We present a unique case of insulin glargine overdose that presented with persistent hypoglycemia and required prolonged in-hospital treatment. [ncbi.nlm.nih.gov]

• Pallor

  Coma is characterized by loss of consciousness, a strong drop in blood sugar levels (more than 5 mmol / l from the initial level), pallor, slowing of the heart rhythm, lack of pupillary reflex. [en.intoxication-stop.com]

  […] to increase the concentration of glucose in the blood by eating or drinking something sweet, then develops the second stage, which is characterized by: the growing feeling of hunger; hyperhidrosis; tremor of the upper extremities; increase of saliva; pallor [poisoning.vsebolezni.com]

• Asymptomatic

  Asymptomatic children with unintentional sulfonylurea ingestions should be observed for 12 h, except if this would lead to discharge at night when they should be kept until the morning. Prophylactic intravenous dextrose is not recommended. [ncbi.nlm.nih.gov]

• Nausea

  Nausea was managed with anti-emetics. Intramuscular and subcutaneous glucagon is effective in the management of refractory and severe hypoglycemia in youth with both T1DM and hyperinsulinism. [ncbi.nlm.nih.gov]

  […] may result if you: take too much insulin excessively exercise, thus use more glucose than normal miss a meal or don’t eat as much as usual, thus ingesting less glucose Symptoms of too much insulin hyperinsulinism may involve: chills hunger fainting nausea [healthblurbs.com]

  Symptoms of an insulin overdose Symptoms include: Depressed mood Dizziness Drowsiness Fatigue Headache Hunger Inability to concentrate Irritability Nausea Nervousness Personality changes Rapid heartbeat Restlessness Sleep disturbances Slurred speech Sweating [diabetes-ayurveda.com]

  Taking insulin when you don't need it causes symptoms such as sweating, shaking, headache, irritability, nervousness, anxiety, weakness, dizziness, hunger, tremors, nausea, and difficulty concentrating or thinking. [livestrong.com]

  These include: Confusion Dizziness Drowsiness Extreme hunger Headache Irritability Mood changes Nausea Nervousness Rapid heartbeat Sleep disturbances Slurred speech Sweating Trembling Trouble concentrating Unsteady movements Severe symptoms of an insulin [diabetescommunity.com]

• Seizure

  If you're unconscious or too confused or are having seizures, those around you will need to take control. Give your family and friends these instructions: If you lose consciousness, they should call 911 immediately. [webmd.com]

  Police say that can cause seizures or more serious problems. Her mother, 22-year-old Deva Young, of Warren, has been jailed in Cleveland on $15,000 bond. Court records listed no attorney for her. [abc6onyourside.com]

  More severe symptoms include: Seizures Loss of consciousness Changes in behavior, such as irritability Loss of coordination Difficulty speaking Confusion Coma Loss of life. You may find that you have your own unique set of low blood sugar symptoms. [diabetes.emedtv.com]

  That level of insulin could cause a child with diabetes to suffer seizures, go into a diabetic coma or die, according to police. Both of her parents had previously been shown how to properly give the girl her medication, police said. [cleveland.com]

• Irritability

  Symptoms of hypoglycemia include: Anxiety Confusion Extreme hunger Fatigue Irritability Sweating or clammy skin Trembling hands If sugar levels continue to fall during an insulin overdose, serious medical complications and even death. [nursinghomelawcenter.org]

  More severe symptoms include: Seizures Loss of consciousness Changes in behavior, such as irritability Loss of coordination Difficulty speaking Confusion Coma Loss of life. You may find that you have your own unique set of low blood sugar symptoms. [diabetes.emedtv.com]

  […] too much insulin excessively exercise, thus use more glucose than normal miss a meal or don’t eat as much as usual, thus ingesting less glucose Symptoms of too much insulin hyperinsulinism may involve: chills hunger fainting nausea tremors sweating irritability [healthblurbs.com]

  Symptoms of Insulin overdose (hypoglycaemia) Trembling Sweating Dizziness or light-headedness Nervousness or irritability Behaviour and mood changes Headache Weakness Numbness or tingling around the mouth Pale skin Confusion Extreme hunger Extreme symptoms [sundaytimes.lk]

  Sweating Dizziness Palpitation Tremor Hunger Restlessness Tingling in the hands, feet, lips, or tongue Lightheadedness Decreased concentration Headache Drowsiness Sleep disturbances Anxiety Blurred vision Slurred speech Depressed mood Irritability Abnormal [rxwiki.com]

• Confusion

  It’ll help them take action if your low blood sugar levels make you confused. Wear a medical alert bracelet. Make sure it says you use insulin. [webmd.com]

  Also, it is a good idea to let others around you know how to spot your particular signs of low blood sugar levels (and how to react), as you may be too confused (due to low blood sugar levels) to recognize the signs and respond adequately. [diabetes.emedtv.com]

  Symptoms of hypoglycemia include: Anxiety Confusion Extreme hunger Fatigue Irritability Sweating or clammy skin Trembling hands If sugar levels continue to fall during an insulin overdose, serious medical complications and even death. [nursinghomelawcenter.org]

  […] exercise, thus use more glucose than normal miss a meal or don’t eat as much as usual, thus ingesting less glucose Symptoms of too much insulin hyperinsulinism may involve: chills hunger fainting nausea tremors sweating irritability dizziness headache confusion [healthblurbs.com]

