By Mark W. J. Strachan, Brian M. Frier
The target of this ebook is to supply transparent and concise information regarding the secure prescribing of insulin either subcutaneously and intravenously. It offers details at the varieties of insulin, the supply units, unintended effects of insulin and, most significantly, on rational dose adjustment.
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Extra resources for Insulin Therapy: A Pocket Guide
1007/978-1-4471-4760-2_5, © Springer-Verlag London 2013 43 44 Chapter 5. Side-Effects of Insulin • Autonomic—sweating, palpitations, shaking, hunger • Neuroglycopenic—confusion, lack of coordination, drowsiness, unusual behavior, difficulty with speech • Nonspecific malaise—headache, nausea These symptoms are triggered when blood glucose falls below a threshold level, which is reproducible in nondiabetic people but can vary in people with diabetes as it is influenced by factors such as exposure to preceding hypoglycemia or the quality of glycemic control.
Because a high-fat meal delays gastric emptying, an “extended square wave” may be employed; some patients use a “dual wave” (which has two peaks) for a meal with a high starch content. Correction of postprandial or pre-bedtime hyperglycemia with additional bolus injections of rapid-acting insulin is discouraged because of the difficulty of estimating the dose of Insulin Pumps 25 insulin with accuracy, and this practice risks hypoglycemia. However, the ability of the pump to calculate the amount of “active” insulin has made the decision on appropriate insulin doses for correction boluses more scientific and safer.
2. Monitoring and Adjusting the VRII Capillary blood glucose should be measured hourly. v. v. insulin for a prolonged period without close supervision. c. long-acting insulin appropriate amount of insulin to infuse for a given blood glucose. Obese patients may require higher rates of insulin infusion, while thin patients may be more insulin-sensitive. It is vital that medical staff monitor the blood glucose response every 2–4 h because the VRII may require adjustment to ensure that blood glucose remains between 6 and 10 mmol/l (between 4 and 12 mmol/l is acceptable, however).
Insulin Therapy: A Pocket Guide by Mark W. J. Strachan, Brian M. Frier