Fasching P, Roden M, Stühlinger H G, Kurzemann S, Zeiner A, Waldhäusl W, Laggner A N
Department of Medicine III, University Hospital, Vienna, Austria.
Diabet Med. 1994 Apr;11(3):323-5. doi: 10.1111/j.1464-5491.1994.tb00279.x.
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 mumol kg-1 min-1 was found at peak serum insulin concentrations of about 14,400 pmol l-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.
报告了一例有充分记录的病例，一名35岁的1型糖尿病男性患者，因自杀企图皮下注射了1500国际单位（IU）胰岛素（750IU普通胰岛素，750IU中效胰岛素）后作为急诊入院。类似于实验性高胰岛素正常血糖钳夹检查，通过计算胰岛素注射后65小时内维持正常血糖所需输注葡萄糖量的消失率，发现在血清胰岛素浓度峰值约为14400pmol/L时，葡萄糖消耗量为55.6μmol·kg-1·min-1。胰岛素诱导的葡萄糖动力学与健康人和1型糖尿病患者在10mU·kg-1·min-1正常血糖钳夹期间的情况非常相似。这些信息可能有助于处理类似的胰岛素中毒病例。
