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患有精神疾病的糖尿病患者需要极高剂量的胰岛素:一个病例报告
Kibret Enyew Belay1, Beza Leulseged Ayalew2, Abdissa Meherete Etana2
1Department of Internal Medicine, Endocrinology and Metabolism Unit, Bahirdar University, Bahirdar, Ethiopia.
SAGE open medical case reports
|December 22, 2023
概括
糖尿病患者每日高剂量胰岛素可能并不总是严重的胰岛素耐药性的信号. 这一案例突显了因不适当使用胰岛素而导致的伪抗性,强调需要首先调查技术和坚持问题.
科学领域:
- 内分泌学 在内分泌学.
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 严重的胰岛素耐药性定义为每天需要>2单位/公斤胰岛素,这是糖尿病患者罕见的情况.
- 潜在的原因包括综合征,药物,内分泌系统疾病,脂质缩和吸收受损.
- 虚假的原因和增加的胰岛素清除率也可能有助于.
研究的目的:
- 描述一个明显严重的胰岛素抵抗病例在患有严重抑郁症的糖尿病患者.
- 为了调查异常高的胰岛素需求的根本原因.
- 强调在高胰岛素剂量场景中评估技术和坚持因素的重要性.
主要方法:
- 一个糖尿病患者的病例报告,患有严重抑郁症,需要高剂量胰岛素.
- 在住院期间评估胰岛素使用和血糖控制.
- 对高外部胰岛素需求的潜在原因进行系统审查.
主要成果:
- 患者每天需要282个单位 (4.9个单位/公斤) 的胰岛素,最初表明严重的胰岛素耐药性.
- 由于不适当使用胰岛素引起的伪耐药性,造成了高要求.
- 在住院和干预后,通过较低的胰岛素剂量实现了血糖控制.
结论:
- 异常高的外源胰岛素需求需要系统评估超出典型的严重胰岛素耐药性.
- 技术问题 (注射技术,注射地点,储存) 和药物错误/药物坚持是调查的关键因素.
- 解决因不适当使用胰岛素而导致的伪抗性对于有效的糖尿病管理至关重要.
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