Insulin and Glycemic Therapy

Insulin is the only drug that can actively lower plasma glucose. It does so by promoting glucose uptake into muscle and adipose tissue and by suppressing hepatic gluconeogenesis and glycogenolysis. In the Canadian context the RN must translate these mechanisms into safe dosing, vigilant monitoring, and rapid response to hypoglycemia or ketoacidosis. Exam questions test cue recognition (e.g., a low glucose reading versus an elevated A1C), the hierarchy of priorities (treat symptomatic hypoglycemia before routine insulin administration), and the ability to avoid common safety traps.