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Dialysis and Diabetics

Urology   (935 Views | 6 Replies)

569 Profile Views; 21 Posts

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!

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

5 Followers; 1,886 Posts; 4,091 Profile Views

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

 

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1 Follower; 372 Posts; 1,391 Profile Views

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.

Edited by Mergirlc
explain

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1 Article; 101 Posts; 5,264 Profile Views

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).

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Chisca has 36 years experience as a RN and specializes in Dialysis.

739 Posts; 14,139 Profile Views

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.

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Chisca has 36 years experience as a RN and specializes in Dialysis.

739 Posts; 14,139 Profile Views

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.

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21 Posts; 569 Profile Views

Thanks everyone for you answers/feedback!

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