Test Scenarios - Levemir®

Scenario 1: No Specific Risks Identified (🟢 Safe Level)

Patient Description:

Male, 45 years old, Type 2 diabetes mellitus (T2DM), recently diagnosed. Weight 90 kg. No significant comorbidities (normal renal/hepatic function, no heart failure (HF), no endocrine disorders). No known allergy to insulin detemir or excipients. Currently taking metformin only. Considering initiation of Levemir® as basal insulin therapy.

Input Data (Example):

  • Age: 45
  • Weight: 90
  • Diabetes Type: Type 2
  • Conditions: (none selected)
  • Medications: Metformin

Expected Result:

🟢 Safe Level

Verdict: "No Specific Risks Identified"

Reasons: (list empty)

General Information Block: Visible (contains information for T2DM, incl. approximate initial dose).

Scenario 2: Medium Risk (🟡 Medium Level)

Patient Description:

Female, 68 years old, Type 1 diabetes mellitus (T1DM) for over 20 years. On a basal-bolus insulin regimen. Planning to switch from another basal insulin to Levemir®. Concomitantly taking an ACE inhibitor (ACE-I) for blood pressure (BP) control. No renal/hepatic insufficiency, no known allergies.

Input Data (Example):

  • Age: 68
  • Weight: (not entered)
  • Diabetes Type: Type 1
  • Conditions: Transferring from another insulin, Basal-bolus regimen
  • Medications: ACE inhibitor (or similar)

Expected Result:

🟡 Medium Risk

Verdict: "Medium Risk"

Reasons:

  • Age ≥ 65 years...
  • Transferring from another insulin type...
  • Concomitant use of drugs reducing insulin requirements...

General Information Block: Visible (contains data for T1DM and basal-bolus regimen).

Scenario 3: High Risk (🟠 High Level)

Patient Description:

Male, 62 years old, Type 2 diabetes mellitus (T2DM). Diagnosed hepatic insufficiency (e.g., Child-Pugh Class A cirrhosis). Taking Levemir® and oral antidiabetic drugs (OADs). Also taking a beta-blocker (e.g., bisoprolol) for ischemic heart disease (IHD). Has risk factors for hypoglycaemia (e.g., irregular meals).

Input Data (Example):

  • Age: 62
  • Weight: (not entered)
  • Diabetes Type: Type 2
  • Conditions: Hepatic impairment, Hypoglycaemia risk factors
  • Medications: OADs/GLP-1 RAs, Beta-blockers

Expected Result:

🟠 High Risk

Verdict: "High Risk"

Reasons:

  • Hepatic impairment...
  • Beta-blockers may mask symptoms... in patients with risk factors...

General Information Block: Visible.

Scenario 4: Use Contraindicated (🔴 Critical Level)

Patient Description:

Female, 30 years old, Type 1 diabetes mellitus (T1DM). History of a systemic allergic reaction (anaphylaxis or generalized urticaria) to insulin detemir administration.

Input Data (Example):

  • Age: 30
  • Weight: (not relevant)
  • Diabetes Type: Type 1
  • Conditions: Allergy to insulin detemir
  • Medications: (none selected)

Expected Result:

🔴 Use Contraindicated

Verdict: "Use Contraindicated"

Reasons:

  • Known allergy to insulin detemir...

General Information Block: Not displayed.