Lantus overdose: case presentation and management options

J Emerg Med. 2009 Jan;36(1):26-9. doi: 10.1016/j.jemermed.2007.02.038. Epub 2007 Jul 20.

Abstract

Insulin glargine (Lantus, Aventis Pharmaceuticals, Bridgewater, NJ) is a long-acting once-daily dosed form of insulin intended to maintain a constant baseline insulin level. As a relatively new medication, there is limited experience in overdoses of Lantus. We present a case of a 37-year-old male insulin-dependent diabetic presenting with refractory hypoglycemia secondary to an intentional overdose of Lantus insulin to illustrate the varied management concerns in overdoses of long-acting insulins. The patient was managed with oral intake, intravenous dextrose bolus, peripheral 10% dextrose solution, 25% dextrose sliding scale via central line, and psychiatry evaluation for suicide attempt. Other potential treatments discussed for possible use with long-acting insulin overdoses include incision and drainage of the injection site, glucagon, and octreotide.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Drug Overdose / drug therapy
  • Glucose / administration & dosage
  • Humans
  • Hypoglycemic Agents / poisoning*
  • Infusions, Intravenous
  • Insulin / analogs & derivatives*
  • Insulin / poisoning
  • Insulin Glargine
  • Insulin, Long-Acting
  • Male
  • Suicide, Attempted*
  • Sweetening Agents / administration & dosage

Substances

  • Hypoglycemic Agents
  • Insulin
  • Insulin, Long-Acting
  • Sweetening Agents
  • Insulin Glargine
  • Glucose