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Some guidelines recommend a bolus (initial large dose) of insulin of 0.1 units of insulin per kilogram of body weight. This can be administered immediately after the potassium level is known to be higher than 3.3 mmol/L; if the level is any lower, administering insulin could lead to a dangerously low potassium level (see below). [3]
Hypokalemia is a low level of potassium (K +) in the blood serum. [1] Mild low potassium does not typically cause symptoms. [3] Symptoms may include feeling tired, leg cramps, weakness, and constipation. [1] Low potassium also increases the risk of an abnormal heart rhythm, which is often too slow and can cause cardiac arrest. [1] [3]
Low potassium is caused by increased excretion of potassium, decreased consumption of potassium rich foods, movement of potassium into the cells, or certain endocrine diseases. [3] Excretion is the most common cause of hypokalemia and can be caused by diuretic use, metabolic acidosis , diabetic ketoacidosis , hyperaldosteronism , and renal ...
In insulin-deficient diabetes (exogenous) insulin levels do not decrease as glucose levels fall, and the combination of deficient glucagon and epinephrine responses causes defective glucose counterregulation. Furthermore, reduced sympathoadrenal responses can cause hypoglycemia unawareness.
The regulation of glucose production in the kidney is achieved by action of insulin, catecholamines and other hormones. [14] Renal gluconeogenesis takes place in the renal cortex . The renal medulla is incapable of producing glucose due to absence of necessary enzymes .
Insulin self-injected for treatment of diabetes (i.e., diabetic hypoglycemia) Insulin self-injected surreptitiously (e.g., Munchausen syndrome) Insulin self-injected in a suicide attempt or fatality; Various forms of diagnostic challenge or "tolerance tests" Insulin tolerance test for pituitary or adrenergic response assessment; Protein challenge
Hyberbolic relationship between insulin sensitivity and beta cell function showing dynamical compensation in "healthy" insulin resistance (transition from A to B) and the evolution of type 2 diabetes mellitus (transition from A to C).
When individuals take insulin without needing it, to purposefully induce hypoglycemia, this is referred to as surreptitious insulin use or factitious hypoglycemia. [ 3 ] [ 2 ] [ 24 ] Some people may use insulin to induce weight loss, whereas for others this may be due to malingering or factitious disorder , which is a psychiatric disorder . [ 24 ]