Critical Low Catastrophe: A Case Report of Treatment-Refractory Hypoglycemia following Overdose of Long-Acting Insulin
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...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2020/8856022 |
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| author | Rashi Sandooja John M. Moorman Monisha Priyadarshini Kumar Karla Detoya |
| author_facet | Rashi Sandooja John M. Moorman Monisha Priyadarshini Kumar Karla Detoya |
| author_sort | Rashi Sandooja |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-a1fe9f5c451a45cca2ee6c3744316684 |
| institution | Kabale University |
| issn | 2090-6501 2090-651X |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Endocrinology |
| spelling | doaj-art-a1fe9f5c451a45cca2ee6c37443166842025-02-03T01:05:15ZengWileyCase Reports in Endocrinology2090-65012090-651X2020-01-01202010.1155/2020/88560228856022Critical Low Catastrophe: A Case Report of Treatment-Refractory Hypoglycemia following Overdose of Long-Acting InsulinRashi Sandooja0John M. Moorman1Monisha Priyadarshini Kumar2Karla Detoya3Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USADepartment of Pharmacy Practice, Northeast Ohio Medical University, Rootstown, OH, USADepartment of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USADepartment of Endocrinology, Cleveland Clinic Akron General, Akron, OH, USAOverdose 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.http://dx.doi.org/10.1155/2020/8856022 |
| spellingShingle | Rashi Sandooja John M. Moorman Monisha Priyadarshini Kumar Karla Detoya Critical Low Catastrophe: A Case Report of Treatment-Refractory Hypoglycemia following Overdose of Long-Acting Insulin Case Reports in Endocrinology |
| title | Critical Low Catastrophe: A Case Report of Treatment-Refractory Hypoglycemia following Overdose of Long-Acting Insulin |
| title_full | Critical Low Catastrophe: A Case Report of Treatment-Refractory Hypoglycemia following Overdose of Long-Acting Insulin |
| title_fullStr | Critical Low Catastrophe: A Case Report of Treatment-Refractory Hypoglycemia following Overdose of Long-Acting Insulin |
| title_full_unstemmed | Critical Low Catastrophe: A Case Report of Treatment-Refractory Hypoglycemia following Overdose of Long-Acting Insulin |
| title_short | Critical Low Catastrophe: A Case Report of Treatment-Refractory Hypoglycemia following Overdose of Long-Acting Insulin |
| title_sort | critical low catastrophe a case report of treatment refractory hypoglycemia following overdose of long acting insulin |
| url | http://dx.doi.org/10.1155/2020/8856022 |
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