Adverse effects of insulin

1. Adverse Effects of Insulin Therapy
• An Evidence-Based Clinical Review
• Presented by: [Your Name]
• Date: [Date]

2. Introduction
• • Insulin is a life-saving therapy for diabetes
mellitus
• • Used in Type 1 DM and advanced Type 2 DM
• • Adverse effects can be acute or chronic, and
patient-specific

3. Classification of Adverse Effects
• • Hypoglycemia (acute, severe)
• • Lipodystrophy (lipohypertrophy, lipoatrophy)
• • Weight gain
• • Allergic reactions (local/systemic)
• • Insulin resistance
• • Edema
• • Hypokalemia

4. Hypoglycemia
• • Most common and serious adverse effect
• • Symptoms: Tremors, sweating, palpitations,
confusion, seizures
• • Causes: Excess dose, skipped meals, exercise
• • Management: Oral glucose (mild), IV
dextrose/glucagon (severe)
• • Prevention: Patient education, insulin
titration

5. Lipodystrophy
• • Lipohypertrophy: Accumulation of fat at
injection site
• • Lipoatrophy: Loss of subcutaneous fat due to
immune reaction
• • Causes: Repeated injection at same site
• • Prevention: Site rotation
• • Impact: Erratic insulin absorption

6. Weight Gain
• • Insulin promotes fat storage and reduces
glycosuria
• • Common in Type 2 DM patients
• • Exacerbated by excessive caloric intake
• • Management: Dietary control, insulin-
sensitizing agents

7. Allergic Reactions
• • Rare with recombinant human insulin
• • Local: Redness, swelling, itching at site
• • Systemic: Anaphylaxis (extremely rare)
• • Management: Antihistamines,
desensitization therapy

8. Insulin Resistance
• • Defined as reduced responsiveness to insulin
• • May be due to obesity, infection, antibodies
• • Requires higher insulin doses
• • Investigations: Insulin antibodies, C-peptide
levels

9. Insulin-Induced Edema
• • Sodium retention due to insulin’s renal
effects
• • Presents as peripheral or generalized edema
• • Usually self-limiting
• • May need dose adjustment or diuretics

10. Hypokalemia
• • Insulin shifts potassium intracellularly
• • Risk in IV insulin therapy (e.g., DKA
treatment)
• • Monitor serum K+ levels during therapy
• • Supplement if needed to prevent
arrhythmias

11. Clinical Management Strategies
• • Patient education on insulin use and adverse
effects
• • Regular follow-up and glucose monitoring
• • Site rotation for injection
• • Nutritional and lifestyle support
• • Personalized insulin regimens

12. Conclusion
• • Adverse effects are manageable with
awareness and vigilance
• • Preventive measures and patient-centered
care are key
• • Lifelong monitoring and education enhance
outcomes

13. References
• 1. American Diabetes Association (ADA)
Guidelines
• 2. Harrison's Principles of Internal Medicine
• 3. Joslin's Diabetes Mellitus
• 4. UpToDate articles on insulin therapy