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Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Hypoglycemia and Glucagon01:15

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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Hypoglycemia01:26

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Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
Hyperglycemia01:29

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Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Diabetes Mellitus: Overview and Type I Subtype01:22

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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
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Improving IV Insulin Administration in a Community Hospital
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Published on: June 11, 2012

Lantus insulin overdose: a case report.

Michael Lu1, Pholaphat Charles Inboriboon

  • 1Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York 14642, USA.

The Journal of Emergency Medicine
|May 25, 2010
PubMed
Summary
This summary is machine-generated.

A massive overdose of insulin glargine, a long-acting insulin, can cause prolonged hypoglycemia requiring extended hospital care. This case highlights the need for vigilant monitoring and treatment in emergency settings for significant insulin glargine overdoses.

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Area of Science:

  • Endocrinology
  • Pharmacology

Background:

  • Insulin glargine is a long-acting basal insulin analog used for diabetes mellitus management.
  • Limited literature exists on insulin glargine overdose, with only six prior case reports.

Observation:

  • A 51-year-old woman with diabetes self-administered 2700 units of insulin glargine in a suicide attempt.
  • The patient experienced persistent hypoglycemia for 96 hours despite continuous intravenous dextrose and oral intake.

Findings:

  • Massive insulin glargine overdose can lead to prolonged and recurrent hypoglycemia.
  • Continuous dextrose infusion and intensive monitoring were required for 96 hours.

Implications:

  • Emergency physicians should consider prolonged hypoglycemia in insulin glargine overdose cases.
  • Continuous dextrose infusions and intensive care monitoring are crucial for managing severe insulin glargine overdoses.
  • Prompt psychiatric evaluation and management are essential for patients with overdose history.