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, uncomfortable side effects of insulin and, most significantly, on rational dose adjustment.
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The purpose of this publication is to supply transparent and concise information regarding the secure prescribing of insulin either subcutaneously and intravenously. It presents details at the types of insulin, the supply units, unwanted effects of insulin and, most significantly, on rational dose adjustment.
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Additional info for Insulin Therapy: A Pocket Guide
Insulin-specific factors (Chap. 3) such as the site and depth of injection and the resuspension of isophane insulins also affect blood glucose profiles. Larger doses of insulin may peak later and last for longer than smaller doses and factors that increase subcutaneous blood 32 Chapter 4. 1 Checklist for initiating insulin What is diabetes? , following hot baths or saunas) may also enhance absorption). Insulin Doses at Initiation Given the intra- and interindividual variation in insulin requirements, determining the initial starting dose of insulin can be difficult and may involve a degree of clinical trial and some educated guesswork!
1007/978-1-4471-4760-2_4, © Springer-Verlag London 2013 29 30 Chapter 4. Initiating and Adjusting Insulin patients to absorb and remember this torrent of new information. In people with type 2 diabetes, insulin is seldom commenced with such urgency, thus allowing the recipient time to adjust psychologically to the imminent need for insulin. Nevertheless, it may still be a time of emotional stress for the individual. While the requirement for insulin is absolute in type 1 diabetes, the decision to commence insulin in a person with type 2 diabetes is not always so clear-cut.
54 Chapter 6. 1 2 The insulin infusion rates are being adjusted every hour in response to fluctuating capillary blood glucose levels. v. v. glucose is also necessary (unless significant hyperglycemia is present). 45 % saline is preferred as a means of providing additional sodium. If a patient is volume-overloaded, 20 % glucose can be used, but is hypertonic and irritant to veins and local tissues, and should be administered via a central line. The daily requirement for potassium is approximately 60 mmol/day.
Insulin Therapy: A Pocket Guide by Mark W. J. Strachan, Brian M. Frier