Persistent Hypoglycemia Induced by Long-acting Insulin Degludec

Area of Science:

• Endocrinology
• Pharmacology

Background:

• Insulin degludec is a long-acting basal insulin used for diabetes management.
• Its prolonged duration of action is attributed to its albumin binding and self-assembly properties.

Observation:

• A patient experienced prolonged hypoglycemia after a massive dose of insulin degludec.
• Intravenous glucose administration was required for eight days.
• Exogenous insulin remained detectable for over three weeks.

Findings:

• The prolonged hypoglycemia correlated with the albumin half-life, suggesting albumin binding influences insulin degludec's duration.
• Massive doses of insulin degludec can lead to persistent and severe hypoglycemia.

Implications:

• Clinicians should be aware of the potential for prolonged hypoglycemia with large insulin degludec doses.
• Management strategies may need to account for the extended duration of action in overdose scenarios.