Patient/caregiver was instructed upon contraindications for insulin administration as follows:
- Insulin use should be avoided in individuals with prior history of serious allergic reactions to insulin administration. But allergy to insulin is a rare condition.
- Insulin is primarily metabolized in the liver and kidney and is significantly excreted in urine by the kidneys. Individuals with liver and/or renal disease cannot metabolize and/or excrete insulin normally. In such patients with compromised liver/renal functions, insulin can stay active in circulation for longer time and so, can alter the dosage requirements for insulin administration. In such individuals, insulin must be administered cautiously with close follow-up on blood sugar readings, changing insulin requirements, and periodical evaluation of liver and/or kidney functions.
- Insulin administered in diabetic individuals helps to promote shifting of glucose from the blood into the cells of body tissues. This helps with reducing/regulating the blood sugar levels and contributes towards improved blood sugar control. If the blood sugars are being overly corrected with insulin administration, individuals can present with severely low blood sugars (hypoglycemia). Frequent hypoglycemic episodes with insulin administration calls for insulin dosage adjustment. Insulin must be administered cautiously in individuals at risk for hypoglycemia, observing close follow-up on blood sugar readings, reporting the numbers appropriately to your physician, seeking suggestions on insulin dose change, and observing compliance with recommendations made.
- Potassium levels in the blood should be maintained in a close range. Too high (hyperkalemia) or too low (hypokalemia) levels of blood potassium, in comparison to normal, can be seriously detrimental to the function of heart. Apart from blood sugar control, insulin normally plays an important role in shifting the potassium from the blood into the cells, thus lowering the potassium levels in the blood. Insulin administration in individuals with hypokalemia can result in insulin shifting the potassium from the blood into the cells, thus lowering the blood potassium levels to dangerous levels. This can invite risk for life-threatening cardiac arrhythmias. So, for severely hypokalemic individuals, insulin administration could be a contraindication for the risk of development of cardiac arrhythmias.
