Question

Your pediatric patient is a new-onset diabetic. He has extreme anxiety and fear of needles. His mother asks why you won't mix his regular insulin with his juice. What explanation can you give?

a. Mixing insulin with juice alters its bioavailability

b. Oral ingestion of insulin is not effective due to gastric acids

c. Insulin must be injected to bypass first-pass metabolism

d. Mixing insulin with juice may cause gastric irritation

Answer 1

Insulin cannot be mixed with juice because gastric acids would break it down, making it ineffective. Insulin must be administered through injections to bypass gastric breakdown and first-pass metabolism in the liver, allowing it to properly decrease blood glucose levels.

Step-by-step explanation:

When explaining to the mother why insulin cannot be mixed with juice, the most accurate reason is that oral ingestion of insulin is not effective due to gastric acids. Insulin is a protein hormone, and when taken orally, the gastric acids and digestive enzymes in the stomach and intestines would break it down, much like any other protein, rendering it ineffective. Therefore, insulin must be administered through injections to ensure that it reaches the bloodstream intact and can effectively regulate blood glucose levels by facilitating the transport and storage of glucose in the cells, which helps decrease blood glucose levels after consuming a meal. Giving insulin via injection also bypasses the first-pass metabolism that occurs in the liver, which would otherwise inactivate a portion of the insulin before it could exert its effect.