Insulin Quiz

1. When considering insulin choose the answer what is the most correct:

A) Only those with type 1 diabetes require insulin for their management.

B) Insulin can only cause a hypoglycaemic event if is injected at the wrong dose.

C) Insulin should be stored between 2-8 degrees, even the vial or pen that the person is currently using.

D) There are many misconceptions about insulin use. One common misconception is once someone with type 2 diabetes requires insulin they are reclassified as having type 1 diabetes. A person with type 2 diabetes who needs insulin has their NDSS status reclassified to insulin requiring type 2 diabetes.

Correct! Wrong!

2. Of the insulin listed below which would be considered insulin prescribed at mealtimes for management of blood glucose levels due to food?

A) Isophane (rys) (Protaphane), Glulisine (Apidra) and Aspart (Novorapid)

B) Glulisine (Apidra), Aspart (Novorapid) and Lispro (Humalog)

C) Detemir (Levemir), Glulisisne (Apidra) and Lispro (Humalog)

D) Detemir (Levemir), Isophane (rys) (Protaphane) and Insulin, Neutral (rys) (Actrapid)

Correct! Wrong!

3. Of the insulin listed below which would be considered insulin prescribed as the basal (background) for the management of blood glucose levels?

A) Detemir (Levemir), Glulisisne (Apidra) and Lispro (Humalog)

B) Detemir (Levemir), Isophane (rys) (Protaphane) and Insulin, Neutral (rys) (Actrapid)

C) Detemir (Levemir), Isophane (rys) (Protaphane) and Glargine (Optisulin)

D) Glargine (Optisulin), Lispro (Humalog) and Isophane (rys) (Protaphane)

Correct! Wrong!

4. Mr King is a regular customer to your pharmacy. He has come in on a Friday night having just seen the GP who has decided to start him on 10 units of Glargine insulin. You are aware Mr King has had type 2 diabetes for several years, but you have never had much of a chance to talk to him since he always seems to speak with the other pharmacist. Mr King is worried about hypoglycaemia since he observed his father have some “nasty turns when he was still alive, and they would have to feed him lots of sugar”. Given it is the weekend, choose the scenario that describes the outcome which will have the best health outcome for Mr King.

A) You decide to hold off on dispensing the insulin until Mr King can see a credentialled diabetes educator to guide him through starting insulin.

B) You dispense Mr King’s insulin upgrade his NDSS status to insulin requiring so you can give him some needles for his insulin pens, ensure he understands the need to read the CMI that you have given him and wish him well.

C) Ring your mum who has had type 2 diabetes and been injecting insulin for years and get her to come to the pharmacy to show Mr King how to give

D) Dispense Mr King’s prescription and check his eligibility for a Diabetes Medscheck. If unable to complete MedsCheck at the present time offer this service at a more convenient time that suits both the pharmacy and Mr King. Update his NDSS status to ensure Mr King can access needles for his insulin pens and provide resources on injection technique and hypoglycaemia. Provide referral to credentialled diabetes educator for injection site technique and sick day management if required. Ensure Mr King is blood glucose monitoring (to understand the effect of his new medicine) and has adequate supply of monitoring strips. Log interventions using the Electronic Intervention Log @ Pharmacy Diabetes.

Correct! Wrong!

5. When considering insulin pen needles which of the following is true?

A) It is best to give anyone starting on insulin the shortest needle length.

B) Insulin needles are universal. Each brand of needles will fit on each brand of insulin pen device.

C) Insulin comes with needles, so I do not need to worry about the length of the needle when I dispense a script.

D) Once registered with diabetes, an individual gets sent needles automatically in a variety of sizes. This system means each person will always have a supply of needles at home.

Correct! Wrong!

6. When considering mixed insulin which of the following is true?

A) All mixed insulin is different, the profile depends on the combination of insulin plus the ratio of that combination and is generally injected just before or just after a meal (s).

B) All mixed insulin is the same, just make sure the person understands it is generally injected at the same time each day.

C) All mixed insulin is the same, just make sure the person understands it is generally injected before or just after a meal(s).

D) All mixed insulin is different, the profile depends on the combination of insulin plus the ratio of that combination, and is generally injected at the same time each day

Correct! Wrong!

