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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]

Entire Body System

  • Short Stature

    In summary, we found that insulin administration in children with short stature decreases plasma leptin levels, equally in those with and without GHD. [ncbi.nlm.nih.gov]

  • Sepsis

    Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 2008;358:125–39 36. Bilotta F, Caramia R, Paoloni FP, Delfini R, Rosa G. Safety and efficacy of intensive insulin therapy in critical neurosurgical patients. [journals.lww.com]

Cardiovascular

  • Heart Disease

    Release Date: 01/28/2019 Heart Disease is the leading cause of death for both men and women in the United States. Each year, one in four deaths are caused by heart disease. [emmc.org]

    2 At least 68% of patients with diabetes aged > 65 years die of some form of heart disease; 16% die of stroke. 2 Type 2 diabetes remains the leading cause for cardiovascular disorders, blindness, end-stage renal disease, amputations, and hospitalizations [mdedge.com]

    disease, may mask symptoms of hypoglycemia (low blood sugar). [rxlist.com]

Skin

  • Erythema

    Adverse reactions Metabolic: hypokalemia, sodium retention, hypoglycemia, rebound hyperglycemia (Somogyi effect) Skin: urticaria, rash, pruritus Other: edema; lipodystrophy; lipohypertrophy; erythema, stinging, or warmth at injection site; allergic reactions [medical-dictionary.thefreedictionary.com]

Psychiatrical

  • Fear

    A small number of parents and patients reported fear of hypoglycaemia as a reason to inject insulin post meals; input from the diabetes MDT (e.g. dietitian and psychologist) may help ameliorate the actual or perceived risk. [adc.bmj.com]

    In our study, severe hypoglycemia, the most feared complication of intensive insulin therapy, was rarely induced. [journals.lww.com]

    For those patients who are truly fearful of needles, referral to a psychologist or psychiatrist proficient in cognitive behavioral therapy for ‘systematic desensitization’ can often quickly resolve the issue. 32 Disposal of Sharps Healthcare workers are [touchendocrinology.com]

  • Hunger

    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]

    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]

Neurologic

  • 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]

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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