The main undesirable effect of insulin is hypoglycemia. This is common, and can cause brain damage. Intensive insulin therapy results in a threefold increase in severe hypoglycemia. The treatment of hypoglycemic is to take a sweet drink or snack, or, if the patient is unconscious, to give intravenous glucose (50% w/v solution) or intramuscular glucagon. Rebound hypergly (Somogyi effect) can follow excessive insulin administration. This results from the release of the insulin-opposing or counter-regulatory hormones in response to insulin-induced hypoglycemia.
This can cause hypercemia before breakfast following an unrecognized hypoglycemic attack during sleep in the early hours of the morning. It is essential to recognize this possibility to avoid the mistake of increasing (rather than reducing) the dose of insulin in this situation. Allergy to insulin is unusual but may take the form of local or systemic reactions. Severe insulin resistance as a consequence of antibody formation is rare. A high tire of circulating anti-insulin antibodies is more likely to occur with bovine than with porcine insulin.
Note, however, that virtually all patients treated with animal insulin have antibodies against the hormone, albeit usually flow. Human insulin is less immunogenic than animal insulin but may still evoke an antibody response, since the source of the hormone is not the only determinant of immunogenicity; insulin undergo physical changes before and after injection which can increase their potential for provoking an immune response. (HP Rang et al, 200-270)
References 1.
Patlak M. 2002. “New weapons to combat an ancient disease: treating diabetes”. Available on http://www. fasebj. org/cgi/content/full/16/14/1853e 2. Perspective Press. 2003. “The Pharmacy Technician” 1st edition: Morton Publishers. P 240- 243. 3. Jahangir Moini. 2005. “Comprehensive Exam Review for the Pharmacy Technician”: Thomson Delmar. P 150-154 4. H. P. Rang, M. Maureen Dale, James M. Ritter, Philip Moore. 2001. “Pharmacology”: Churchill Livingstone. P 200-270.