Thewjitcharoen Yotsapon, Lekpittaya Nampetch, Himathongkam Thep
Department of Medicine, Theptarin Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2008 Dec;91(12):1920-4.
The authors present a case of an 80-year-old man, non-diabetic, who attempted suicide by injecting himself subcutaneously with 10,000 units of Humulin R and 6000 units of Humulin N. Administration of dextrose intravenously was required for 13 days to maintain the capillary blood glucose within the range of 100-180 mg/dl. Hyponatremia, hypokalemia, hypophosphatemia, and elevated liver enzymes were also seen after massive insulin injection. Glucose requirement index was established to demonstrate the trend of glucose requirement during hospitalization. He recovered completely without any complication after monitoring blood glucose and titrating intravenous glucose carefully for two weeks. Current literature about how to manage insulin overdose was reviewed in the present article.
作者报告了一例80岁非糖尿病男性患者，他通过皮下注射10000单位的优泌林R和6000单位的优泌林N企图自杀。为将毛细血管血糖维持在100 - 180mg/dl范围内，需静脉输注葡萄糖13天。大量注射胰岛素后还出现了低钠血症、低钾血症、低磷血症及肝酶升高。建立了葡萄糖需求指数以显示住院期间葡萄糖需求的趋势。经过两周仔细监测血糖和调整静脉输注葡萄糖剂量后，他完全康复且无任何并发症。本文回顾了当前关于胰岛素过量处理的文献。
