Massive Levemir (Long-Acting) Insulin Overdose: Case Report
A 52-year-old insulin-dependant diabetic man presented to the Emergency Department 2 hours after a deliberate massive overdose of 2100 units of long-acting Levemir insulin and a large quantity of whisky. On initial assessment, his GCS was 3/15 and his capillary blood sugar was 2.6 mmol/L. The patien...
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Wiley
2012-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2012/904841 |
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| author | Mamatha Oduru Mahmood Ahmad |
| author_facet | Mamatha Oduru Mahmood Ahmad |
| author_sort | Mamatha Oduru |
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| description | A 52-year-old insulin-dependant diabetic man presented to the Emergency Department 2 hours after a deliberate massive overdose of 2100 units of long-acting Levemir insulin and a large quantity of whisky. On initial assessment, his GCS was 3/15 and his capillary blood sugar was 2.6 mmol/L. The patient was given a 50 ml bolus of 50% dextrose, followed by intravenous infusions of both 5% and 10% dextrose. Despite the continuous infusions, he experienced 4 symptomatic hypoglycaemic episodes in the first 12 hours after admission. These were managed with oral glucose, IM glucagon, and further dextrose boluses. Blood electrolytes and pH were monitored throughout.
Insulin overdoses are relatively common and often occur with an excess of other drugs or alcohol which can enhance its action. Overdoses can result in persistent hypoglycaemia, liver enzyme derangement, electrolyte abnormalities, and neurological damage. Overall mortality is 2.7% with prognosis poorest in patients who are admitted with decreased Glasgow Coma scale (GCS) 12 hours after overdose. |
| format | Article |
| id | doaj-art-6d0385a33e994bd686bba422dcd724d0 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-6d0385a33e994bd686bba422dcd724d02025-02-03T06:05:24ZengWileyCase Reports in Medicine1687-96271687-96352012-01-01201210.1155/2012/904841904841Massive Levemir (Long-Acting) Insulin Overdose: Case ReportMamatha Oduru0Mahmood Ahmad1St Mary's Hospital, Imperial College Healthcare Trust, London W2 1NY, UKCardiology Department, Tahir Heart Institute, Rabwah, Jhang 35460, PakistanA 52-year-old insulin-dependant diabetic man presented to the Emergency Department 2 hours after a deliberate massive overdose of 2100 units of long-acting Levemir insulin and a large quantity of whisky. On initial assessment, his GCS was 3/15 and his capillary blood sugar was 2.6 mmol/L. The patient was given a 50 ml bolus of 50% dextrose, followed by intravenous infusions of both 5% and 10% dextrose. Despite the continuous infusions, he experienced 4 symptomatic hypoglycaemic episodes in the first 12 hours after admission. These were managed with oral glucose, IM glucagon, and further dextrose boluses. Blood electrolytes and pH were monitored throughout. Insulin overdoses are relatively common and often occur with an excess of other drugs or alcohol which can enhance its action. Overdoses can result in persistent hypoglycaemia, liver enzyme derangement, electrolyte abnormalities, and neurological damage. Overall mortality is 2.7% with prognosis poorest in patients who are admitted with decreased Glasgow Coma scale (GCS) 12 hours after overdose.http://dx.doi.org/10.1155/2012/904841 |
| spellingShingle | Mamatha Oduru Mahmood Ahmad Massive Levemir (Long-Acting) Insulin Overdose: Case Report Case Reports in Medicine |
| title | Massive Levemir (Long-Acting) Insulin Overdose: Case Report |
| title_full | Massive Levemir (Long-Acting) Insulin Overdose: Case Report |
| title_fullStr | Massive Levemir (Long-Acting) Insulin Overdose: Case Report |
| title_full_unstemmed | Massive Levemir (Long-Acting) Insulin Overdose: Case Report |
| title_short | Massive Levemir (Long-Acting) Insulin Overdose: Case Report |
| title_sort | massive levemir long acting insulin overdose case report |
| url | http://dx.doi.org/10.1155/2012/904841 |
| work_keys_str_mv | AT mamathaoduru massivelevemirlongactinginsulinoverdosecasereport AT mahmoodahmad massivelevemirlongactinginsulinoverdosecasereport |