Estimated Glucose Requirement Following Massive Insulin Overdose in a Patient with Type 1 Diabetes

Abstract

A well‐documented case of a 35‐year‐old male Type 1 diabetic patient who was admitted as an emergency after having injected 1500 international units (IU) of insulin (750 IU regular insulin,750 IU NPH‐insulin) subcutaneously as a suicidal attempt is reported. Computing disappearance rates of glucose from its infused amounts necessary to maintain euglycaemia during 65 h after the insulin injection in analogy to experimental hyperinsulinaemic euglycaemic clamp examinations, a glucose consumption of 55.6 μmol kg −1 min −1 was found at peak serum insulin concentrations of about 14400 pmol I −1 . The insulin‐induced glucose dynamics resemble closely those seen in healthy persons and Type 1 diabetic subjects during a 10 mU kg −1 min −1 euglycaemic clamp. This information may be useful in the handling of similar cases of insulin intoxication.