- Optimal Range
Is IV insulin therapy different from daily insulin injections?
Intravenous insulin therapy is a treatment procedure to manage high blood sugar (hyperglycemia) with intravenous infusion of insulin. Intravenous insulin is administered only in a hospital ICU setting in selected critically ill patients with a diabetes emergency or other conditions affecting blood sugar who require rapid and efficient control of hyperglycemia.
Self-administration of insulin by people with diabetes is always with an injection in the fatty tissue under the skin (subcutaneous). Intravenous insulin therapy is performed only under medical supervision along with continuous monitoring of blood sugar levels and various other vital parameters.
What insulin can be given intravenously?
The only type of insulin that is given intravenously is human regular insulin. A rapid-acting insulin analog is unnecessary in intravenous insulin administration because the insulin is delivered directly into the bloodstream and takes immediate effect.
An insulin analog is human insulin genetically altered in the laboratory to make them rapid-acting or long lasting. A rapid-acting analog insulin may be used to increase the insulin absorption rate in subcutaneous insulin.
How long does intravenous insulin last in the body?
Intravenous insulin acts rapidly and lasts for a very short duration in the body. To maintain the desired glucose levels in the blood, insulin is infused continuously with appropriate dosage titrations depending on the blood sugar level.
When is intravenous insulin therapy administered?
The potential uses for intravenous insulin therapy for treatment of hyperglycemia in patients under critical care include the following conditions:
- Heart-related conditions such as:
- Diabetic ketoacidosis (high level of acidic substances known as ketones in the blood)
- Hyperglycemia and hyperosmolarity (high concentration of dissolved electrolytes in blood)
- Medical or surgical critical care
- Patients on enteral (feeding tube) or parenteral (nutrition through veins) feeding for prolonged periods
- During labor and delivery
- Patients on high dose glucocorticoid therapy
- Post organ transplantation
- To determine the dosage before transition to subcutaneous insulin
What is the optimal range of glucose control?
Both American Diabetes Association (ADA) and American College of Endocrinology recommend that the target blood glucose range should be 140-180 mg/dl for the majority of the patients. A target of 110-140 mg/dl may be appropriate for some patients if it can be achieved without causing significant hypoglycemia.
What are the potential complications of intravenous insulin therapy?
Hypoglycemia is the primary adverse effect of intravenous insulin therapy. Successful implementation of IV insulin therapy while preventing hypoglycemia heavily depends on accurate bedside measurement of the glucose levels. Hospitals rely on point-of-care testing with portable monitors because of the requirement for frequent testing.
Bedside glucometers are more accurate in normal blood sugar range but in hyper or hypoglycemic patients, glucometers may vary up to 20% from lab results. Factors that affect bedside glucose measurement include:
- Operator errors such as improper calibration or use
- Source of blood (serum, plasma or whole blood)
- Blood sampling site (capillary, vein or artery)
- Amount of blood
- Excess blood can show false high reading
- Inadequate blood can show false low reading
- Anemia can show false high level in whole blood test
- Peripheral hypoperfusion (reduced blood flow) from:
- Blood vessel constriction
- Arterial spasms
- Delay in processing of blood sample
Certain medications and other substances in the bloodstream can interfere with the glucose measurements, which include
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Intravenous insulin therapy is a treatment procedure to manage high blood sugar (hyperglycemia) with intravenous infusion of insulin. Intravenous insulin is administered only in a hospital ICU setting in selected critically ill patients with a diabetes emergency or other conditions affecting blood sugar. People with diabetes self administer insulin subcutaneously, not in the vein.
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Diabetes (Type 1 and Type 2)
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Diabetes Symptoms in Men
Diabetes mellitus is a disease in which a person's blood sugar (blood glucose) is either too high (hyperglycemia) or too low (hypoglycemia) due to problems with insulin regulation in the body. There are two main types of diabetes mellitus, type 1 and type 2. Type 1 diabetes usually occurs during childhood, while type 2 diabetes usually occurs during adulthood, however, rates of both types of diabetes in children, adolescents, and teens is increasing. More men than women have diabetes in the US, and the disease can affect men differently than women.Warning symptoms of diabetes that men have and women do not include low testosterone (low-t), sexual problems, impotence (erectile dysfunction), decreased interest in sex, and retrograde ejaculation. Type 1 and type 2 diabetes symptoms and signs that are the same in men and women include skin infections, numbness or tingling in the feet or hands, nausea, excessive thirst or hunger, fatigue, irritability, blurred vision, weight gain, weight loss, urinary tract infections (URIs), and kidney problems. Treatment for type 1 diabetes is insulin, and treatment for type 2 diabetes are lifestyle changes like eating a healthy diet, getting exercise daily, and if necessary, diabetes medications.
Diabetes Treatment: Medication, Diet, and Insulin
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with: insulin, exercise, and a diabetic diet. Type 2 diabetes is first treated with: weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Diabetes Symptoms in Women (Early and Late)
Diabetes symptoms in women include vaginal itching, pain, or discharge, loss if interest or pain after having sex, polycystic ovarian syndrome (POS), and urinary tract infections or UTIs (which are more common in women. Symptoms of diabetes that are the same in women and men are excessive thirst and hunger, bad breath, and skin infections, darkening of skin in areas of body creases (acanthosis nigricans), breath odor that is fruity, sweet, or acetone, and tingling or numbness in the hands or feet, blurred vision, fatigue, tingling or numbness in the hands or feet, wounds that heal slowly, irritability, and weight loss or gain. Complications of type 1 and type 2 diabetes are the same, for example, skin, eye, and circulation problems, low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), ketoacidosis, and amputation. If diabetes is not managed a person may not survive.
Diabetes insipidus is a condition in which the patient has frequent urination. Symptoms of diabetes insipidus include irritable, listless, fever, vomiting, or diarrhea due to the loss of large volumes of urine. There are three types of diabetes insipidus, central, nephrogenic, dipsogenic, and gestational. Treatment depends upon the type of diabetes insipidus.
Can Type 2 Diabetes be Cured?
Type 2 diabetes is a long-term medical condition in which the body is not able to regulate blood sugar (glucose) level because of the inability of the body to properly use insulin. An individual can get type 2 diabetes because of a number of factors that reduce insulin action or quantity in the body. The goals of diabetes management are to eliminate symptoms and prevent the development of complications. Many drugs, both oral and injectable, are available for diabetes management.
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