A patient with severe and protracted hypoglycaemia
Authors:
Karvunidis Thomas; Kroužecký Aleš; Raděj Jaroslav; Sýkora Roman; Chvojka Jiří; Novák Ivan; Matějovič Martin
Authors‘ workplace:
JIP, I. interní klinika, FN Plzeň, LF UK v Plzni
Published in:
Anest. intenziv. Med., 20, 2009, č. 4, s. 200-202
Category:
Intesive Care Medicine - Case Report
Overview
Severe hypoglycemia is a life-threatening condition requiring rapid diagnostics and adequate treatment. In this article we present a case-report of suicidal intoxication with long-acting insulin and a brief summary of suitable diagnostic approaches.
Keywords:
hypoglycaemia – insulin – sulfonylurea – intentional intoxication – suicide
Sources
1. Service, F. J. Hypoglycemias. West J. Med., 1991, 154, 4, p. 442–454.
2. Service, F. J. Hypoglycemic disorders. N. Engl. J. Med., 1995, 332, 17, p. 1144–1152.
3. Service, F. J. Classification of hypoglycemic disorders. Endocrinol. Metab. Clin. North Am., 1999, 28, 3, p. 501–517.
4. Service, F. J. Diagnostic approach to adults with hypoglycemic disorders. Endocrinol. Metab. Clin. North Am., 1999, 28, 3, p. 519–532.
5. Matsumura, M., Nakashima, A., Tofuku, Y. Electrolyte disorders following massive insulin overdose in a patient with type 2 diabetes. Intern. Med., 2000, 39, 1, p. 55–57.
6. Fasching, P., Roden, M., Stuhlinger, H. G. et al. Estimated glucose requirement following massive insulin overdose in a patient with type 1 diabetes. Diabet. Med., 1994, 11, 3, p. 323–325.
7. Bayly, G. R., Ferner, R.E. Persistent insulin secretion after insulin overdose in a non-diabetic patient. Lancet, 1993, 341, 8841, p. 370.
8. Kaminer, Y., Robbins, D. R. Attempted suicide by insulin overdose in insulin-dependent diabetic adolescents. Pediatrics, 1988, 81, 4, p. 526–528.
9. Shibutani, Y., Ogawa, C. Suicidal insulin overdose in a type 1 diabetic patient: relation of serum insulin concentrations to the duration of hypoglycemia. J. Diabetes Complications, 2000, 14, 1, p. 60–62.
10. Hsi, E., Werner, P. L. An unusual case of insulin overdose. Diabetes Care, 1987, 10, 2, p. 255–256.
11. Arem, R., Zoghbi, W. Insulin overdose in eight patients: insulin pharmacokinetics and review of the literature. Medicine (Baltimore), 1985, 64, 5, p. 323–332.
12. Campbell, I. W., Ratcliffe, J. G. Suicidal insulin overdose managed by excision of insulin injection site. Br. Med. J. (Clin Res Ed), 1982, 285, 6339, p. 408–409.
13. Martin, F. I., Hansen, N., Warne, G. L. Attempted suicide by insulin overdose in insulin-requiring diabetics. Med. J. Aust., 1977, 1, 3, p. 58–60.
14. Kuhn, B., Cantrell L. Unintentional overdose of insulin glargine. Am. J. Health Syst. Pharm., 2008, 65, 6, p. 508.
15. Rao, N. G., Menezes, R. G., Nagesh, K. R. et al. Suicide by combined insulin and glipizide overdose in a non-insulin dependent diabetes mellitus physician: a case report. Med. Sci. Law., 2006, 46, 3, p. 263–269.
16. Brva, M., Mozina, M., Bunc, M. Prolonged hypoglycaemia after insulin lispro overdose. Eur. J. Emerg. Med., 2005, 12, 5, p. 234–235.
17. Service, F. J., McMahon, M. M., O’Brien, P. C. et al. Functioning insulinoma—incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin. Proc., 1991, 66, 7, p. 711–719.
18. Hirshberg, B., Cochran, C., Skarulis, M. C. et al. Malignant insulinoma: spectrum of unusual clinical features. Cancor, 2005, 104, 2, p. 264–272.
19. Tucker, O. N., Rotty, P. L., Conlon, K. C. The management of insulinoma. Br. J. Surg., 2006, 93, 3, p. 264–275.
20. Vezzosi, D., Bennet, A., Fauvel, J. et al. Insulin, C-peptide and proinsulin for the biochemical diagnosis of hypoglycaemia related to endogenous hyperinsulinism. Eur. J. Endocrinol., 2007, 157, 1, p. 75–83.
21. Service, F. J., Natt, N. The prolonged fast. J. Clin. Endocrinol. Metab., 2000, 85, 11, p. 3973–3974.
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Anaesthesiology, Resuscitation and Inten Intensive Care MedicineArticle was published in
Anaesthesiology and Intensive Care Medicine
2009 Issue 4
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