Learning unit: Insulins


Impact of the learning unit:

The number of diabetic patients has been growing recently. Diabetes is a chronic metabolic disease
with different etiopathology. Hyperglycemia is the common feature due to the insufficient effect of
insulin through its relative or absolute deficiency. Type I diabetes mellitus (i.e., with absolute
deficiency) is associated with high morbidity and mortality. Insulin therapy is a basis of
treatment, but it is also used in patients with type II diabetes when diet and antidiabetic drugs
are not effective. Information about insulin preparations and their combinations in insulin
regimens is essential for every physician.

Relevant terms

hypoglycemia as an adverse effect

lipodystrophy

sites of injection

insulin analogues

human insulins

classification according to their onset and duration of effect

short-acting insulins

rapid-acting analogues

lispro

aspart

glulisine

short-acting human insulins

neutral insulin solutions

intermediate-acting insulins

NPH insulin (Isophane insulin)

Long-acting insulin analogues

                glargine

detemir

                degludec

                insulin mixtures

                               biphasic analogues

                               stabilized mixtures of human insulins

insulin regimen

                conventional

                intensified

insulin pen

insulin pump


Learning outcomes

Student characterizes different types of insulin preparations according to their onset and duration
of effect.

Student describes pitfalls of insulin therapy – adverse effects and site of injections.

Student explains the principles of setting the insulin regimen and preparations for the individual
model patient.

Student is aware of other drugs used in diabetology, mainly in acute states.

Student briefly describes the principles of gestational diabetes therapy.

Student knows basic pharmacological profile (mode of action, unwanted effects, indications and
contraindications) of single subgroups of insulins.

Information sources

Rang & Dale's Pharmacology, 8th edition, 2016, chapter 31 (The control of blood glucose and drug
treatment of diabetes mellitus)

Study materials for courses aVLFA0721p and aVLFA0721c.


Exam questions

Special pharmacology:  9. Insulines

Essential drugs: 26. insulin lispro, 27. insulin glargin