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DIABETES MELLITUS: INSULIN SHOCK AND DIABETIC COMA

Insulin shock
Insulin shock is the effect of too much insulin. It occurs because the patient has failed to eat some of his food; he has increased his activity; or he has a gastrointestinal upset so that the nutrients are not being normally absorbed.
The symptoms of insulin shock result from the marked lowering of the blood glucose. The patient becomes weak, nervous, pale, and hungry. He trembles, perspires, complains of headache, and may become irrational in behavior as if intoxicated. If he is not given carbohydrate promptly he becomes drowsy disoriented, and eventually unconscious. Prolonged hypoglycemia is damaging to the brain cells because glucose is the only form of energy used by nervous tissue.
Patients who take insulin should always carry some lump sugar or hard candy in case they feel the signs of a reaction. Orange juice or other fruit juice or tea with sugar may be given to the patient who has signs of insulin shock. When the patient is unconscious glucose is given intravenously.

Diabetic coma (acidosis)
Diabetic coma is caused by inadequate insulin to meet body needs. The patient may have failed to follow his diet, or to take the prescribed insulin, or may have an infection.
When the insulin supply to the body is inadequate, the blood sugar rises and glycosuria occurs. A rapid increase of incompletely metabolized fatty acids in the blood leads to a low blood pH. The patient may complain of thirst, headache, frequent urination, fatigue, and drowsiness. His face becomes red, his skin is hot and dry, and his breath has a sweetish (acetone) odor. Nausea and vomiting sometimes occur. The respirations become rapid and the pulse is fast. Finally, the patient lapses into unconsciousness.
Immediate medical attention is required for the patient who goes into diabetic coma. Treatment includes insulin and fluid therapy.
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HUMAN INSULINS COMMONLY USED IN YOUNG PEOPLE: UNMODIFIED (CLEAR) INSULINS

Actrapid HM insulin (neutral insulin)

Actrapid acts quickly.

This is an unmodified human insulin. It is soluble insulin so it is a clear insulin solution. Actrapid works quickly – it may start its effect within half an hour, its strongest effect is from one to four hours but its activity fades after about six or seven hours.

Hypoglycemic reactions due to Actrapid tend to occur about one to five hours after the injection.

Velosulin insulin (neutral insulin)

Velosulin acts quickly.

Velosulin is an unmodified human insulin and is very similar to Actrapid. It is a soluble insulin so that it is a clear insulin solution.

Velosulin works quickly – it may start its effect within half an hour, its strongest effect is from one to four hours but activity fades after six to seven hours.

Hypoglycemic reactions due to Velosulin tend to occur from one to five hours after it is given.

Humulin R insulin (neutral insulin)

Humulin R acts quickly.

Humulin R is an unmodified human insulin and is very similar to Actrapid and Velosulin. It is a soluble insulin so that it is a clear insulin solution. It works quickly and may start its effect within half an hour, its strongest effect is from one to four hours, but its activity fades after about six or seven hours.

Hypoglycemic reactions due to Humulin R tend to occur about one to five hours after the injection.

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