Table 1.
Summary of clinical information of 34 patients.
| reference | age/sex | indication | daily dose (mg/d) | duration(d) | symptoms | serum glucose (mg/dL) | Insulin (μU/ml) | C-peptide (ng/mL) | serum creatinine (mg/dL) | Management |
|---|---|---|---|---|---|---|---|---|---|---|
| 5 | 65/f | UTI | 320/1600 po | 10 | seizure, dyspnea, lethargic | 27 | 36 | na | 6.1 | discontinued, dextrose iv |
| 6 | 63/m | pyogenic arthritis | 960/4800 po; 320/1600 po | 5/na | seizures, mental status changes | 26 | 58.7 | na | HD | dose decreased |
| 7 | 85/f | UTI | 320/1600 po | 7 | confusion, loss of consciousness | 24 | 3 | na | 1.3 | discontinued, dextrose iv |
| 7 | 74/f | UTI | 320/1600 po | na | loss of consciousness | 12 | 6 | na | 8.2 | discontinued, dextrose iv |
| 8 | 69/f | UTI | na | 2 | nausea, vomiting, weakness, slurred speech, numbness | 48 | na | na | normal | discontinued, dextrose iv |
| 9 | 62/m | PCP | 960/4800 po | 5 | consciousness disturbance | 20 | 34.5 | na | 3.3 | discontinued |
| 10 | 64/m | PCP | 1280/6400 iv | 2 | loss of consciousness | 36 | na | na | 9.5 | dextrose iv |
| 11 | 34/m | PCP | na | 6 | stuporous | 18 | 12 | ↑ | normal | discontinued, dextrose iv |
| 12 | 88/f | UTI | 320/1600 po | 4 | GTCS, incoherence, confusion | 33 | na | NA | 1.2 | discontinued, dextrose iv |
| 13 | 19/f | na | 320/1600 po | 1 | confusion | 17 | na | NA | PD | dextrose iv |
| 14 | 36/m | PCP | 960/4800 iv, 1920/9600 po |
8 | tremor, loss of consciousness, seizure, sweating | 28.8 | na | 4.3 | 3.6 | discontinued, dextrose iv,diazepam |
| 15 | 54/f | PCP | 1280/6400 | 5 | neuroglycopenic symptoms | 36 | 24.2 | 7.7 | normal | discontinued, dextrose iv |
| 16 | 73/m | HAP | 1280/6000 iv;600/3000 iv | 6/9 | asymptomatic | 22 | na | na | 5.1 | discontinued, dextrose iv, low-dose re-challenge |
| 17 | 91/f | UTI | 640/3200 po | 7 | decreased level of consciousness | 34 | na | na | 1.7 | discontinued |
| 18 | 41/m | PCP | 640/3200 po | 6 | tremor, sweating, disorienting, unresponsive | 18 | 30.2 | 12.6 | 1.4 | discontinued |
| 19 | 5m/f | PCP | 20/100 mg/kg per d | 3 | generalized convulsion | 18 | 16.4 | 4.88 | normal | dose decreased, diazoxide |
| 20 | 46/m | PCP | 1280/6400 po | 18 | GTCS, altered state of consciousness, falls | 28.8 | na | na | 2 | discontinued, dextrose iv |
| 21 | 76/m | UTI | 160/800 | 5 | symptomatic hypoglycemia, inability to speak | 34 | na | na | 2 | discontinued, dextrose iv |
| 22 | 44/f | PCP | 1920/9600 iv | 7 | sweating, asthenia, dizziness | 59 | 40 | na | normal | continued, dextrose iv |
| 22 | 24/m | PCP | 960/4800 iv | 20 | sweating, asthenia, confusion, nausea, dizziness | 56 | 80 | na | normal | discontinued, dextrose iv |
| 23 | 83/m | prophylaxis | 160/800 | na | loss of muscle tone, pale skin and mucous membranes | 28 | 3.2 | 2.2 | 1.7 | discontinued, dextrose iv |
| 24 | 56/f | PCP | no | 5 | coma | 30.6 | 2ULN | 2ULN | CKD 5 | discontinued, dextrose iv |
| 25 | 52/f | prophylaxis | 80/400 | 7 | dizziness, hunger, headaches, sweating. | 30.6 | 41.1 | 6.1 | > 60 * | continued, oral sugar |
| 26 | 60/f | UTI | 160/800 | 3 | tremor, sweating, fatigue | 60 | na | na | normal | discontinued |
| 27 | 71/m | PCP | 1120/5600 | 11 | coma, acute neurological deterioration, nervous breakdown, hypothermia | 24 | na | na | 3.2 | discontinued, dextrose iv |
| 28 | 69/m | PCP | 960/4800 | 4 | Tonic clonic seizure | 28.8 | 95.9 | 12.8 | AKI | discontinued, dextrose iv, glucagon |
| 29 | 18/f | prophylaxis | 80/400 po | 2 | na | 43.2 | 8.1 | 11.7 | 0.5 | discontinued, dextrose iv |
| 30 | 85/m | UTI | 320/1600 po | 7 | pale, altered state of consciousness | 35 | 8.8 | 4.57 | 1.79 | discontinued, dextrose iv |
| 31 | 75/f | PCP | 96 mg/kg/day | 10 | lost consciousness | 20 | na | na | 53.7 * | discontinued, oral sugar, low-dose re-challenge |
| 32 | 64/m | PCP | 1280/6400 po | 5 | delirious, spoke nonsense words, displayed dancing arms, deliration | 30.6 | 115.3 | 19.55 | 49.67* | dose decreased |
| 33 | 73/m | bacteremia | 160/800 2d, 960/4800 po | 8 | lethargy, visual hallucinations | 45 | 31.8 | 4.5 | 1.3 | Discontinued, hydrocortisone and dextrose iv, intramuscular glucagon and octreotide. |
| 34 | 62/f | Cerebral toxoplasmosis | 320/1600 | 6 | GTCS | 21 | 99 | 20 | na | discontinued, dextrose iv, glucagon |
| 35 | 64/f | PCP | no | na | confusion | 21.6 | no | 15.5 | AKI | discontinued, dextrose iv, glucagon |
| 36 | 79/f | UTI | 320/1600 po | 6 | consciousness disorder, coma, wandering, sweating | 28.8 | na | na | na | discontinued, dextrose iv |
AKI, acute kidney injury; CKD, Chronic kidney disease; GTCS, generalized tonic clonic seizure; HD, hemodialysis; na, not applicable; PCP, Pneumocystis carinii pneumonia; PD, peritoneal dialysis; iv, intravenous; ULN, upper limit of normal value; UTI, urinary tract infection.
*Represents estimated glomerular filtration rate (mL/min).
AKI, acute kidney injury; CKD, Chronic kidney disease; GTCS, generalized tonic clonic seizure; HD, hemodialysis; na, not applicable; PCP, Pneumocystis carinii pneumonia; PD, peritoneal dialysis; iv, intravenous; ULN, upper limit of normal value; UTI, urinary tract infection.
*Represents estimated glomerular filtration rate.