Year: 2024
Type: article
Study design: Case Report
Abstract: BACKGROUND: Acute hyperglycemia due to insulin resistance is common in critically ill patients, typically managed with insulin infusion. However, the occurrence of transient extreme insulin resistance (EIR) requiring exceptional high-dose insulin is rare. CASE SUMMARY: We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest, subsequently developing transient EIR following a new episode of sepsis. Remarkably, insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour (a total of 18224 units on that day), and it was promptly titrated down to zero upon achieving the target glucose level. CONCLUSION: Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR, which is typically transient. Clinicians should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.
Source: World Journal of Clinical Cases
Authors: Xiu-Yu Wei, Hsiu-Nien Shen
Institutions: Taichung Veterans General Hospital, Chi Mei Medical Center
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4405018465