to increase glucose excretion in urine.
    • Side effects: genital mycotic infections, urinary tract infections, and hypotension.
    • Nursing considerations: primarily used for type 2 diabetes, monitor for genital infections, and may cause hypotension.

    Laboratory Tests

    • Liver function tests: AST and ALT elevate if liver function is impaired.
    • Renal function tests: BUN and creatinine elevate if renal function is impaired.

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    Description

    This quiz covers the characteristics of different insulin types, including rapid acting, short acting, and intermediate acting insulin, used to manage type 1 diabetes. It includes information on onset, peak, duration, and potential side effects.

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