  Symptoms of Insulin overdose (hypoglycaemia) Trembling Sweating Dizziness or light-headedness Nervousness or irritability Behaviour and mood changes Headache Weakness Numbness or tingling around the mouth Pale skin Confusion Extreme hunger Extreme symptoms [sundaytimes.lk]

• Agitation

  The court heard that Mr Rhoden was woken when Miss Dunne returned from her local pub in an ‘agitated’ state on December 17 last year and threatened to take painkillers. She told him to leave, saying he was ‘too good for her’. [dailymail.co.uk]

  Persistent, untreated hypoglycaemia can cause permanent neurological injury and death Clinical features are consistent with hypoglycaemia and usually manifest within 2 hours: Autonomic (nausea, vomiting, diaphoresis, tachycardia) CNS (Agitation, tremors [lifeinthefastlane.com]

  There are inability to move, excessive sweating, rapid heart rate, trembling of the limbs, blackout, depression or agitation of the psyche. Then develop clonic or tonic seizures. [en.intoxication-stop.com]

Inability to maintain euglycemia following glucose administration suggests excessive insulin and requires further workup. Evaluation of serum insulin and C-peptide levels is useful in confirming intentional overdoses in cases that are not clear-cut. [ncbi.nlm.nih.gov]

Unlike the pH during cardiac arrest, interpreting a venous lactate level in relation to an arterial value could be useful in the workup and management of critically ill patients. [forums.studentdoctor.net]

• Hypoglycemia

  Massive insulin overdose may be associated with unpredictable and prolonged hypoglycemia. [ncbi.nlm.nih.gov]

  The patient required 20% glucose infusion to normalize blood sugar and had the last episode of hypoglycemia 30 h after insulin injection. 11 In our case, no other form of insulin was injected, but severe hypoglycemia developed by 1–2 h suggesting that [elsevier.es]

• Insulin Increased

  Doctors call this pathology - absolute insulin deficiency. The main sign of it is hyperglycemia - an increase in glucose (sugar) in the blood. [en.intoxication-stop.com]

  Even in a CCB poisoned animal model insulin increases myocardial glucose uptake resulting in improved contractility. [coreem.net]

• Hyperinsulinemia

  Using Hyperinsulinemia Euglycemia Therapy (Lugassy 2015) Hyperinsulinemia Euglycemia Therapy (HIET) Initiation: Intravenous bolus of regular insulin at a dose of 1 unit/kg. [coreem.net]

• Fasting Hypoglycemia

  Its hallmark presentation is a fasting hypoglycemia because even though the person hasn’t eaten overnight where normally there would be negligible insulin secretion, the insulinoma has run amok and is doing its own thing. [arn.org]

First-line treatment was IV glucose treatment in 95% of cases. [ncbi.nlm.nih.gov]

If your symptoms still don’t improve after three treatments, seek medical help immediately. Also, be sure to eat a meal after treating a low blood sugar reaction. [healthline.com]

Assessment of prognosis relies on clinical findings. The observed plasma insulin EC 50 is 46 mIU/l. [ccforum.biomedcentral.com]

However, early presentation has an excellent prognosis with glucose replenishment. Hypoglycaemia can last for days and the erratic release from the subcutaneous tissues creates an unpredictable duration of hypoglycaemia. [lifeinthefastlane.com]

Starter #10 http://www.emedmag.com/html/pre/fea/features/038120044.asp Lactate levels Elevated arterial lactate levels are an early sensitive marker of tissue hypoperfusion, predicting both the severity of hemodynamic compromise and overall patient prognosis [forums.studentdoctor.net]

The cases were analyzed in regard to etiology, type of insulin used, concomitant substances being taken by the patient, symptoms and clinical outcome. [ncbi.nlm.nih.gov]

Epidemiological assessment of 160 cases of insulin overdose recorded in a regional poisons unit. Int J Clin Pharmacol Ther 2004;42(5):277-80. 3. Mégarbane B, Deye N, Bloch V, Sonneville R, Collet C, Launay JM, Baud FJ. [webmedcentral.com]

View Article Google Scholar von Mach MA, Meyer S, Omogbehin B, Kann PH, Weilemann LS: Epidemiological assessment of 160 cases of insulin overdose recorded in a regional poisons unit. Int J Clin Pharmacol Ther 2004, 42: 277-280. [ccforum.biomedcentral.com]

Only by understanding the pathophysiology of disease, dysfunction, and death, can one begin to appreciate the complexity of life and how easy it is for us to die and fall off the radar screen for the survival of the fittest. [arn.org]

Follow this up with sufficient slower-absorbed carbohydrate, such as bread, to prevent hypoglycemia occurring later. [diabetes.co.uk]

Don’t leave anything to chance and make sure you have eaten enough carbohydrate to prevent hypoglycemia. Very low blood glucose levels can cause us to feel very lethargic and sleepy. [diabetes-ayurveda.com]

[…] of glucose from the polymers in uncooked cornstarch, we hypothesized this might help to prevent nocturnal hypoglycemia. [elsevier.es]

Concerns surrounding the potential provocation of insulin release from beta cells have previously prevented the use of intravenous glucagon as an adjunct to infusion of dextrose in this situation. [ncbi.nlm.nih.gov]

This is to prevent hypoglycemia occurring later on. Test your blood as soon as realise you may have overdosed on insulin. [diabetescommunity.com]