Lantus overdose: case presentation and management options.
Insulin glargine (Lantus, Aventis Pharmaceuticals, Bridgewater, NJ) is a long-acting once-daily dosed form of insulin intended to maintain a constant baseline insulin level. As a relatively new medication, there is limited experience in overdoses of Lantus. We present a case of a 37-year-old male insulin-dependent diabetic presenting with refractory hypoglycemia secondary to an intentional overdose of Lantus insulin to illustrate the varied management concerns in overdoses of long-acting insulins. The patient was managed with oral intake, intravenous dextrose bolus, peripheral 10% dextrose solution, 25% dextrose sliding scale via central line, and psychiatry evaluation for suicide attempt. Other potential treatments discussed for possible use with long-acting insulin overdoses include incision and drainage of the injection site, glucagon, and octreotide.
Fuller
Everett T
ET
Department of Emergency Medicine, Darnall Army Community Hospital, Fort Hood, Texas 76544-4752, USA.
Miller
Michael A
MA
Kaylor
David W
DW
Janke
Cliff
C
D000328:Adult; D062787:Drug Overdose / Q000188:drug therapy; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007004:Hypoglycemic Agents / Q000506:poisoning*; D007262:Infusions, Intravenous; D007328:Insulin / Q000031:analogs & derivatives* / Q000506:poisoning; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; D008297:Male; D013406:Suicide, Attempted; D013549:Sweetening Agents / Q000008:administration & dosage
D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D013549:Sweetening Agents; D000069036:Insulin Glargine; D005947:Glucose