Why Check I&O on a Diabetic

I&O is shorthand for Inputs & Outputs; in other words, measuring a patient's inputs (food and liquids) and her outputs (urine, feces, vomit). While I&O applies to many types of patients, there are specific reasons I&O is important for diabetics.

Dehydration

• Excess output relative to input may indicate dehydration, which can lead to higher blood sugars. In this case, the dehydration should be treated as soon as possible and insulin levels closely monitored. If excess insulin is given in response to the higher blood glucose levels without realizing the presence of dehydration, too much insulin may be administered, leading to hypoglycemia.

Weight Fluctuations

• Initial insulin dosages for newly-diagnosed diabetics are based largely on weight. Tracking I&O can provide a more accurate picture of a patient's true weight by allowing doctors to subtract the weight of recent inputs.

Heart Disease

• Diabetics are at increased risk of heart disease, and excess fluid/electrolyte gains can be indicative of congestive heart failure, pulmonary edema, or poor cardiac functioning levels.

Kidney Disease

• Increased fluid gains, or overhydration, can also be a sign of early kidney failure, for which patients with diabetes are also at increased risk.

Excessive Output and Decreased Insulin Needs

• Insulin is administered in specific dosages relative to the amount of carbohydrates consumed. If that food is not fully absorbed--for example, if the patient vomits--either the insulin dosage should be adjusted down or additional glucose must be administered to avoid an incident of severe hypoglycemia (low blood sugar).