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2.1
Insulin Administration
Injection of Insulin

Presentation

Diabetes mellitus is an independent risk factor for stroke, and the incidence of diabetes in patients presenting with stroke is 16% to 20%. [ncbi.nlm.nih.gov]

A student shall not administer insulin without the instructor present until he/she has successfully completed the course. Insulin Status Your Insulin Certificate goes directly with your CMT or LIMA certification. [health.mo.gov]

Cardiovascular

  • Heart Failure

    Fluid retention, which may lead to or exacerbate heart failure, can occur with concomitant use of thiazolidinediones (TZDs) with insulin. These patients should be observed for signs and symptoms of heart failure. [lantus.com]

    failure; monitor for signs and symptoms of heart failure, treat accordingly, and consider discontinuing thiazolidinediones Coadministration with these drugs (eg, antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide [reference.medscape.com]

Eyes

  • Blurred Vision

    Symptoms of hypoglycemia can include dizziness, trembling, headache, blurred vision, having trouble concentrating, confusion, and sometimes trouble with speaking. [wikihow.com]

Neurologic

  • Dizziness

    Low blood sugar can come on very quickly and symptoms may include dizziness, shakiness, sweating, and rapid heartbeat. [everydayhealth.com]

    Initial signs of hypoglycemia include dizziness, sweating, tremor, confusion, and hunger. It's important to intervene before symptoms progress. High doses of insulin can lower levels of potassium. [rxlist.com]

    Symptoms of hypoglycemia can include dizziness, trembling, headache, blurred vision, having trouble concentrating, confusion, and sometimes trouble with speaking. [wikihow.com]

  • Tremor

    Initial signs of hypoglycemia include dizziness, sweating, tremor, confusion, and hunger. It's important to intervene before symptoms progress. High doses of insulin can lower levels of potassium. [rxlist.com]

    Proper recapping requires adequate vision, manual dexterity, and no obvious tremor. [care.diabetesjournals.org]

    Other symptoms can include tremor, heavy sweating, increased heart rate, feeling anxious, and hunger. [114] Using fast-acting insulin in the midst of a hypoglycemic event will quickly drop your blood sugar even further and result in severe confusion, [wikihow.com]

  • Headache

    […] unawareness Accidental mix-ups between insulin products can occur; instruct patients to check insulin labels before injection Rapid changes in serum glucose may induce symptoms of hypoglycemia Hypoglycemia is the most common cause of adverse reactions (eg, headache [reference.medscape.com]

    Symptoms of hypoglycemia can include dizziness, trembling, headache, blurred vision, having trouble concentrating, confusion, and sometimes trouble with speaking. [wikihow.com]

  • Seizure

    Incidence of Severe Hypoglycemia Events [ Time Frame: 12 months ] The total number of severe hypoglycemia events, defined as a clinical episode of hypoglycemia (resulting in seizure or coma, requiring hospitalization, intravenous glucose or glucagon administration [clinicaltrials.gov]

  • Agitation

    Extreme temperatures ( 86°F, 30°C) and excess agitation should be avoided to prevent loss of potency, clumping, frosting, or precipitation. Specific storage guidelines provided by the manufacturer should be followed. [care.diabetesjournals.org]

Workup

Serum

  • Glucose Decreased

    At the same time, HAEC grown with 12 mM glucose expressed lesser E-selectin and, more ICAM-1 (for 64%) and VCAM-1 (41%) molecules. 16.5 mM glucose decreased expression of all investigated adhesion molecules. [ncbi.nlm.nih.gov]

Treatment

Additional treatment with caspofungin and G-CSF was associated because of poor initial result to treatment. Caspofungin was later continued as monotherapy when LAmB had to be interrupted because of renal toxicity. [ncbi.nlm.nih.gov]

Epidemiology

Richardson T, Kerr D (2003) Skin-related complications of insulin therapy: epidemiology and emerging management strategies. Am J Clin Dermatol 4:661–667 PubMed CrossRef Google Scholar 7. [link.springer.com]

Heidelberg, Melbourne, VIC, 3084, Australia (2) Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, Trieste, Italy (3) Department of Pathology, Austin Health, Melbourne, VIC, Australia (4) Department of Epidemiology [annalsofintensivecare.springeropen.com]

Pathophysiology

Abstract Reduced insulin-mediated glucose transport in skeletal muscle is a hallmark of the pathophysiology of T2DM (Type II diabetes mellitus). Impaired intracellular insulin signalling is implicated as a key underlying mechanism. [ncbi.nlm.nih.gov]

Colorado State University, Pathophysiology of the Endocrine System [On-line Biomedical Hypertextbook]. Available online through http://arbl.cvmbs.colostate.edu. CSU (1999 June 15, Updated). Glucagon. [labtestsonline.it]

The hyperglycaemic response to surgery: pathophysiology, clinical implications and modification by the anaesthetic technique. Clin Intensive Care 1998;9:118–28 2. Lattermann R, Carli F, Wykes L, Schricker T. [journals.lww.com]

Accumulation of c-peptide in atherogenic plaques and chemotactic effects of c-peptide on monocytes may be involved in the pathophysiology of such complications [ 21 ]. [annalsofintensivecare.springeropen.com]

Prevention

Several anabolic agents have been utilized for retarding or preventing progressive wasting with limited success. [ncbi.nlm.nih.gov]

Centers for Disease Control and Prevention. Nosocomial hepatitis B virus associated with spring-loaded fingerstick blood sampling devices – Ohio and New York City, 1996. MMWR 1997;46:217-221. Centers for Disease Control and Prevention. [cdc.gov]

The American Nurses Association (ANA) and several other organizations representing nurses brought a lawsuit seeking to prevent this from taking place. [dredf.org]

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2.1
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