10 Questions
What is the patient's current HbA1c value?
8.1%
What insulin regimen is the patient currently on?
50 units of insulin glargine and an average of 25 units of insulin aspart pre-meals.
Why was metformin stopped for the patient?
Metformin was stopped because the patient was no longer achieving his glycemic targets.
What signs of complications were present on examination?
Mild peripheral neuropathy
How many times a day was the patient checking his glucose levels?
Four times a day
What are the six analogs of human insulin?
Insulin lispro, insulin aspart, insulin glulisine, insulin glargine, insulin detemir, insulin degludec
What is the duration of the hypoglycemic effect of regular insulin?
5–7 hours
What is the concentration of most insulins in the United States?
100 units/mL (U100)
What are the characteristics of short-acting insulin preparations?
Clear solutions at neutral pH, exist as dimers, assemble into hexamers in the presence of two zinc ions, further stabilized by phenolic compounds
What are the bioavailability characteristics of the insulins?
The mutations engineered into the rapidly acting insulin analogs are designed to disrupt the stabilizing intermolecular interactions of the dimers and hexamers, leading to more rapid absorption into the circulation after subcutaneous injection
Test your knowledge on pancreatic hormones, glucose-lowering drugs, and diabetes treatment with this case study of a 66-year-old obese man. Explore the management of diabetes, including the use of metformin and insulin, in a clinical setting.
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