INSULIN TREATMENT FOR DIABETES | HOW TO START INSULIN ON A PATIENT | DIABETES MELLITUS TREATMENT |

Summary

This video discusses insulin treatment for diabetes, covering different types of insulin, such as ultra short-acting, rapid-acting, intermediate-acting, and long-acting. It explains insulin regimens like basal bolus and mixed insulin, highlighting the importance of insulin timing with meals to control glucose peaks and baseline levels, and the challenges of compliance.

Takeaways

• 😀 Insulin is crucial in managing diabetes by controlling glucose levels, mimicking the body's natural response to meals.
• 🌡️ Normal glucose levels are maintained by insulin, which responds to glucose spikes after meals and brings them back to baseline.
• 🚀 In diabetics, the lack of insulin or insulin resistance leads to high baseline glucose levels and uncontrolled post-meal glucose peaks.
• 💉 Treatment involves synchronizing insulin administration with meal times to control these glucose peaks.
• 🔍 There are different types of insulin, including ultra short-acting, rapid-acting, intermediate-acting, and long-acting, each with varying peak times and durations of action.
• 🏥 Basal bolus regimen involves using long-acting insulin to control baseline glucose and ultra short-acting insulin as a bolus dose before meals to control glucose peaks.
• 🛌 Advising patients on basal bolus involves taking the basal dose before bed and the bolus dose before each meal, ensuring they eat immediately after the insulin shot to avoid hypoglycemia.
• ⚖️ Calculating insulin doses in basal bolus involves starting with 0.3 to 0.5 units per kg, splitting it 50% basal and 50% bolus, with further division for meals.
• 🤔 Mixed insulin regimen combines rapid-acting and intermediate-acting insulins to mimic basal bolus, but is less effective in glucose control.
• 🏃‍♂️ Mixed regimen involves two daily injections, one in the morning and one in the evening, which is less frequent but also less precise in glucose control compared to basal bolus.
• 📉 Calculating insulin doses in mixed regimen is similar to basal bolus, with total daily insulin divided into two equal parts for morning and evening injections.

Q & A

What is the primary function of insulin in the body?

Insulin is a hormone that regulates blood sugar levels by allowing glucose to enter cells. It helps maintain a normal baseline glucose level and controls glucose spikes after meals.

What happens to glucose levels in diabetic patients who do not produce insulin?

In diabetic patients without insulin production, the baseline glucose level is high and glucose peaks after meals are uncontrolled, leading to persistent hyperglycemia.

What are the different types of insulin mentioned in the script?

The script mentions ultra short-acting insulin (e.g., Lispro, Aspart, Glulisine), regular insulin (short-acting), NPH (intermediate-acting), and long-acting insulins like Glargine and Detemir.

How does the duration and peak action of insulin affect its use in treatment?

Ultra short-acting and regular insulins have a quick peak but a short duration, making them suitable for controlling mealtime glucose spikes. Intermediate and long-acting insulins have a slower peak and longer duration, suitable for maintaining baseline glucose levels.

What is the basal bolus regimen and how does it mimic normal body control?

The basal bolus regimen involves using long-acting insulin (basal dose) to control baseline glucose levels and ultra short-acting insulin (bolus dose) before each meal to control glucose peaks, mimicking the body's natural insulin release.

How should patients on the basal bolus regimen take their insulin?

Patients should check their glucose level, take their bolus insulin dose, and then eat immediately to control the mealtime glucose peak. The basal dose is typically taken at bedtime.

What is the risk associated with the basal bolus regimen?

The risk with the basal bolus regimen is the potential for hypoglycemia, especially if patients take their bolus insulin but do not eat their meal.

What is the mixed insulin regimen and how does it differ from basal bolus?

The mixed insulin regimen combines rapid-acting insulin (e.g., regular) with intermediate-acting insulin (e.g., NPH) into a single injection. It aims to mimic the basal bolus regimen but is less effective in controlling glucose levels.

How often should patients on the mixed insulin regimen take their insulin?

Patients on the mixed insulin regimen typically take two injections per day, one in the morning before breakfast and one in the evening.

What are the advantages and disadvantages of the mixed insulin regimen compared to basal bolus?

The mixed insulin regimen is simpler with fewer injections per day, which may improve patient compliance. However, it is less effective in controlling glucose levels and may result in persistent hyperglycemia compared to the basal bolus regimen.