Indication in T2DM

Mechanism of Action

Adverse Effect

• Hypoglycemia ↓( ≤ 4)

• Weight gain

• Injection (not a Pill)

• Need Adjusting

• Need CBG (Chronic Blood Glucose) monitoring

  • BG is measured 4 times a day:

    Time	Target (mmol)
    Pre-breakfast (fasting)	4-7
    Pre-lunch	7
    Pre-dinner	7
    Before Bed	7

  <aside> 💡 The BG measures the effect of insulin LAST administered (administered before last meal)

  • e.g. pre-breakfast BG measures the effect of Before Bed insulin </aside>

Administration

• 2 types

  • Basal Insulin
  • Bolus Insulin

• Time of administration: (A - B - C - D)

  • A = pre-breakfast
  • B = pre-lunch
  • C = pre-dinner
  • D = pre-bed

  <aside> 💡 The insulin works to lower the pre-meal BG of the next meal

  • e.g. pre-breakfast insulin lowers pre-lunch BG </aside>

• Rotate Injection site to avoid Lipohypertrophy

  

• It takes a few hours to work

  • When transition from IV Insulin:
    • Stop IV 4h after injection of Basal Insulin
    • Stop IV 2h after injection of Bolus Insulin

Approach of Prescribing

1. Determine the total dosage

   $$ Dosage = 0.5 U / kg $$