Clinical management of diabetes and insulin use: Indications for hospitalization, contraindications for injection, and long-term blood sugar control strategies

Generally speaking, diabetes is a lifelong disease and cannot be cured. However, the prospects for diabetes treatment are very optimistic. Diabetes is a treatable disease with satisfactory results; it simply cannot be cured. Although treating diabetes is not easy, it can be controlled by strictly controlling diet, adhering to appropriate exercise, arranging a reasonable lifestyle, paying attention to mental health, and using scientific medical methods. Diabetic patients must be hospitalized in the following situations, otherwise their lives may be in danger: When diabetic patients have infectious diseases, it is often difficult to control; in cases of severe infection, hospitalization is necessary. Recurrent hypoglycemia (<2.8 mmol/L) or high fasting blood glucose (>16.8 mmol/L) requires hospitalization. Emergency hospitalization is required when diabetic ketoacidosis, lactic acidosis, or nonketotic hyperosmolar coma occurs. Hospitalization for observation and treatment is generally required when starting insulin or adjusting insulin dosage. Hospitalization is even more necessary when diabetic patients have serious complications. Some middle-aged male diabetic patients have severe conditions but are reluctant to inject insulin, mistakenly believing that their pancreatic tissue will become ineffective after starting insulin. While this has some merit, it is a one-sided view. Human glucose metabolism relies primarily on insulin. When the body's pancreatic function is insufficient to maintain glucose metabolism, supplementing with insulin externally is a rare and effective treatment. Insulin injection therapy should be considered especially in cases of ketoacidosis, lactic acidosis, non-ketotic hyperosmolar diabetic coma; when complicated by infection, trauma, or requiring surgery; or when serious complications have already developed. Middle-aged male diabetic patients using insulin injection therapy still need to strictly control their diet. Subcutaneous insulin injections take effect within half an hour. Therefore, a meal must be eaten within half an hour after injection, otherwise hypoglycemia is likely. Injections should be continued without interruption, and the dosage should not be arbitrarily increased or decreased. Obese patients often have low insulin sensitivity after injection, requiring a higher dosage. As weight loss occurs, the insulin dosage should be reduced. Those who enjoy exercise should begin exercising one hour after a meal. Patients should avoid exercise and strenuous activity before or approximately one hour before insulin injection to prevent hypoglycemia. Insulin injections generally do not cause allergic reactions. However, insulin is a protein, and allergic reactions can occur after protein preparations are injected into the body. Some patients experience erythema at the injection site, accompanied by itching, swelling, and other discomfort. This usually appears within 4-12 hours after injection and gradually subsides. A very small number of patients develop urticaria (hives). Local allergic reactions can be relieved by applying heat, and frequently changing the injection site is also a way to reduce symptoms. If systemic reactions occur, different anti-allergy medications are used depending on the severity of the symptoms. If the patient still needs to use insulin, they should consider continuing use only after undergoing desensitization therapy under the guidance of a doctor.

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