Dialysis and Diabetics

[cslagle1989]

New grad here, when a patient goes to diaylsis and they are a diabetic, should you hold insulin till they get back if they wont eat till they return? I think im just overthinking this. Thanks!

[Hoosier_RN, MSN]

I would ask your manager for your policy. Generally, I would say yes to hold, but since I don't work where you do, I don't want to tell you wrong. If you give the insulin, send a light snack-pack of crackers, etc. Your manager can give you the correct guidance

[Mergirlc, MSN, APRN, NP]

I would also say yes hold it, but check the policy where you work.

I once accompanied a relative of mine to get their dialysis and an unfortunate older gentleman was given insulin prior to arriving there. Once he was hooked up, he went into a hypoglycemic episode and went unconscious. I could see the sweat on his face and knew what was going on due to having a relative w/ diabetes. The clinic ended up calling the Fire Department to administer aid.

[NormaSaline]

Insulin and dialysis is a scary combination. That's not a very helpful answer, I know, but depending on your setting and colleagues, I might question the Rx of insulin with renal disease (when degradation of insulin happens extremely slowly).

[Chisca, RN]

Glucose molecule slightly bigger than water molecule so sugar is easily removed during dialysis treatment. I would recommend NEVER give a patient insulin before a dialysis treatment.

[Chisca, RN]

Dialysis solutions used to have 200 mg/dl sugar in the dialysate bath that would somewhat protect the patient but now it is 100 mg/dl. For some patients that is not enough to protect them during a treatment. Tell me you gave insulin before a treatment and i will be checking their blood sugars hourly.

[cslagle1989]

Thanks everyone for you answers/feedback!