How To Get Good Results From Your Insulin Injection Sites - Case Study
| Steady Shot
The case of an elderly woman with stage-III diabetes mellitus was presented at our recent meeting by her husband, in which the 70-year old woman developed extreme insulin resistance related to repeated injections of insulin into a subcutaneous fat deposit formed by numerous injections over several years. Insulin resistance was found to be related to the increased level of HDL and decreased level of LDL cholesterol and triglycerides in her blood. She had no prior cardiovascular diseases or hypertension. She had a BMI (Body Mass Index) of 45.5, but her weight was normal.
During a routine medical examination and tests, insulin resistance was diagnosed to be due to insulin deficiency and not related to hyperglycemia. She underwent blood glucose monitoring on a regular basis and had normal blood sugar levels throughout her adult life.
Insulin treatment using insulin sensitizers was introduced to reduce the risk of hypoglycemia in this patient. The first insulin insufficiency occurred when she started receiving two doses of one gram of insulin per kilogram of body weight per hour in a 24-hour period. Her glucose levels fell rapidly during the second week of the treatment. The second episode of hypoglycemia took place when her doctor switched her to a single dose of one gram of insulin per kilogram of body weight per hour in a day. Again, her glucose levels fell quickly.
After several months, her doctor decided to increase the dose of insulin to two grams of insulin per kilogram of body weight per hour for a total of four grams of insulin per day. This dose of insulin was needed to treat her severe hypoglycemia. Insulin sensitivity decreased due to the presence of additional insulin in the bloodstream.
After three months, she was still unable to maintain normal blood glucose levels despite receiving the recommended dose of insulin. Her physician asked her to switch to an insulin infusion system in which he added the insulin in the vein through an IV. but he was unable to achieve an optimal insulin response due to low availability of insulin in his system. After switching to this system, she experienced moderate hypoglycemia for the second time.
This time, she developed hypoglycemia with a rapid onset. Her blood glucose levels fell rapidly and she was admitted to the hospital where she was kept under medical observation. Since her glucose levels were still extremely low despite repeated doses of insulin, she was put on a high dose of oral medication to reduce her blood glucose level and prevent hypoglycemia and the need for continuous insulin infusion.
It is clear from the case report that, if used properly, insulin sensitizers can provide effective control of hypoglycemia and the need for insulin infusion but the most important thing is to monitor the levels closely and correct them when necessary. The results of insulin testing are useful to guide treatment to improve diabetic control but in some cases, it may be necessary to change the dosage or use a different form of insulin to reduce the risk of hypoglycemia or to reduce the need for continuous administration of insulin.
Insulin therapy is a vital component of diabetes management but should never be substituted for proper diet and exercise, especially when it is used alone to treat the whole spectrum of diabetes, especially in individuals with impaired insulin sensitivity. Diabetic control is a lifelong process that requires careful monitoring and appropriate treatment of diabetes as well as healthy eating and lifestyle changes.
If you are having trouble managing your diabetes care team is a resource available online. They can also help you decide which insulin will be best for your needs. You can also find resources to learn about how to make changes to your diet and lifestyle to help manage your diabetes.
Remember that diabetes is a progressive disease that develops over time and if you have chronic diabetes, you may develop serious complications. Diabetes mellitus is a very serious problem that often causes blindness, kidney failure, heart problems, and nerve damage. For some, diabetes can be fatal and it is very important to discuss all your options with your doctor before you begin any new treatment plan.
Long term management of diabetes is necessary. You may need insulin for life. Diabetes is not a problem to be ashamed of or one to be ignored. It is a progressive disease that is preventable and managed by using the right tools and information to learn what you can do now.