Massive Levemir (Long-Acting) Insulin Overdose: Case Report

@article{Oduru2012MassiveL,
  title={Massive Levemir (Long-Acting) Insulin Overdose: Case Report},
  author={Mamatha Oduru and Mahmood Ahmad},
  journal={Case Reports in Medicine},
  year={2012},
  volume={2012}
}
A 52-year-old insulin-dependant diabetic man presented to the Emergency Department 2 hours after a deliberate massive overdose of 2100 units of long-acting Levemir insulin and a large quantity of whisky. On initial assessment, his GCS was 3/15 and his capillary blood sugar was 2.6 mmol/L. The patient was given a 50 ml bolus of 50% dextrose, followed by intravenous infusions of both 5% and 10% dextrose. Despite the continuous infusions, he experienced 4 symptomatic hypoglycaemic episodes in the… 
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8 Citations

Citation Type

Citation Type

Intentional insulin overdose associated with minimal hypoglycemic symptoms in a non-diabetic patient.
TLDR
The case of a previously healthy non-diabetic young medical professional who presented with a rapid-acting insulin overdose is presented to familiarize the medical professionals involved in managing this condition with the recognition, pathophysiology and appropriate therapeutic interventions.
Prolonged Coma after Single, Unintentional Overdose of Insulin: Concurring Factors Leading to a Persistent Neurological Condition
TLDR
The patient was emergently admitted in an intensive care unit with profound hypoglycemia and hypokalemia, and in deep coma, with the patient remaining in coma for another two days after glycemia normalization, but improved considerably within the next month from the event.
Prolonged Severe Hypoglycemia in a Pediatric Patient With Type 1 Diabetes
TLDR
A 13-year-old girl with type 1 diabetes presented to the emergency department (ED) after being found unresponsive at home by her mother with a capillary blood glucose (CBG) of 1.488 mmol/L (26.8 mg/dL) and was admitted to the intensive care unit (ICU) for further management and careful monitoring.
Problem based review: the patient who has taken an overdose of long-acting insulin analogue.
TLDR
Once the effects of overdose have receded, diabetes treatment must be restarted with care, especially in patients with type 1 diabetes, where continuous intravenous 10% or 20% glucose infusion with frequent capillary blood glucose monitoring is needed.
Inadvertent iatrogenic insulin detemir 1000 units overdose in a hospitalised patient
TLDR
Proper safety measures and mandatory nurse education about administration of insulin were implemented to prevent future occurrences.
Literature review: drug and alcohol-induced hypoglycaemia
TLDR
Mechanisms for hypoglycaemia include one or more stimulation of insulin release, reduction of insulin clearance, alteration of insulin sensitivity, interference with glucose metabolism and modulation of effect of antidiabetic medications.
Oral Lactobacillus reuteri GMN-32 treatment reduces blood glucose concentrations and promotes cardiac function in rats with streptozotocin-induced diabetes mellitus
TLDR
The results highlight that L. reuteri GMN-32 treatment reduces blood glucose levels, inhibits caspase 8-mediated apoptosis and promotes cardiac function in DM rats as observed from their ejection fraction and fractional shortening values.
Lactobacillus reuteri GMN-32 treatment reduces blood glucose concentrations and promotes cardiac function in rats with streptozotocin-induced diabetes mellitus
TLDR
The results highlight that L. reuteri GMN-32 treatment reduces blood glucose levels, inhibits caspase 8-mediated apoptosis and promotes cardiac function in DM rats as observed from their ejection fraction and fractional shortening values.

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