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Re: [IPm] (Fwd) [peds-endo] Diabetes unresponsive to SQ insulin!

At 02:15 PM 2/2/2002, you wrote:
>Dear Dr. Eapen:
>     As an anesthesiologist, the first thing that comes to mind in this
>teenager is whether she is has unrecognized hypovolemia and is thus poorly
>absorbing any subcutaneously injected insulin.  Does she have any signs of
>this like low CVP, low urine output, concentrated urine, poor tissue turgor,
>mental changes, etc.?  This is the only explanation for why subcutaneous
>insulin is poorly effective yet the same insulin given IV works fine.    I
>would wonder also what caused the pulmonary embolus.  It bothers me that the
>cause of this girl's embolus is unknown.  Good luck!
>John Pullerits, MD

You may also want to send this message directly to Dr. Eapen also since he 
does not get any mail sent to the IP Med-Pro list.

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