The patient is a 78 year old woman who only had 20% kidney function. She also has diabetes and is prescribed insulin to help her
blood sugar. Insulin is canceled out by the kidney action. What type of dosage adjustment would you expect for this patient?
What problems would occur if the dosages are not adjusted?
I would suggest doubling the dosage of insulin so that it would have an effect on the woman.
If you did not adjust the dosage then glucose wouldn’t be able to get into the cells without insulin and this could cause an irregular or fast heartbeat, fatigue, pale skin, hypoglycemia, cardiac death, and cause ischemic cerebral damage.
The patient presents with the symptoms that are common with dysarthria-clumsy hand syndrome. This is one of the lacunar stroke syndromes where dysarthria is common. A x-ray or other imaging would reveal lesions in the contralateral pons.
