9. Insulin Regimens

what is the goal of insulin regimens?

to mimic the functioning pancreas

what is a conventional insulin regimen?

simple insulin plan where meals and activity should stay consistent every day

• eat and exercise the same every single day

• the doses arent flexible

who is a conventional insulin regimen appropriate for?

• some patients with type 2 diabetes

• terminally ill patients

• older adults with limited self-care abilities

• patients unwilling or unable to engage in self-management activities

what is an intensive insulin regimen?

an flexible regimen that allows doses to be changed based on eating, activity, and as needed

• sliding scale

what is sliding-scale insulin?

insulin dosing based on the current blood glucose level

is there any critical nursing judgment to be done before administering insulin using an sliding scale?

no, just give the insulin depending on the scale

what are the main complications of insulin therapy?

• local allergic reactions

• systemic allergic reactions

• insulin lipodystrophy

• resistance to injected insulin

what is a local allergic reaction to insulin?

redness, swelling, tenderness, induration, or a wheal at the injection site

• usually appears 1 to 2 hours after insulin administration

• usually resolves within hours to days

what is a systemic allergic reaction to insulin?

an allergic reaction that starts locally and then spreads

• can cause edema or anaphylaxis

what is insulin lipodystrophy?

change in subq fat at injection site that can mess up insulin absorption

• can be lipoatrophy or lipohypertrophy

what are the 2 forms of insulin lipodystrophy?

lipoatrophy and lipohypertrophy

what is lipoatrophy?

• loss of fat under the skin

• the area looks sunken or dented

what is lipohypertrophy?

• buildup/thickening of fat under the skin

• the area looks lumpy, rubbery, or raised

why should an area with insulin lipodystrophy not be used for injection?

it changes insulin absorption

how is insulin lipodystrophy prevented?

by rotating injection sites

what is resistance to injected insulin?

a problem where the immune system decreases the amount of injected insulin available for use

how is resistance to injected insulin treated?

with a more concentrated insulin preparation

what are the main methods of insulin delivery?

• traditional subcutaneous injections

• insulin pens

• jet injectors

• insulin pumps

• inhaled insulin

what is an insulin pen?

a prefilled insulin cartridge loaded into a pen-like holder

• uses an attached disposable needle and lets the dose be dialed up for injection