title: Electrolyte disorders following massive insulin overdose in a patient with type 2 diabetes.
abstract: We present a case of a 47-year-old man with Type 2 diabetes mellitus who attempted suicide with 2,100 U of insulin injected subcutaneously. Administration of dextrose intravenously was required to maintain the blood glucose concentration normally for 5 days. Moreover, hypokalemia, hypophosphatemia, and hypomagnesemia were also seen for 24 hours after insulin injection. The serum phosphorus and magnesium concentrations decreased to nadirs of 1.6 mg/dl and 1.6 mg/dl respectively 7 hours after insulin injection. Electrolyte disorders other than hypokalemia may be induced in hypoglycemic patients by massive insulin overdose.
authors.affiliation: Department of Internal Medicine, Ishikawa-ken Saiseikai Kanazawa Hospital, Ishikawa.
authors.forename: M
authors.initials: M
authors.lastname: Matsumura
authors.forename: A
authors.initials: A
authors.lastname: Nakashima
authors.forename: Y
authors.initials: Y
authors.lastname: Tofuku
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D062787:Drug Overdose; D004573:Electrolytes / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D013406:Suicide, Attempted; D014883:Water-Electrolyte Imbalance / Q000139:chemically induced*
chemical_list: D001786:Blood Glucose; D004573:Electrolytes; D007328:Insulin