Cardiac failure after initiation of insulin treatment in diabetic patients with beta-thalassemia major.
Diabetes mellitus is a complication of beta-thalassemia major. Two patients are described who developed severe cardiac failure after initiation or intensification of insulin treatment. We hypothesize that insulin-induced fluid retention combined with reduced cardiac reserve was responsible for the cardiac failure. Careful initiation of insulin treatment in these patients is important.
Division of Endocrinology, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
Daniel
D
Konrad
Denis
D
Daneman
Melanie
M
Kirby
Diane
D
Wherrett
D000293:Adolescent; D003925:Diabetic Angiopathies / Q000139:chemically induced*; D016883:Diabetic Ketoacidosis / Q000150:complications* / Q000188:drug therapy*; D004489:Edema, Cardiac / Q000139:chemically induced* / Q000503:physiopathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007328:Insulin / Q000009:adverse effects*; D017086:beta-Thalassemia / Q000150:complications*
D007004:Hypoglycemic Agents; D007328:Insulin