By which routes can insulin be administered? (Select All that Apply.)

A. Pancreatitis: Pancreatitis is not directly caused by diabetes. It has different etiologies, such as gallstones, alcohol use, and certain medications.
B. New blindness: Diabetes is a leading cause of new cases of blindness among adults due to diabetic retinopathy, which damages the blood vessels in the retina.
C. Nontraumatic lower extremity amputations: Diabetes is the primary cause of nontraumatic lower extremity amputations due to complications such as peripheral neuropathy and poor circulation leading to severe infections and gangrene.
D. Hepatitis: Hepatitis is an inflammation of the liver, commonly caused by viral infections, alcohol abuse, or other factors, not directly by diabetes
E. Renal failure: Diabetes is a major cause of end-stage renal disease (ESRD) due to diabetic nephropathy, which damages the kidneys over time.

A. Ask the patient an open-ended question about feelings: This might reveal anxieties but not necessarily confirm understanding of the steps.
B. Ask the patient to repeat the information in the pamphlet: Repeating information doesn't guarantee comprehension of how to perform the task.
C. Have the patient list the steps: This can be helpful, but observing actual performance allows for correcting any errors in technique.
D. Observe as the patient prepares and injects a dose of insulin: Direct observation is the most reliable way to assess if the patient can safely and accurately self-administer insulin.