Case Report
Volume: 3 | Issue: 2 | Published: Jan 01, 1970 | Pages: 91 - 94 | DOI: 10.24911/ejmcr/173-1556259277
Delayed hypoglycemic effect of insulin overdose in a diabetic child: a case report
Authors: Khalid Al Noaim , Amir Babiker , Angham Al Mutair , Mohsen Al Atawi , Mohammed Al Dubayee , Fahad Al Juraibah , Ibrahim Al Alwan
Article Info
Authors
Khalid Al Noaim
College of Medicine, King Faisal University, Al Ahsa, Saudi Arabia
Amir Babiker
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Angham Al Mutair
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Mohsen Al Atawi
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Mohammed Al Dubayee
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Fahad Al Juraibah
Department of Pediatrics, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
Ibrahim Al Alwan
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Publication History
Received: April 26, 2019
Accepted: May 07, 2019
Published: January 01, 1970
Abstract
Background: Insulin overdose can result in fatal hypoglycemia. We report on a diabetic child who received an unintentional insulin overdose. Case presentation: A 13-year-old girl with type1 diabetes, who was on insulin pump therapy, developed high blood glucose (BG) level due to pump malfunction. She gave herself 7 ml (700 units) instead of 7 units by an error. She presented to hospital 2 hours later when this was recognized. The initial BG in the emergency room was 13.9 mmol/L. A dextrose infusion was started 6 hours after the insulin injections when her BG dropped significantly before it reached a lowest level of 3.3 mmol/L 9 hours after the event. It was only possible to discontinue this infusion 15 hours after insulin injections when BG was stable. Conclusion: Hypoglycemia could be delayed in insulin overdose in diabetic children. This may necessitate prolonged monitoring beyond the usual half-life of insulin.
Keywords: Insulin, overdose, delayed hypoglycemia, dextrose, glucagon, aspart, diabetes, case report, green
