DURATION OF HYPOGLYCEMIA AND NEED FOR INTRAVENOUS GLUCOSE FOLLOWING INTENTIONAL OVERDOSES OF INSULIN
DURATION OF HYPOGLYCEMIA AND NEED FOR INTRAVENOUS GLUCOSE FOLLOWING INTENTIONAL OVERDOSES OF INSULIN
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DOI：
10.1016/s0196-0644(84)80513-2
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发表时间：
1984-01-01
影响因子：
6.2
通讯作者：
HASKELL, RJ
中科院分区：
文献类型：
--
作者：
STAPCZYNSKI, JS;HASKELL, RJ
目的：评价静脉注射治疗故意过量胰岛素的效果。(Iv)葡萄糖，回顾了10年间15名患者17次自杀未遂的记录。患者的平均年龄为29。+-。9岁，平均胰岛素超量为386.+-。276例患者中，8例为胰岛素依赖型糖尿病患者，7例无糖尿病病史。非糖尿病患者更有可能出现低血糖(血清葡萄糖50 mg/dl)，并出现反复低血糖、异位口服和静脉注射。葡萄糖输注组，均为糖尿病患者(P<；0.05，Fisher‘S精确检验)。单次过量服用胰岛素的量与静脉注射总量之间存在显著的相关性(P<；0.01)。或静脉注射葡萄糖的总时间。葡萄糖治疗直到过量胰岛素的降糖作用消失(葡萄糖[g]=52+(0.699)(剂量U)，R=0.9029，时间[h]=10.5+0.28(剂量U)，R=0.817)。无患者因低血糖而出现永久性并发症。长时间的攻击性静脉注射。胰岛素过量时需要输注葡萄糖和连续监测血糖水平。这些患者的低血糖可能比从各种胰岛素制剂的常规作用时间预测的要晚得多。
To assess the treatment of intentional insulin overdoses with i.v. (IV) glucose, the records of 17 suicide attempts in 15 patients seen during a 10-yr period were reviewed. The mean age of the patients was 29 .+-. 9 yr and the mean overdose of insulin was 386 .+-. 276 U. Eight patients were insulin-dependent diabetics and 7 patients had no history of diabetes. The nondiabetics were more likely to present with hypoglycemia (serum glucose < 50 mg/dl) and develop recurrent hypoglycemia, depsite oral intake and i.v. glucose infusion, than were diabetic patients (P < 0.05, Fisher''s exact test). A significant relationship (P < 0.01) between the amount of insulin taken as a single overdose and either the total amount of i.v. glucose administered or the total time of i.v. glucose treatment until the hypoglycemic effects of excess insulin had resolved (glucose [g] = 52 + (0.699) (dose U), R = 0.9029 and time [h] = 10.5 + (0.28) (dose U), R = 0.817) was also found. No patient sustained permanent complications from hypoglycemia. Prolonged, aggressive i.v. glucose infusion and serial monitoring of serum glucose levels is required in insulin overdoses. These patients may become hypoglycemic much later than predicted from the conventional duration of action of the various insulin preparations.