INSULIN
Clinical effects
Hypoglycaemia
Aspiration pneumonia or pulmonary oedema is sometimes seen particularly after seizures or prolonged hypoglycaemia. Hypokalaemia
Electrolyte imbalances, often occur during prolonged treatment with glucose.
Investigations Blood glucose
Renal functions and Blood concentrations
Blood concentrations of insufin are unhelpful in acute management but may be able to differentiate hypoglycaemia from overdose from therapeutic misadventures. Insulin, C- peptide and proinsulin can help to differentiate between exogenous insulin overdose and insulinoma.
The ECG should be monitored if significant hypokalaemia occurs
Treatment
- Supportive
- Iv Glucose
- Antidotes (Glucagon can be used but is not recommended in large overdoses)
- Surgical excision (In massive Insulin injection, local excision of Insulin injection site has been suggested as a means to reduce Insulin exposure, especially in long-acting Insulin
overdose.)