KINE 2475 Lecture Notes - Lecture 28: Contraindication, Diabetes Mellitus Type 2, Peripheral Neuropathy
Insulin: commercial insulin contains active insulin peptides. Insulin products are administered subcutaneously for chronic management of diabetes. Also human insulin as dry powder which is inhaled & absorbed through pulmonary tissue. Insulin over antihyperglycemic agents b/c can achieve a wide range of glucose targets. Doses can be individualized based on glycemic levels. Dosed bid at low doses: glargine u-100 offers better profile. Peakless, given od: longer active (glargine u-300 & degludec) has not peal, longer duration of action compared to (glargine u-100 & detemir). Rapid insulin offers faster onset & shorter duration of action. Rapid & ultra rapid mimic endogenous insulin release. Rapid acting have lower risk of hypoglycemia: u-500 reserved for patients with extreme insulin resistance. Given 2-3x/day: exogenous, unlike endogenous, is not associated with increased cv ae, patients with type 1 dm, experience more hypoglycemic events that type 2. Insulin cause injection site reactions: pain, redness, itches, urticaria, edema & inflammation.