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10 Cards in this Set

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onset, peak, and duration times for insulin preparations
rapid: O-15min, P-60/90min, D- 3/5hrs. Lispro/aspart/glulisine

short: O-30/60min, P-2/4h, D- 6/8hrs, regular

intermediate: O-1/2h, P-6/10h, D-12+hrs. NPH/Lente

long-acting: Ultralente O-4/6h, P-18h, D-24+h
glargine O-1.5h, P-flat, D-24+h
Premixed insulin prep
70/30 70%NPH, 30%regulat
75/25 75% NPH 25% lispro
Delivery systems for insulin
syringe-subcut, abdomin, rotate sites, hypertrophy

pen-conveinent and discrete, hole either 150 or 300cc.

pumps-alternative to shots, catheter infusion set into subcut tissue, holds only rapid acting insulin
Two Modes of Delivery by pumps
basal rate-constant flow, replaces long use insulin, run automatically, pts needs

bolus-hits button, before meal, for high fate meals, good for slow digestion meals
Pumps: Pros and Cons
pros: more flexible lifestyle, better control, matchs individual needs, must be motivated, keep records, be able to problem solve

Cons: high cost, training and monitoring pt. infection, DKA risks, interruption in delievery leads to DKA
benefits of carbohydrate counting
carb consistance is nessisary for proper insulin dosing. couted by gram, or by exchanges.

significantly inproves glycemia in those with insulin resistance
Self-Monitoring of Blood Glucose
essentail, efficacy of therapy and management of disease. pts recieve training for managment strategies

times to check: fasting, before meals, 1-2hrs after meals for peak postprandial value, Occasionally at 2-3am, before and after exercise, when drinking

record keeping: patterns of control used for problem solving, treatment adjustments
Blood Glucose Targets
preprandial 90-130
postprandial 140-180
bedtime 110-150
Causes of delayed hypoglycemia after excerised. 2 prevention strategies
increased insulin sensitivity, increased glucose disposal by muscles, and deplete liver and muscle glycogen stores, effect glycemic control.

glycogen repleation and increased insulin sensitivity at muscle.

1. reduce insulin doses for planned exercise.
2. consume additional carbs.
treatment of hypoglycemia
15g carb
15 min wait and recheck glucose
15g carb (if needed)

NO HIGH FAT, Delays digestion