Estimated glucose requirement following massive insulin overdose in a patient with type 1 diabetes.
A well-documented case of a 35-year-old male Type 1 diabetic patient who was admitted as an emergency after having injected 1500 international units (IU) of insulin (750 IU regular insulin,750 IU NPH-insulin) subcutaneously as a suicidal attempt is reported. Computing disappearance rates of glucose from its infused amounts necessary to maintain euglycaemia during 65 h after the insulin injection in analogy to experimental hyperinsulinaemic euglycaemic clamp examinations, a glucose consumption of 55.6 mumol kg-1 min-1 was found at peak serum insulin concentrations of about 14,400 pmol l-1. The insulin-induced glucose dynamics resemble closely those seen in healthy persons and Type 1 diabetic subjects during a 10 mU kg-1 min-1 euglycaemic clamp. This information may be useful in the handling of similar cases of insulin intoxication.
Department of Medicine III, University Hospital, Vienna, Austria.
P
P
Fasching
M
M
Roden
H G
HG
Stühlinger
S
S
Kurzemann
A
A
Zeiner
W
W
Waldhäusl
A N
AN
Laggner
D000328:Adult; D001714:Bipolar Disorder; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005947:Glucose / Q000627:therapeutic use*; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000097:blood / Q000506:poisoning*; D007336:Insulin, Isophane / Q000506:poisoning; D008297:Male; D013406:Suicide, Attempted; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin; D007336:Insulin, Isophane; D005947:Glucose