Abstract
Background: Insulin glargine is a relatively new medication in the treatment of diabetes
mellitus, and there have only been six case reports of overdoses in the literature
with this specific insulin. Objectives: We present a unique case of insulin glargine
overdose that presented with persistent hypoglycemia and required prolonged in-hospital
treatment. Case Report: A 51-year-old woman with insulin-dependent diabetes and a
history of suicide attempts by medication overdose presented to the Emergency Department
the morning after she had self-administered 2700 units of her insulin glargine in
an attempted suicide. She was treated with continuous intravenous dextrose infusion
with liberal oral intake, and continued to have recurrent hypoglycemic episodes 96
h into her hospital stay. She was discharged on hospital day 5 after psychiatric clearance
without any permanent complications. Conclusions: A single massive overdose of insulin
glargine can present with prolonged hypoglycemia. Emergency physicians should have
a low threshold for initiating continuous dextrose infusions and admitting these patients
for frequent blood glucose and serum electrolyte monitoring, preferably in an intensive
care setting.
Keywords
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Article info
Publication history
Published online: May 21, 2010
Accepted:
April 4,
2010
Received in revised form:
November 28,
2009
Received:
July 27,
2009
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
