Question

You are working in an outpatient clinic when a mother brings in her 20-year-old daughter, C.J., who has type 1 diabetes mellitus (DM) and has just returned from a trip to Mexico. She’s had a 3-day fever and diarrhea with nausea and vomiting (N/V). She has been unable to eat and has tolerated only sips of fluid. Because she has been unable to eat, she has not taken her insulin. Because C.J. is unsteady, you bring her to the examining room in a wheelchair. While assisting her onto the examining table, you note that her skin is warm and flushed. Her respirations are deep and rapid, and her breath is fruity smelling. C.J. is drowsy and unable to answer your questions. Her mother states, “She keeps telling me she’s so thirsty, but she can’t keep anything down.”

The mother tells you the following: “Blood glucose monitor has been reading ‘high’ ” (some glucometers do not read above 400 mg/dl). “C.J. has had sips of ginger ale but that’s all.” “She has been vomiting about every other time she drinks.” “When she first got home, she went [voided] a lot, but yesterday she hardly went at all, and I don’t think she has gone today.” “She went to bed early last night, and I could hardly wake her up this morning. That’s why I brought her in.”

Orders have been corrected and initiated. C.J. has received fluid resuscitation and is on a sliding scale insulin drip via infusion pump. Her latest glucose was 347 mg/dl. The patient is in DKA.

  What is the rationale behind using an infusion pump for the insulin drip?

Answer 1

Ans) An insulin pump provides continuous delivery of short acting insulin all day long. The insulin pump substitutes the need for long acting insulin. A pump also replaces the need for multiple daily injections with a continuous insulin infusion, and also helps to improve your blood sugar levels.