Humulin引起的难治性低血糖

Mao Tang, Lu Cixin
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引用次数: 0

摘要

Humulin 70/30胰岛素是一种用于治疗糖尿病的中效药物。根据系统综述,已有44例不同类型胰岛素过量的病例报告。我们报告了一个独特的案例,Humulin 70/30胰岛素过量是由于自杀未遂,表现为持续低血糖,需要长期住院治疗。A47岁女性患者因自我服用2000国际单位Humulin胰岛素70/30自杀未遂后意识水平下降而就诊于急诊科。在急诊科,接受250毫升D10%治疗的患者随后转到医疗部门。患者继续使用10%葡萄糖200 ml/小时连续输注、普通肝素7500国际单位/12小时、氢化可的松100mg/6小时、奥曲肽100微克/8和胰高血糖素1 mg进行治疗。第四天,所有药物和D10%停止,患者仍在观察中,然后出院,一般情况下没有低血糖发作。Humulin胰岛素的单次高剂量过量可导致长期持续低血糖,这对D10%的单独用药是难治的。所有医生都应该知道治疗严重低血糖的指南,以及何时进入医疗部门或重症监护室,并进行血糖和血清电解质监测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Refractory Hypoglycemia due to Humulin
Humulin 70/30 insulin is an intermediate acting medication used for treatment diabetes mellitus. According to systematic review and there have been forty four case reports of overdoses with different types of insulin. We present a unique case of insulin Humulin 70/30 overdose due to suicidal attempt that presented with persistent hypoglycemia and required prolonged hospital treatment. A47 years old female patient presented to the emergency department due to decreased level of consciousness after self -administration of 2000 international unit Humulin insulin 70/30 suicidal attempt. In the emergency department patient treated with 250 ml D10% then shifted to the medical department. The patient continue treatment with dextrose 10% 200 ml/hour as continuous infusion, unfractionated heparin 7500 international unit/12 hour, hydrocortisone 100mg /6 hours, octreotide 100 microgram /8 and glucagon 1 mg . On the fourth day all medication and D10% stopped and the patient still under observation then discharged on will general condition without hypoglycemia attacks. A single high overdose of Humulin insulin can present with prolonged persistent hypoglycemia that is refractory to D10% alone. All physicians should know the guidelines to treat severe form of hypoglycemia and when to admit into medical department or intensive care unit with follow up for blood glucose and serum electrolyte monitoring.
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