The client is taking an antiplatelet, which is causing the swelling. The blood sugar changes are unrelated.

The client has developed lipodystrophy (LD) due to repeated insulin injections in the abdomen, and the injection of insulin into parts of the body affected by LD may cause wide glycemic oscillations, including inappropriately high glucose levels and a high risk of hyperglycemia.

The client has an underlying autoimmune disorder that predisposes her to rejecting the type of insulin she is currently receiving. She and the NP must find a different type of insulin to ensure no more glycemic oscillations. The swollen abdomen is unrelated.

The client is not taking her insulin as directed, and she is trying to distract the NP with the swollen stomach issue.