Insulin

Question 1

What are the generic and brand names of insulin?

Answer 1

• Short acting insulin (Actrapid)
• Rapid acting insulin (Novorapid)
• Intermediate acting (Humulin)
• Long acting insulin (Lantus/Levemir)
• Biphasic insulin (Novomix 30)

Question 2

What is the method of action of insulin?

Answer 2

• Works like endogenous insulin
• Stimulates glucose uptake from the circulation → tissues
• ↑ use of glucose as an energy source
• ↑ glycogen, lipid and protein synthesis
• ↓ gluconeogenesis and ketogenesis
• Drives K+ into cells

Question 3

What are the indications for insulin?

Answer 3

• Type 1 diabetes
• Type 2 diabetes – when oral treatment is insufficient
• Diabetic emergencies (IV) e.g. DKA, hyperglycaemic hyperosmolar syndrome
• Alongside glucose to treat hyperkalaemia

Question 4

What are the contraindications for insulin?

Answer 4

• Renal impairment

Question 5

What are the side effects of insulin?

Answer 5

• Hypoglyceamia = coma/death in severe cases

* Fat overgrowth at injection site

Question 6

What drugs does insulin interact with?

Answer 6

• Other hypoglycaemic agents = ↑ risk of hypoglycaemia

* Systemic corticosteroids - ↑ dose of insulin

Question 7

What organs eliminate insulin?

Answer 7

Kidney and liver

Question 8

What information should be given to patients taking insulin?

Answer 8

• Advise on lifestyle changes – calorie controlled diet, regular exercise
• Tell them about signs and symptoms of hypoglycaemia and if this develops to have something sugary then something starchy