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What Are the Complications of Insulin Therapy?

Insulin therapy is commonly prescribed for people living with diabetes. It can control blood sugar and prevent or slow the progression of long-term diabetes complications, but the therapy itself can have complications for some patients.

  1. What is insulin?

    • Insulin is a hormone, normally secreted by the pancreas, which performs a number of functions in the body, most notably controlling blood sugar levels.

    Who needs insulin therapy?

    • For patients with type 1 diabetes, previously called "juvenile diabetes," insulin therapy replaces insulin that the body does not produce on its own. Patients with type 2 diabetes and gestational diabetes are sometimes advised to take insulin if other therapies have failed to keep blood glucose levels within the desired range.

    How is insulin therapy administered?

    • Insulin is usually given by subcutaneous injection with single-use needles, an insulin pump or an insulin pen. Researchers are investigating several other methods of insulin delivery, including inhalation, transdermal and oral methods.

    Hypoglycemia

    • Hypoglycemia is the most common and often the most serious complication of insulin therapy. Symptoms can range from vaguely "feeling bad" to seizures, unconsciousness, and (rarely) permanent brain damage or death.

      If a patient injects too much insulin, exercises too much in relation to carbohydrates consumed, doesn't eat enough or eats at inappropriate times, blood glucose level can fall low enough to cause hypoglycemia.

    Skin complications

    • Lipoatrophy, a pitting appearance of the skin, is a rare immune reaction related to insulin injections, which can be prevented by changing to a highly purified insulin preparation. Lipohypertrophy refers to an area of subcutaneous tissue that becomes thickened and hard. This complication can be lessened by rotating insulin injection sites.

    Diabetic ketoacidosis

    • A potentially life-threatening condition, diabetic ketoacidosis can be a result of poor compliance with insulin therapy. Diabetic ketoacidosis develops when a patient has a severe shortage of insulin in his system. Blood sugar levels rise, and the body begins to break down fat for energy. This produces toxic acids known as ketones.

      Usage of an insulin pump can sometimes result in a case of diabetic ketoacidosis for a variety of reasons. Some examples include a pump battery not being charged, an empty insulin reservoir, loose tubing, or a bent or kinked cannula that prevents delivery of insulin.

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