Samuels M H, Eckel R H
Division of Endocrinology, University of Colorado Health Sciences Center, Denver 80262.
J Toxicol Clin Toxicol. 1989;27(3):157-68. doi: 10.3109/15563658909038579.
The course of a diabetic patient who self-administered 2500 U of NPH insulin subcutaneously was examined in detail. Despite resumption of oral intake on day 3, she required iv glucose for 6 days, during which time serum free insulin levels remained elevated. Glucose requirements closely matched those calculated from published euglycemic clamp data on maximal glucose disposal rates during insulin infusion. We postulate that her prolonged course was due to delayed absorption of the subcutaneous insulin. This is the first case of massive insulin overdose studied in such detail, and the results may facilitate management of future cases.
对一名自行皮下注射2500单位中效胰岛素（NPH）的糖尿病患者的病程进行了详细检查。尽管在第3天恢复了口服摄入，但她仍需静脉输注葡萄糖6天，在此期间血清游离胰岛素水平持续升高。葡萄糖需求量与根据已发表的关于胰岛素输注期间最大葡萄糖处置率的正常血糖钳夹数据计算得出的需求量密切匹配。我们推测她病程延长是由于皮下胰岛素吸收延迟所致。这是首例如此详细研究的大量胰岛素过量病例，其结果可能有助于未来病例的管理。
