Journal article

A Case of Surreptitious Glargine Overdose Confirmed by Insulin Pharmacokinetic Time Curves

Rahul Barmanray, Cherie Ying Chiang, Kim Yeoh, Christopher James Yates

Journal of Analytical Toxicology | OXFORD UNIV PRESS INC | Published : 2019


CASE: A 49-year-old man presented with recurrent altered conscious state suggestive of encephalitis. This was followed by an episode of severe hypoglycemia requiring protracted intravenous glucose administration. Comparing the pharmacokinetic time curves of serum insulin levels on two insulin immunoassays with different insulin analog cross-reactivity allowed the likely diagnosis of surreptitious glargine overdose to be made rapidly. DISCUSSION: The differing insulin analog cross-reactivity of serum insulin immunoassays, in this case the Abbott ARCHITECT and Roche Elecsys, allows the presence of insulin analog to be detected. Through comparison of time curves the characteristic signature of ..

View full abstract