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Insulin Reaction
This refers to a condition where too much insulin leads to a rapid drop in the blood sugar level. This problem exists commonly in the insulin dependent diabetic who has had their daily insulin dose but has "skipped" a meal. A rapid drop in blood sugar can occur from an overdosage of insulin, inadequate diet, or a higher level of physical activity. Common symptoms include: weakness, nausea, palpitations progressing to decreased level of consciousness, fainting, or seizures. Early symptoms should be treated with oral sugar if possible. Colas, candy, or juice can alleviate the symptoms if given promptly. If the patient becomes too lethargic or loses consciousness, one SHOULD NOT attempt to force the patient to drink. This could result in aspiration into the lungs. Notify the ambulance personnel IMMEDIATELY so that they can administer dextrose intravenously. The time interval between the last insulin dose and the abrupt decline in blood glucose can provide a clue for the physician in determining how the insulin dose should be adjusted. Diabetic patients MUST remain on a fixed caloric intake (don't skip meals) secondary to their fixed insulin dosing schedule.
REMEMBER
1. Peak effect of NPH (lente) insulin is at 8-10 hours after the injection.
2. Peak effect of REGULAR insulin is 3-4 hours after the injection.
3. You should be careful to check your blood sugar at these crucial times.
4. An increase in physical activity (sports) can lead to a lowering of the blood sugar level. This is due to a higher glucose utilization by the body with activity.
5. See your doctor for any insulin dose adjustments.
6. Early morning insulin reactions can be seen in the diabetic patient who takes NPH insulin in the evening (second dose). Many of these patients can correct their problem with the addition of a "bedtime snack". Discuss these issues with your physician BEFORE manipulating your insulin or diet.
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