Quick Guide to Insulin Therapy
Hey everyone, this is Dr. Jocelyn, your Johns Hopkins university educated, board certified Endocrinologist, author, and national speaker. Through my web series, courses and books, I help busy primary care physicians, nurse practitioners, and Physician’s assistants learn how to better manage their most complicated diabetic patients, improve their patient satisfaction scores, and maximize their salaries and bonus income.
Today we will review a Quick Guide to Insulin Therapy
Insulin is a hormone that allows glucose to go from the blood stream into the cells for energy or storage. It now comes in multiple forms to allow you to provide your patient with the most physiologic support possible.
Basal Insulins
Provide background support and are generally adjusted based on the fasting glucose level. Half life is ~ 24 hours in a patient with normal renal function. Currently available in U-100, U-200, and U-300 formulations
Prandial Insulins
Provide support for a meal or to treat a high blood glucose levels. Usually given up to 30 min before to immediately after a meal, or when the sugar is high. These insulin peak in 2-4 hours and are gone in 4-6 hours in patients with normal renal function. Currently available in U-100 and U-200 formulations.
Mixed Insulins
Available in human (Humulin, Novolin) and synthetic (Humalog, Novolog) formulations. The human insulins have a longer time to onset of action and take longer to clear. The synthetic insulins have a shorter time to onset and clear more reliably. They provide both meal-related and background support in a single injection. They are usually given immediately before a meal and are dosed 2-3 times a day. These insulins should not be used to treat a high blood sugar if the patient is not eating. These insulins should be mixed (rolled, not shaken) immediately before injection.
If you liked this information and would like more, or would like to learn more about my courses or consulting, follow me on Facebook at Dr. Jocelyn MD and join my group the Medi-pros. They are always the first to get the latest information.
Dr. Jocelyn