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Intensive insulin therapy or flexible insulin therapy is a therapeutic regimen for diabetes mellitus treatment. This newer approach contrasts with conventional insulin therapy. Rather than minimize the number of insulin injections per day (a technique which demands a rigid schedule for food and activities), the intensive approach favors ...
Glucagon is a hormone that rapidly counters the metabolic effects of insulin in the liver, causing glycogenolysis and release of glucose into the blood. It can raise the glucose by 30–100 mg/dL within minutes in any form of hypoglycemia caused by insulin excess (including all types of diabetic hypoglycemia).
Insulin can be injected by several methods, including a hypodermic needle, jet injector, or insulin pump. There is also inhaled insulin that can be used in adults with diabetes. [33] There are several types of insulin that are commonly used in medical practice, with varying times of onset and duration of action. [32]
Initial treatment generally consists of intravenous fluids to manage dehydration, intravenous insulin in those with significant ketones, low molecular weight heparin to decrease the risk of blood clotting, and antibiotics among those in whom there are concerns of infection. [3] The goal is a slow decline in blood sugar levels. [3]
Hypoglycemia due to exogenous (injected) insulin Insulin self-injected for treatment of diabetes (i.e., diabetic hypoglycemia) Insulin self-injected surreptitiously (e.g., Munchausen syndrome) Insulin self-injected in a suicide attempt or fatality; Various forms of diagnostic challenge or "tolerance tests"
The primary treatment of DKA is with intravenous fluids and insulin. [1] Depending on the severity, insulin may be given intravenously or by injection under the skin. [3] Usually, potassium is also needed to prevent the development of low blood potassium. [1] Throughout treatment, blood sugar and potassium levels should be regularly checked. [1]
The purpose of the off-label 'mini-dose' is to avoid an emergency condition that may require glucagon rescue. This might be needed in cases such as when a diabetic child is injected with insulin before breakfast, eats, and then vomits and cannot eat again: with the injected insulin working its way into the bloodstream and no carbohydrate to balance, there may soon be a hypoglycemic emergency.
Insulin is used to treat a number of diseases including diabetes and its acute complications such as diabetic ketoacidosis and hyperosmolar hyperglycemic states. It is also used along with glucose to treat high blood potassium levels. Use during pregnancy is relatively safe for the baby. [6]