People with diabetes all have an element of insulin deficiency present, whether type 1 or type 2, just the degree of deficiency is different. Insulin is the most common treatment for people with diabetes, and many people with diabetes need insulin injections to control their blood sugar.
The advent of insulin has greatly improved the prognosis for people with diabetes, allowing patients to survive much longer. However, insulin, as an effective glucose-lowering drug, also has side effects. Here, in this article, we will describe the side effects of insulin therapy.
Systemic side effects
The main systemic side effects of insulin therapy include hypoglycemic reactions, edema, refractive errors, and allergic reactions.
Among these, hypoglycemia is the most common insulin side effect, and patients with diabetes on intensive insulin therapy have a 2- to 3-fold increased risk of severe hypoglycemia compared with patients with regular diabetes. Hypoglycemia can occur because of excessive insulin dosing, not eating on time or eating too little after insulin injection. In addition, patients who are too active or exercise for too long can also cause hypoglycemia to occur.
Some insulin-treated patients can present with edema, mostly on the face and extremities, which usually resolves on its own after a period of continued insulin use.
In patients who have just started insulin therapy, especially those with significantly elevated prior blood glucose, they are more likely to develop refractive error, which manifests as blurred vision and hyperopia. When blood glucose control is stable, the symptoms disappear rapidly and usually do not require special treatment.
In addition, a very small number of patients can develop allergic reactions after insulin administration, such as urticaria, angioneurotic edema, purpura, and even anaphylaxis in individual patients.
Local side effects
Local side effects of insulin therapy mainly include subcutaneous fatty growth and pain at the injection site.
Subcutaneous fat hyperplasia is the most common local complication of insulin therapy. Some patients exhibit skin redness, itchiness, subcutaneous hard nodules, and subcutaneous fat atrophy or hyperplasia at the injection site. Subcutaneous fat hyperplasia can cause slower or unstable insulin absorption, which can adversely affect the management of diabetes. Therefore, as soon as you notice the appearance of pain, dimpling, or hard nodules at the injection site, you should stop injecting in that area until the symptoms disappear.
There are also a few patients on insulin therapy who experience pain at the injection site, and ways to avoid and reduce pain include:
- Store the insulin being used at room temperature.
- Let the sterile site alcohol evaporate thoroughly before administering the injection.
- Avoid injecting at the root of body hair.
- Use a smaller diameter and shorter length needle.
- Use a new needle for each injection.
- Use a new needle for each injection, etc.