Premium
Intentional Overdose with Insulin Glargine and Insulin Aspart
Author(s) -
Tofade Toyin S.,
Liles E. Allen
Publication year - 2004
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.24.14.1412.43147
Subject(s) - medicine , hypokalemia , hypoglycemia , insulin , insulin glargine , drug overdose , hypomagnesemia , insulin aspart , hypophosphatemia , diabetes mellitus , depression (economics) , emergency department , pediatrics , anesthesia , intensive care medicine , emergency medicine , endocrinology , poison control , psychiatry , materials science , macroeconomics , economics , magnesium , metallurgy
Reports of intentional massive overdoses of insulin are infrequent. A review of the literature revealed no reports of overdose attempts with either insulin glargine or insulin aspart. We report the case of a 33‐year‐old woman without diabetes mellitus who intentionally injected herself with an overdose of both products, which belonged to her husband. She arrived at the emergency department 15 hours after her suicide attempt, which took place the night before. Her husband had checked her blood glucose level throughout the night and had given her high‐carbohydrate drinks and foods. The patient had a history of obsessive‐compulsive disorder, major depression, and numerous suicide attempts. She recovered from the resulting hypoglycemia after 40 hours of dextrose infusion and was transferred to a mental health facility. The main danger associated with insulin overdose is the resultant hypoglycemia and its effects on the central nervous system; hypokalemia, hypophosphatemia, and hypomagnesemia also can develop with excess insulin administration. Dextrose infusion, with liberal oral intake when possible, and monitoring for electrolyte changes, making adjustments as needed, are recommended for the treatment of intentional insulin overdose.