Treatment of insulin poisoning: A 100‐year review
Authors' conclusion
There is no randomized controlled trial to guide treatment of insulin poisoning. Treatment with glucose infusion, sometimes supplemented with glucagon, is almost always effective in restoring euglycaemia, but optimum treatments to maintain euglycaemia and restore cerebral function remain uncertain.
Study context
- Population
- Published cases of insulin poisoning from 1923 to 2022admissions (301 patients)
- Participants
- 315 cases
- Comparison
- Up to 1999 vs 2000–2022
- Up to 1999n = 156reference
- 2000–2022n = 159
- Outcome
- Deaths
Methodological detailsno restrictions of date or language, UK National Poisons Information Service data
- No restrictions of date or language
- UK National Poisons Information Service data
Pooled result
As reported in the abstract
Up to 1999
86% survival
22 of 156
2000–2022
96% survival
7 of 159
P = 0.003
- Deaths reported
- 29
Further pooled results
Insulin with longest duration of action
Cases
- Long-acting
- 83
- Medium-acting
- 116
- Short-acting
- 36
- Rapid-acting analogue
- 16
Treatments
- Surgical excision of injection site
- 6 cases
- Glucose infusion duration, median (IQR), in 179 cases
- 51 h (16-96 h)
- Glucagon
- 14 patients
- Octreotide
- 9 patients
- Adrenaline, corticosteroids and mannitol given occasionally
Original publication
Treatment of insulin poisoning: A 100‐year review. Diabet Med. Published 23 March 2023. doi:10.
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