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Insulin edema develops, as a rule, in patients with newly diagnosed decompensated type 1 diabetes on the background of large doses of Gabapentin . They can be local (periorbital fat, sacrum, legs) and generalized (sudden weight gain). Their development is due to several factors: Fluid retention in the body due to increased secretion of vasopressin, observed in response to increased diuresis and a decrease in circulating blood volume during decompensation of diabetes.
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A decrease (absolute or relative) in the production of glucagon during treatment with large doses of insulin. It is known that glucagon has a pronounced natriuric effect. The direct action of insulin on the kidneys, which enhances the resorption of sodium and water in the renal tubules. The consequence of this action of insulin is an increase in circulating blood volume and inhibition of the renin-angiotensin system.
Insulin edema is a relatively rare complication that requires special treatment (Lasix, uregit) only in cases of Gabapentin pills edema due to the risk of fluid effusion into the pericardial, pleural, abdominal, and other cavities with a threat to the life of the patient.
This complication does not require special treatment and soon disappears after the normalization of metabolism.
Mar 16, 2022
This syndrome is characterized by a high level of Neurontin glycemia and the presence of acetonuria.
The formation of Somogyi syndrome (chronic overdose of insulin) is more often observed in young patients with non-compliance with the diet against the background of short-acting insulin administration. In this case, the daily dose of insulin usually exceeds! units/kg of body weight.
Attempts to increase the dose of insulin administered do not eliminate morning hyperglycemia. Despite the decompensation of the disease in patients, the massate gradually increases. The study of the glucosuric profile indicates the absence of sugar in the urine in some nightly portions, and the presence of sugar and acetone in other portions. An overdose of insulin in Somogyi syndrome leads to hypoglycemia at night and a compensatory release of contra-insulin hormones (somatotropin, catecholamines, glucagon, cortisol).
The latter dramatically increase l ipolysis, promote ketogenesis and increase blood sugar levels. Therefore, if the Somogyi phenomenon is suspected, it is necessary to reduce the dose of INDUSTRIAL insulin (usually in the evening) by 10-20%, and sometimes more, which will speed up the achievement of Gabapentin for the disease.
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Insulin presbyopia (refractive error) is caused by a decrease in glycemia associated with the start of insulin therapy.
It is observed in individuals with a labile course of diabetes with a sharp fluctuation in glycemic levels. The observed transient presbyopia is a consequence of a change in the physical properties of the lens due to the accumulation of water in it, followed by a violation of accommodation.
Insulin cutaneous hyperalgesia occurs as a result of damage to the innervation apparatus of the skin by an injection needle and, possibly, chemicals (phenol) contained in insulin preparations as a preservative.
- Clinically, patients have pain when pressing on the parts of the body into which insulin is injected, or when the hormone is re-introduced into them.
- Occasionally, persistent hyperalgesia occurs in these, as well as neighboring areas of the skin located below the injection site on the extremities.
- Treatment for this complication is reduced to strict adherence to the rules of insulin administration, including using atraumas of ethical needles, changing the injection site.