Lipodystrophy, insulin resistance and hypersensitivity reactions have been associated with insulin therapy, but the incidence and severity of these unwanted effects is minimal with monocomponent insulin.
Common Problems of Diabetes:
Hypoglycemia (Insulin Reaction): Hypoglycemia (too little glucose in the blood) is one of the most frequent adverse events experienced by insulin users. It can be brought about by: Taking too much insulin; missing or delaying meals; exercising or working more than usual; an infection or illness (especially with diarrhea or vomiting); a change in the body's need for insulin; diseases of the adrenal, pituitary or thyroid gland, or progression of kidney or liver disease; interactions with other drugs that lower blood glucose eg, oral hypoglycemics, salicylates (eg, aspirin), sulfa antibiotics and certain antidepressants; consumption of alcoholic beverages.
Symptoms of mild to moderate hypoglycemia may occur suddenly and can include: Sweating, dizziness, palpitation, tremor, hunger, restlessness, tingling in the hands, feet, lips or tongue, lightheadedness, inability to concentrate, headache, drowsiness, sleep disturbances, anxiety, blurred vision, slurred speech, depressive mood, irritability, lightheadedness, inability to concentrate, headache, abnormal behavior, unsteady movement and personality changes.
Signs of severe hypoglycemia can include: Disorientation, unconsciousness, seizures and death.
Therefore, it is important that assistance be obtained immediately.
Early warning symptoms of hypoglycemia may be different or less pronounced under certain conditions eg, long duration of diabetes, diabetic nerve disease, medications eg, β-blockers, change in insulin preparations, intensified control (≥3 insulin injections/day) of diabetes.
A few patients who have experienced hypoglycemic reactions after transfer from animal-source insulin to human insulin have reported that the early warning symptoms of hypoglycemia were less pronounced or different from those experienced with their previous insulin.
Without recognition of early warning symptoms, the patient may not be able to take steps to avoid more serious hypoglycemia. Be alert for all the various types of symptoms that may indicate hypoglycemia. Patients who experience hypoglycemia without early warning symptoms should monitor their blood glucose frequently, especially prior to activities eg, driving. If the blood glucose is below the normal fasting glucose, consider eating or drinking sugar-containing foods to treat hypoglycemia.
Mild to moderate hypoglycemia may be treated by eating foods or drinks that contain sugar. Patients should always carry a quick source of sugar eg, candy mints or glucose tablets. More severe hypoglycemia may require the assistance of another person. Patients who are unable to take sugar orally or who are unconscious require an injection of glucagon or should be treated with IV administration of glucose at a medical facility.
The patient should learn to recognize the symptoms of hypoglycemia. If uncertain about these symptoms, the patient should monitor his/her blood glucose frequently to help him/her learn to recognize the symptoms that the patient experiences with hypoglycemia.
If the patient has frequent episodes of hypoglycemia or experience difficulty in recognizing the symptoms, he/she should consult the physician to discuss possible changes in therapy, meal plans and/or exercise programs to help avoid hypoglycemia.