Insulin resistance and flu
A patient called to report that they had the flu, were vomiting and had diarrhea. The patient was not eating and so assumed, because of this, that they should not be taking their insulin. I had the patient check their blood sugars which were found to be over 340mg/dL.
Immediately I told them to drink some fluids and begin taking their basal insulin. I then helped them to adjust the dosage for the elevated blood sugars.
Lesson Learned: Omitting Insulin During Illness
One of the most common mistakes patients make with insulin, and one that often leads to hospitalization, is to neglect to take their insulin when they are ill. Such patients may think that they don’t need their insulin because they are nauseated or vomiting, and therefore not eating. In fact, however, more insulin is often needed in times of illness due to an increase in insulin resistance.
Make sure that you tell your patients the importance of maintaining their insulin injections if they get sick and to call if they have problems controlling their blood sugars, which almost always will be elevated during infections and sick days.
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