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INSULIN
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Cards (31)
What is a common indication for insulin in type 1 diabetes?
Insulin replacement therapy
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When is insulin given intravenously?
During diabetic emergencies
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Why is insulin given with IV glucose for hyperkalaemia?
To prevent
hypoglycaemia
during treatment
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How does exogenous insulin function in the body?
It stimulates
glucose uptake
into tissues
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What is the primary therapeutic effect of insulin?
Lowering
blood glucose concentration
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What happens to potassium levels when insulin treatment is stopped?
Potassium
leaks
back into
circulation
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What are the classifications of insulin preparations?
Rapid
,
short
,
intermediate
, long acting
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What is an example of a rapid-acting insulin?
NovoRapid®
(
insulin aspart
)
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What type of insulin is used for IV administration in emergencies?
Soluble insulin (
Actrapid®
)
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Why are insulin preparations dosed in units?
To correspond to
glucose-lowering
activity
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What is the main adverse effect of insulin therapy?
Hypoglycaemia
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What can repeated SC injection of insulin cause?
Fat overgrowth (
lipohypertrophy
)
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How does renal impairment affect insulin clearance?
It reduces insulin clearance, increasing
hypoglycaemia
risk
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What is a risk of combining insulin with other hypoglycaemic agents?
Increased risk of
hypoglycaemia
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What is a key component of a basal–bolus insulin regimen?
Daily
long-acting
insulin injection
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What is the advantage of a basal–bolus regimen?
It provides flexibility in
insulin
dosing
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How is a 1-unit/mL IV solution of insulin prepared?
50
units
in 50 mL
sodium chloride
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What should be monitored when administering IV insulin?
Serum potassium levels
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What is the mainstay of monitoring insulin therapy?
Capillary blood glucose
measurements
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How much does the NHS spend on insulin annually?
Over
£300 million
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What is the acceptable blood glucose range in acute illness?
4–12 mmol/L
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How should insulin dosage be adjusted for hyperglycaemia?
Increase the dose by about
10%
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What is the preferred insulin type for correcting acute hyperglycaemia?
Rapid-acting insulin (e.g.
NovoRapid®
)
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What are the mechanisms of action of insulin?
Stimulates
glucose
uptake into tissues
Stimulates glycogen, lipid, and protein synthesis
Inhibits gluconeogenesis and ketogenesis
Activates
Na+/K+-ATPase
, reducing
serum K+
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What are the types of insulin preparations and their characteristics?
Rapid acting: Immediate onset, short duration (e.g.
NovoRapid®
)
Short acting: Early onset, short duration (e.g.
Actrapid®
)
Intermediate acting: Intermediate onset and duration (e.g.
Humulin I®
)
Long acting: Flat profile, regular administration (e.g.
Lantus®
)
Biphasic: Mixture of rapid and intermediate acting (e.g.
NovoMix®
30)
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What are the important lifestyle measures for diabetes management?
Healthy, balanced diet
Regular exercise
Monitoring
blood glucose
levels
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What are the symptoms of hypoglycaemia and how to treat it?
Symptoms:
Dizziness
Agitation
Nausea
Sweating
Confusion
Treatment:
Sugary drink
followed by a sandwich
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What should be monitored in patients receiving insulin therapy?
Capillary blood glucose measurements
Haemoglobin A1c
at least annually
Serum potassium during
IV insulin infusion
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What are the key considerations for insulin dosage adjustment in hospitals?
Acceptable blood glucose range: 4–12
mmol/L
Increase dose by
10%
for
hyperglycaemia
Decrease dose by
20%
for
hypoglycaemia
Adjustments made for future control
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What are the adverse effects of insulin therapy?
Hypoglycaemia
(risk of
coma
and death)
Lipohypertrophy from repeated
SC injections
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What are the important interactions with insulin therapy?
Increased
hypoglycaemia
risk with other
hypoglycaemic
agents
Increased insulin requirements with
systemic corticosteroids
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