Insulin Overdose- Altered Sensorium & Recurrent Hypoglycaemia
Keywords:
Insulin, glargine, overdose, suicide, glucagon
Abstract
Reported here is a case of 32 year old unmarried female presenting with altered sensorium and recurrent hypoglycaemia after a suspected high dose of insulin glargine with suicidal intent.
Management of the patient in an intensive care setting with intravenous dextrose, subcutaneous glucagon injections and oral glucose rich diet produced effective results. The measurement of
insulin and c-peptide levels helped confirm the diagnosis of insulin overdose.
References
1. Spiller HA: Management of antidiabetic medications inoverdose. Drug Saf. 1998;19:411-24.
2. Gillies PS, Figgitt DP, Lamb HM. Insulin glargine. Drugs.2000; 59:253-60.
3. Thewjitcharoen Y, Lekpittaya N, Himathongkam T. Attempted suicide by massive insulin injection: A case report and review of literature. J Med Assoc Thai.2008; 91:1920-4.
4. Wong OF, Tsui KL, Kam CK. A case of acute insulin poisoning. Hong Kong J Emerg Med. 2006; 13:232-4.
5. Tofade TS, Liles EA. Intentional overdose with insulin glargine and insulin aspart. Pharmacotherapy. 2004; 24:1412-8.
6. Cryer PE, Axelrod L, Grossman AB, et al. Evaluation and Management of Adult Hypoglycemic Disorders: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2009; 94:709-28.
7. Hawton K, Clements A, Simkin S et al. Doctors who kill themselves: A study of methods used for suicide. Q J Med. 2000; 93:351-7.
8. Fuller ET, Miller MA, Kaylor DW et al. Lantus overdose: case presentation and management options. J Emerg Med. 2009; 36: 26-9.
9. Pollack C. Utility of glucagons in the emergency department. J Emerg Med. 1993; 11:195-205
10. Vukmir R, Paris P, Yearly D. Glucagon: prehospital therapy of hypoglycemia. Ann Emerg Med.1991; 20:375-9
2. Gillies PS, Figgitt DP, Lamb HM. Insulin glargine. Drugs.2000; 59:253-60.
3. Thewjitcharoen Y, Lekpittaya N, Himathongkam T. Attempted suicide by massive insulin injection: A case report and review of literature. J Med Assoc Thai.2008; 91:1920-4.
4. Wong OF, Tsui KL, Kam CK. A case of acute insulin poisoning. Hong Kong J Emerg Med. 2006; 13:232-4.
5. Tofade TS, Liles EA. Intentional overdose with insulin glargine and insulin aspart. Pharmacotherapy. 2004; 24:1412-8.
6. Cryer PE, Axelrod L, Grossman AB, et al. Evaluation and Management of Adult Hypoglycemic Disorders: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2009; 94:709-28.
7. Hawton K, Clements A, Simkin S et al. Doctors who kill themselves: A study of methods used for suicide. Q J Med. 2000; 93:351-7.
8. Fuller ET, Miller MA, Kaylor DW et al. Lantus overdose: case presentation and management options. J Emerg Med. 2009; 36: 26-9.
9. Pollack C. Utility of glucagons in the emergency department. J Emerg Med. 1993; 11:195-205
10. Vukmir R, Paris P, Yearly D. Glucagon: prehospital therapy of hypoglycemia. Ann Emerg Med.1991; 20:375-9
Published
2019-08-27
How to Cite
Gaurav Bhaskar Nigam, Takkar A , Sharma R , Paljor H P. (2019). Insulin Overdose- Altered Sensorium & Recurrent Hypoglycaemia. The Indian Practitioner, 68(4), 40-42. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/648
Section
Case Reports
