Hypoglycemic reactions, severe

Hypoglycemic reactions - Hypoglycemia when using this concentrated insulin can be prolonged and severe. Deep secondary hypoglycemic reactions may develop 18 to 24 hours after the original injection of concentrated insulin. 

Glucagon, whose regulalory crfect on carbohydrate and fatty acid metabolism is well understood, is therapeutically important. It is recommended for the treatment of severe hypoglycemic reactions cau.sed by the administration of in-.sulin to diabetic or psychiatric patients. Of course, this treatment is effective only when hepatic glycogen is available. Nausea and vomiting are the most frequently encountered reactions to glucagon. 

Importantly, the observed hypoglycemia induced by rather higher doses of the drug is mostly not as severe and acute as can be induced by insulin and, therefore, the chances of severe hypoglycemic reactions is quite lower with tolbutamide however, one may observe acute relractory hypoglycemia occasionally does take place. In other words, refractoriness to it often develops. 

Human glucagon of rDNA origin is marketed for the treatment of severe hypoglycemic reactions in patients with diabetes, as can occur when there is an overdose of insulin. In patients with type I diabetes, the increase in glucose, resulting from glucagon administration, may not be sufficient, and supplemental carbohydrates may need to be administered quickly, especially in children. 

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