7. When considering insulin and the role of glucose monitoring which of the following is true?

A) Blood glucose monitoring is not necessary since most people know how they are feeling and can tell you how their glucose levels are going.

B) Those starting insulin need only monitoring their blood glucose levels first thing in the morning since it is this level that will decide how much the dose of insulin will change.

C) Diabetes management should be individualised for each person - this is defined as person centred care. Blood glucose monitoring (BGM) or continuous glucose monitoring (CGM) are tools that people prescribed insulin can use to understand the effect on their blood glucose levels. How often and when to monitor is determined by a significant number of factors

D) Monitoring of glucose levels need only occur if a person on insulin suspects a low blood glucose level and needs to know if they are going to treat this.

Correct! Wrong!

8. Mr Nguyen is a regular customer to the pharmacy and returns with an insulin pen recently dispensed. He is concerned the insulin is out of date since the insulin in the disposable pens is cloudy like milk. Mr Nguyen has recently been changed from a once-a-day insulin (Glargine) to twice a day insulin to be injected just before meals (30% soluble insulin aspart (rys) and 70%insulin aspart (rys) crystallised with protamine, Novomix 30). He has seen both an endocrinologist and credentialled diabetes educator in the past. When considering this, what would be the best scenario for Mr Nguyen for insulin management?

A) Ask Mr Nguyen to bring back all the new insulin he has at home as you suspect it has not been stored correctly. Once he has done this give him a new script of insulin making sure it is a different batch number.

B) Explain to Mr Nguyen that the new insulin is what is known as “cloudy” insulin. This is different to the other insulin he has been on which is clear. Give Mr Nguyen a CMI on the insulin and ensure he understands how to mix the insulin with the “rock and roll” technique.

C) Tell Mr Nguyen that the insulin is supposed to look like this, and he should inject it in the same way as he did the other insulin he had.

D) Explain to Mr Nguyen that the new insulin is what is known as “cloudy” insulin. This is different to the other insulin he has been on which is clear. Determine if Mr Nguyen is eligible for either a Diabetes Medscheck or MedsCheck. Invite Mr Nguyen to talk about his diabetes and counsel him on how to mix his insulin. Provide him with a CMI on the product. Check if he is glucose monitoring or not and refer to allied health if appropriate. Ensure Mr Nguyen is up to date with his hypoglycaemia treatments. Log all interventions using the Electronic Intervention Log @ Pharmacy Diabetes.

Correct! Wrong!

9. When considering Insulin degludec (rys) and insulin aspart (rys) (Ryzodeg 70/30) which of the following statements are true

A) Ryzodeg 70/30 is described as a coformulation insulin which means each insulin component does not interact with the other.

B) Ryzodeg 70/30 is a soluble insulin product consisting of the ultra-long-acting basal insulin degludec and the rapid acting prandial insulin aspart in a ratio of 70:30.

C) Ryzodeg 70/30 can be administered once or twice a day always with the main carbohydrate containing meals.

D) All the above.

Correct! Wrong!

10. When considering glargine insulin (Optisulin) which of the following statements is true?

A) The usual starting dose is 10 units. It is important to let each person know that the dose may change at any time throughout their journey with their diabetes and will be governed by their blood glucose levels.

B) Insulin is not a last resort and should never be seen as a failure.

C) One of the side effects of insulin is hypoglycaemia. It is important to acknowledge if a person is fearful of this and give them resources and tools to help them manage this side effect. Referral to a credentialled diabetes educator may be helpful if regular hypoglycaemia is occurring.

D) All the above

Correct! Wrong!

Insulin Quiz

1. When considering insulin choose the answer what is the most correct:

2. Of the insulin listed below which would be considered insulin prescribed at mealtimes for management of blood glucose levels due to food?

3. Of the insulin listed below which would be considered insulin prescribed as the basal (background) for the management of blood glucose levels?

5. When considering insulin pen needles which of the following is true?

6. When considering mixed insulin which of the following is true?

7. When considering insulin and the role of glucose monitoring which of the following is true?

9. When considering Insulin degludec (rys) and insulin aspart (rys) (Ryzodeg 70/30) which of the following statements are true

10. When considering glargine insulin (Optisulin) which of the following statements is true?

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