QuestionSBA
QuestionChoice
When administering insulin, patients are advised to inject it at a different spot each time to prevent lipohypertrophy
34081
b
She should inject insulin at the same spot each time
QuestionChoice
Insulin should be stored in the fridge and not the freezer because very low temperatures might damage the insulin
34082
c
She should store the insulin in the freezer when not using
QuestionChoice
Insulin could cause hypoglycaemia, hence patients are encouraged to bring along a source of sugar with them at all times
34084
e
Insulin is not known to cause hypoglycaemia
QuestionChoice
During sickness, patients are advised to check blood glucose levels every 2 to 4 hours and adjust the insulin dose accordingly. It is common for patients to need an increased insulin dose during sickness to help keep the blood glucose level within control. There is a need for insulin dose to be increased because adrenaline and cortisol produced by the body to fight against infection may contribute to insulin resistance, ultimately leading to stress hyperglycaemia. Hence, patients are advised to never omit their insulin (especially basal long-acting insulin) even if there is a reduction in dietary intake
34080
a
She should continue her long-acting insulin during sickness
QuestionChoice
Insulin may lead to weight gain
34083
d
Insulin may cause weight loss
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2760
Insulin sick day rules
Topic
92
General Practice
6827
Case presentation: A 30-year-old woman visits her GP complaining of weight loss, excessive thirst and frequent urination.  

PMH: Coeliac disease, Vitiligo
FH: Type 1 Diabetes Mellitus
Investigation: HbA1c 63 mmol/mol (20-42)
Treatment with insulin is to be initiated.

Question: Select the most important information that should be provided for this patient.
a