Endocrine Drugs and Medications Q 21

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A major side effect of insulin use that can be life threatening is:

  

     A. Hyperglycemia

     B. Stomach upset

     C. Hypoglycemia

     D. Tremors

    

    

Correct Answer: C. Hypoglycemia

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The action of insulin will lower glucose levels, which may prove fatal if levels drop too low. Hypoglycemia is, by far, the most common adverse effect of insulin therapy. The other adverse effects of insulin therapy include weight gain, and rarely electrolyte disturbances like hypokalemia, especially when used along with other drugs causing hypokalemia.

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Option A: Some patients who take insulin before bed, wake up with high blood sugar levels. This effect occurs when the insulin causes a hypoglycemic condition in the body, which activates the antihyperglycemic hormones such as cortisol and adrenaline, resulting in rebound hyperglycemia.; this can be corrected by reducing the dose of bedtime insulin or changing the time of insulin dosing.

Option B: The subcutaneous route of administration also has its adverse effects. Pain at the injection site, lipodystrophy at the site of injection are the most common adverse effects of daily subcutaneous injections. Other adverse effects like peripheral hyperinsulinemia and decreased compliance are also seen in the population using the subcutaneous route for administration of insulin.

Option D: Insulin taken in large doses will cause symptoms of hypoglycemia in the patient. Some of these symptoms include headache, dizziness, palpitations, sweating, abdominal pain, and blurring of vision. The immediate therapy for such patients is increasing the levels of glucose. In a conscious patient, this can be done by eating a high energy bar or drinking a glass of glucose water. If the patient is unconscious, he needs to be hospitalized and given dextrose solution intravenously and monitor glucose levels continuously.

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