Persistent Hypoglycemia Induced by Long-acting Insulin Degludec

Yukino Katakura; Fuminori Tatsumi; Takashi Kusano; Masashi Shimoda; Kenji Kohara; Tomohiko Kimura; Atsushi Obata; Shuhei Nakanishi; Tomoatsu Mune; Kohei Kaku; Hideaki Kaneto

doi:10.2169/internalmedicine.7915-21

CASE REPORTS

Persistent Hypoglycemia Induced by Long-acting Insulin Degludec

Yukino Katakura, Fuminori Tatsumi, Takashi Kusano, Masashi Shimoda, Kenji Kohara, Tomohiko Kimura, Atsushi Obata, Shuhei Nakanishi, Tomoatsu Mune, Kohei Kaku, Hideaki Kaneto

Author information

Yukino Katakura
Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Fuminori Tatsumi
Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Takashi Kusano
Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Masashi Shimoda
Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Kenji Kohara
Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Tomohiko Kimura
Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Atsushi Obata
Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Shuhei Nakanishi
Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Tomoatsu Mune
Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Kohei Kaku
Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Hideaki Kaneto
Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan

Keywords: severe hypoglycemia, insulin therapy, insulin degludec, a pitfall, diabetes care

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 6 Pages 861-864

DOI https://doi.org/10.2169/internalmedicine.7915-21

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Details

Abstract

A 58-year-old Japanese man was brought to the emergency room due to disturbance of consciousness. He regained consciousness on the day of admission and started taking hospital meals, but he needed intravenous glucose administration for eight days. The total amount of glucose administration was 4,464 g. It took over three weeks for exogenous insulin to be almost undetectable. While degludec binds to albumin and exerts glucose-lowering effects for a long time, the above-mentioned period of three weeks was consistent with the half-life of albumin. Hypoglycemia induced by massive dose of insulin degludec is persistent and prominent.

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