Critical low catastrophe: a case report of treatment-refractory hypoglycemia following overdose of long-acting insulin.

Title

Critical low catastrophe: a case report of treatment-refractory hypoglycemia following overdose of long-acting insulin.

Creator

Sandooja R;Moorman JM;Priyadarshini KM;Detoya K

Publisher

Case Reports in Endocrinology

Date

2020
1905-07

Description

Overdose of long-acting insulin can cause unpredictable hypoglycemia for prolonged periods of time. The initial treatment of hypoglycemia includes oral carbohydrate intake as able and/or parenteral dextrose infusion. Refractory hypoglycemia following these interventions presents a clinical challenge in the absence of clear guidelines for management. Octreotide has sometimes been used, but its use is generally limited to sulfonylurea overdose. In this case report, we present a case of refractory hypoglycemia following an overdose of 900 units of long-acting insulin glargine that failed to respond to usual modes of therapy mentioned above. Stress-dose corticosteroids were then initiated, followed by subsequent improvement in IV dextrose and glucagon requirements and blood glucose levels. Hence, corticosteroids may serve as an adjunctive therapy in managing hypoglycemia and can be considered earlier in the course of treatment in patients with refractory hypoglycemia to prevent volume overload, especially when large volumes of dextrose infusions are required.

Subject

BLOOD sugar; DEXTROSE; HYPOGLYCEMIA; INSULIN; INSULINOMA; PARENTERAL infusions

Format

journalArticle

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

8856022

Volume

2020

ISSN

2090-6501 2090-651X 2090-651X

NEOMED College

NEOMED College of Medicine
NEOMED College of Pharmacy

NEOMED Department

Department of Internal Medicine
Department of Pharmacy Practice

Update Year & Number

October 2020 List

Affiliated Hospital

Cleveland Clinic Akron General Hospital

Citation

Sandooja R;Moorman JM;Priyadarshini KM;Detoya K, “Critical low catastrophe: a case report of treatment-refractory hypoglycemia following overdose of long-acting insulin.,” NEOMED Bibliography Database, accessed January 27, 2021, https://neomed.omeka.net/items/show/11341.

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