Exam 3 Pharm :)

Immediate monitoring for glucose

Blood glucose (70-99 mg/dL fasting) by blood draw or finger stick most

common

Long term monitoring

Hemoglobin A1c – reflects glucose control over the past several months

Exogenous insulin (synthetic insulin diabetic patients all use)

Action:

– Lowers glucose by pushing glucose from blood into cells

– Can be a supplement of insulin or the only sources depending on type of DM

• Administration:

– Injectable only (see next slide)

• SQ the most common form

• IV

• Side Effects:

– Hypoglycemia (light headed, nervousness, change of level of consciousness, cold sweat,

seizure)

• “Cold and Clammy, need some candy”

• WBG less than 70.

– Somogyi Effect, Dawn Phenomenon

– Injection site reactions

Rapid acting (insulin lispro and insulin aspart)- onset, peak, and duration

15-30 minutes, 30-120 minutes, 3-5 hours

Short-acting (insulin regular)- onset, peak, duration

30 min SubQ, 2.5-5hours, 4-12 hours

intermediate-acting (insulin NPH “cloudy”)- onset, peak, duration

1-2 hours, 4-12 hours, 14-24 hours

long-acting (insulin glargine)- onset, peak, duration

1-2 hours, no peak, up to 24 hours

combinations (NPH/regular 70/30, lispro 75/25)- onset peak, duration

15-30 min, 4-12 hours for NPH/regular and 1-6 hours for Lispro, up to 24 hours