insulin reaction

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(dex-trose) ,


(trade name),


(trade name),


(trade name),

Insulin Reaction

(trade name)


Therapeutic: caloric sources
Pharmacologic: carbohydrates
Pregnancy Category: C


Intravenous: Lower-concentration (2.5–11.5%) injection provides hydration and calories.Higher concentrations (up to 70%) treat hypoglycemia and in combination with amino acids provide calories for parenteral nutrition.50%—treatment of hypoglycemia (hyperinsulinemia or insulin shock). Oral: Corrects hypoglycemia in conscious patients.


Provides calories.

Therapeutic effects

Provision of calories.
Prevention and treatment of hypoglycemia.


Absorption: Well absorbed following oral administration.
Distribution: Widely distributed and rapidly utilized.
Metabolism and Excretion: Metabolized to carbon dioxide and water. When renal threshold is exceeded, dextrose is excreted unchanged by the kidneys.
Half-life: Unknown.

Time/action profile (effects on blood sugar in diabetic patients)



Contraindicated in: Allergy to corn or corn products; Hypertonic solution (>5%) should not be given to patients with CNS bleeding or anuria or who are at risk of dehydration.
Use Cautiously in: Known diabetic patients (frequent lab assessment necessary to quantitate appropriate doses); Neonates (excess/rapid infusion of solutions >10% may ↑ risk of intracerebral hemorrhage); Chronic alcoholics or severely malnourished patients (administration requires initial pretreatment with thiamine).

Adverse Reactions/Side Effects


  • inappropriate insulin secretion (long-term use)

Fluid and Electrolyte

  • fluid overload
  • hypokalemia
  • hypomagnesemia
  • hypophosphatemia


  • local pain/irritation at IV site (hypertonic solution)


  • glycosuria
  • hyperglycemia


Drug-Drug interaction

Will alter requirements for insulin or oral hypoglycemic agents in diabetic patients.


Hydration (as 5% solution)
Intravenous (Adults and Children) 0.5–0.8 g/kg/hr.
Oral (Adults and Children) Conscious patients—10–20 g, may repeat in 10–20 min.
Intravenous (Adults) 20–50 mL of 50% solution infused slowly (3 mL/min).
Intravenous (Infants > 6 mo and Children) 0.5–1 g/kg/dose (maximum of 25 g/dose) (as 25% dextrose).
Intravenous (Infants ≤ 6 mo and Neonates) 0.25–0.50 g/kg/dose (maximum of 25 g/dose) (as 25% dextrose);.

Availability (generic available)

Oral gel: 40% in 15-g, 30-g, and 45–g tubesOTC
Chewable tablets: 4 g, 5 gOTC
Solution for injection: 2.5%, 5%, 10%, 20%, 25%, 30%, 40%, 50%, 60%, 70%
In combination with: sodium chloride, other electrolytes, and amino acids.

Nursing implications

Nursing assessment

  • Assess the hydration status of patients receiving IV dextrose. Monitor intake and output and electrolyte concentrations. Assess patient for dehydration or edema.
  • Assess nutritional status, function of gastrointestinal tract, and caloric needs of patient.
  • Diabetic patients and patients receiving hypertonic dextrose solution (>5%) should have serum glucose, potassium, and phosphate monitored regularly.
  • Monitor IV site frequently for phlebitis and infection.
  • Lab Test Considerations: May cause an ↑ serum glucose level.

Potential Nursing Diagnoses

Deficient fluid volume (Indications)
Imbalanced nutrition: less than body requirements (Indications)
Excess fluid volume (Adverse Reactions)


  • Dextrose solution alone does not contain enough calories to sustain an individual for a prolonged period. Dextrose contains 3.4 kcal/g. D5W contains 170 cal/liter and D10W contains 340 cal/liter.
  • Oral: Concentrated dextrose gels and chewable tablets may be used in the treatment of hypoglycemia in conscious patients. The dose should be repeated if symptoms persist and serum glucose has not increased by at least 20 mg/dL within 20 min. May be followed by more complex carbohydrates.
  • Intravenous: Hypertonic dextrose solution (>10%) should be administered IV into a central vein. For emergency treatment of hypoglycemia, administer slowly into a large peripheral vein to prevent phlebitis or sclerosis of the vein. Assess IV site frequently. Rapid infusions may cause hyperglycemia or fluid shifts. When hypertonic solution is discontinued, taper solution and administer D5W or D10W to prevent rebound hypoglycemia.
    • Patients requiring prolonged infusions of dextrose should have electrolytes added to the dextrose solution to prevent water intoxication and maintain fluid and electrolyte balance.
  • Additive Incompatibility: whole blood

Patient/Family Teaching

  • Explain the purpose of dextrose administration to patient.
  • Instruct diabetic patient on the correct method for self–blood glucose monitoring.
  • Advise patient on when and how to administer dextrose products for hypoglycemia.

Evaluation/Desired Outcomes

  • Correction and maintenance of adequate hydration status and normal serum glucose levels.
  • Maintenance of adequate caloric intake.

insulin reaction

the adverse effects caused by excessive levels of circulating insulin causing hypoglycemia. See also hyperinsulinism.

in·su·lin re·ac·tion

(insŭ-lin re-akshŭn)
Very low levels of blood sugar, which result from misdosage of insulin.
References in periodicals archive ?
The general research question for this study was: "Are time-limited appraisal and coping reactions to a particular stressful event, specifically an insulin reaction, related to extended or long-term adaptation to the condition of diabetes itself?
3) to recover their energy after experiencing an insulin reaction (three outliers were dropped from this analysis, due to their reporting of needing more than 24 hours to recover from an insulin reaction).
Participants completed the "Reactions to Impairment and Disability Inventory" (RIDI; Livneh & Antonak, 1990), the "Responses to Insulin Reactions Scale" (RIRS; Martz, 2000), and demographic questions, including a question concerning the use of oral medication or insulin.
Respondents tended to present a profile of positive adaptation to diabetes and insulin reactions (see Table 1).
Finally, acceptance of insulin reactions as predicted, was negatively linked to scores on RIDI's psychosocial distress factor (r = -.
Shock, Anxiety, Depression, Internalized Anger, Externalized Hostility) to examine the latter's unique and combined contributions to psychosocial stressful reactions associated with insulin reactions.
Hence, although insulin reactions are stressful events for people with diabetes, these reactions do not always parallel their more long-term psychosocial adaptation to diabetes as a chronic condition.
More specifically, responses to insulin reactions that typically suggest negative affectivity, such as anxiety, depression, and anger, were indeed strongly associated with more distressing long-term psychosocial reactions to diabetes.
Although caution should be taken concluding that a parallel exists between situational responses to insulin reactions and psychosocial reactions to having diabetes, the results of this study do suggest a need of further research, such as on the applicability of the stress-coping model to reactions to hypoglycemia and diabetes.
1994) reviewed research on the "Fear of Hypoglycemia Scale," created to examine fear of hypoglycemia or insulin reactions among individuals with diabetes.

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