Citation

Ishibashi T, Gyobu H, Hayakawa T, Ota T, Furukawa Y, Nishi M, Furuta H, Akamizu T. Journal of the Japan Diabetes Society 2015; 58(9): 675-680.

Copyright

(Copyright © 2015)

DOI

unavailable

PMID

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Abstract

A 46-year-old woman with type 2 diabetes and depression was admitted to our hospital due to an insulin overdose. She had received prescriptions for metformin 500 mg and 70 U of insulin per day. She had been in good glycemic control and her HbA1c level was 5.4 %. On the day of admission, she was transported by ambulance one hour after she had self-administered 3000 units of insulin (2100 U of Lispro plus 900 U of glargine). She was admitted to the hospital to prevent subsequent severe hypoglycemia. She was treated by an intravenous infusion of glucose and oral ingestion of glucose and meals. A measurement of her serum insulin level revealed an exponential decrease from 31975 μ U/ml at one hour after the insulin injection to 20903 μ U/ml at 6 hours and 9370 μ U/ml at 9 hours. The final supplementation of oral glucose was 141 hours after injection. An analysis of the patient's blood glucose concentration by continuous glucose monitoring revealed rapid fluctuations as a sawtooth pattern in response to the administration of glucose. Although changes in the serum insulin level may be helpful for estimating the recovering time from hypoglycemia, frequent measurements of the blood glucose concentration are necessary for patients who overdose on insulin. © 2015 Journal of the Japan Diabetes Society.

Language: ja