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Intentional insulin overdose associated with minimal hypoglycemic symptoms in a non-diabetic patient

Catalin-Iulian Efrimescu1, Elfaki Yagoub2, Rachel Doyle3

  • 1SHO Medicine, St. Columcille's Hospital, Loughlinstown, Co. Dublin, Ireland.

Maedica
|May 3, 2014
PubMed

Insights

Non-accidental suicidal insulin overdose in non-diabetic individuals is rare but occurs in medical professionals. Prompt recognition and management are crucial to prevent severe complications like hypoglycemic encephalopathy.

Area of Science:

  • Endocrinology
  • Toxicology
  • Medical Case Study

Background:

  • Non-accidental suicidal insulin overdose is an uncommon yet serious clinical presentation.
  • This specific scenario appears more prevalent among healthcare professionals.

Observation:

  • A case of a young, non-diabetic medical professional presenting after a rapid-acting insulin overdose.
  • Initial presentation included mild symptoms despite a large insulin dose, with initial glucose of 1.4 mmol/L.
  • Standard interventions like oral glucose and glucagon were ineffective; complications included electrolyte imbalances and lactic acidosis.

Findings:

  • Treatment involved intravenous dextrose and electrolyte replacement.
  • The patient experienced an uneventful recovery and was discharged after 36 hours.
  • Psychiatric follow-up was arranged post-discharge.

Implications:

  • Insulin overdose must be considered in hypoglycemic patients unresponsive to conventional treatment.
  • Inadequate management poses a significant risk of hypoglycemic encephalopathy and potentially permanent neurological damage.
  • This case highlights the importance of awareness and preparedness among medical professionals for managing such overdoses.

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