Agents for Diabetes Insulin

HPI AJ is a 27-year-old woman with type 1 diabetes diagnosed at age 11. She has not been seen by a health-care provider for 3 years. She is 5 feet 6 inches tall and weighs 60 kg. She takes 70/30 insulin twice daily, before breakfast and dinner. She self-monitors her blood glucose once a day her FBG range is 200 to 250 mg/dL. 

Labs Upon completing her laboratory work, you learn her HgbAlc is 9.5% Nl  

Type 1 diabetes is characterized by a near-absolute insulin deficiency at diagnosis or soon thereafter. The beta cells of the pancreas are no longer able to secrete insulin due to autoimmune destruction. Therefore, people with type 1 diabetes require exogenous administration of insulin for survival. People with type 2 diabetes may require insulin therapy when diet, exercise, and the oral agents are no longer enough to provide adequate glucose control. 

The insulin molecule consists of 51 amino acids arranged in two chains, an A chain (21 amino acids) and B chain (30 amino acids), that are linked by two disulfide bonds. Proinsulin is the insulin precursor that is first processed in the Golgi apparatus of the beta cell where it is processed and packaged into granules. Proinsulin, a single-chain 86-amino acid peptide, is cleaved into insulin and C-peptide, a connecting peptide. These are secreted in equimolar portions 

Do nothing. Her HgbAlc represents good glycemic control. 

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