Prolonged hypoglycemia after an insulin glargine overdose in a patient with type 2 diabetes mellitus
Journal Title: Scholars Journal of Medical Case Reports - Year 2017, Vol 5, Issue 1
Abstract
A fifty-seven-year-old male patient self-administered maximum 300 units of glargine by subcutaneous injection. He was found after being in an unconscious state for approximately 15 hours, and was transferred to a nearby medical facility. He had been taking glargine for type 2 diabetes mellitus. He had been in a depressive state following his retirement. He was diagnosed with prolonged hypoglycemia induced by a suicide attempt and was transported to our hospital by a physician staffed helicopter. On arrival, He was alert and admitted to an intensive care unit where he received a continuous drip infusion with 10% glucose and intermittent 50% glucose injection (40ml) when his blood glucose level fell to <70mg/dl (his blood glucose level was measured every 30 minutes). The patient consumed a 1600 Kcal meal each day. At 36 hours after admission, he no longer showed hypoglycemia and did not require glucose injections. The total amount of glucose required from admission until he left the intensive care unit was 1244 g. He was discharged on the 15th day of hospitalization after treatment for transient delirium and a depressive state by psychologists. As we could not find any such cases in which the use of glargine in a suicide attempt resulted in death, glargine might be useful for preventing suicide attempts using insulin and might therefore be a useful hypoglycemic drug for treating psychiatric patients with diabetes mellitus. Keywords:glargine; suicide; psychiatric disease; diabetes mellitus.
Authors and Affiliations
Kei Jitsuiki, Toshihiko Yoshizawa, Ikuto Takeuchi, Chikato Hayashi, Hiromichi Ohsaka, Kouhei Ishikawa, Kazuhiko Omori, Youichi Yanagawa
Keywords
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