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REGUB Medicine: T1DM (i) (Intro (younger age (usually 2-4, puberty or…

- - - - hypoglyc
        
        cognitive dysfunction
        
        hypoglyc unawareness if repeated episodes (brain adjusts + thinks it's normal)
        
        a normal pancreas stops producing insulin when blood sugar drops to 4
      - weight gain - insulin stims appetite
    - - give 50% as basal, 50% as bolus
    - - NPH/Insulatard
        
        older
        
        not used as much in Ire but common worldwide
        
        peaks @ 4-6 hrs (bad for basal insulins to have a peak, increases risk of hypoglyc)
      - glargine/lantus
        
        causes less hypoglyc esp @ night compared to NPH
      - levemir/detemir
        
        causes less hypoglyc esp @ night compared to NPH
        
        give twice a day
      - degludec (long-acting)
      - insulin tuojeo (glargine U300) - long-acting
    - - to match carb ingestion
      - actrapid: take 20-30 mins before eating, lasts 5-8 hrs
      - novorapid (aspart): lasts 4hrs
      - humalog (lispro): lasts 4hrs
      - glulisine (apidra) - lasts 4 hrs
      - FiAsp: fast acting novorapid, take as you eat, works in 5 mins
  - - - 30% novorapid
      - 70% insulatard
    - - 25% humalog
      - 75% insulatard
  - - - can get ones that don't alarm
      - funded by HSE if under 21y/o