title: Attempted suicide by massive insulin injection: a case report and review of the literature.
abstract: The authors present a case of an 80-year-old man, non-diabetic, who attempted suicide by injecting himself subcutaneously with 10,000 units of Humulin R and 6000 units of Humulin N. Administration of dextrose intravenously was required for 13 days to maintain the capillary blood glucose within the range of 100-180 mg/dl. Hyponatremia, hypokalemia, hypophosphatemia, and elevated liver enzymes were also seen after massive insulin injection. Glucose requirement index was established to demonstrate the trend of glucose requirement during hospitalization. He recovered completely without any complication after monitoring blood glucose and titrating intravenous glucose carefully for two weeks. Current literature about how to manage insulin overdose was reviewed in the present article.
authors.affiliation: Department of Medicine, Theptarin Hospital, Bangkok, Thailand. kamijoa@hotmail.com
authors.forename: Yotsapon
authors.initials: Y
authors.lastname: Thewjitcharoen
authors.forename: Nampetch
authors.initials: N
authors.lastname: Lekpittaya
authors.forename: Thep
authors.initials: T
authors.lastname: Himathongkam
mesh_terms: D000279:Administration, Cutaneous; D000369:Aged, 80 and over; D062787:Drug Overdose / Q000188:drug therapy*; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000506:poisoning*; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000506:poisoning*; D008297:Male; D013406:Suicide, Attempted; D013549:Sweetening Agents / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D013549:Sweetening Agents; D005947:Glucose