Prognostic Factors in Intentional Insulin Overdose
Author Information
Author(s): Mégarbane Bruno, Deye Nicolas, Bloch Vanessa, Sonneville Romain, Collet Corinne, Launay Jean-Marie, Baud Frédéric J
Primary Institution: Assistance Publique – Hôpitaux de Paris, Hôpital Lariboisière
Hypothesis
What are the prognostic factors in insulin poisoning related to plasma insulin concentration?
Conclusion
Intentional insulin overdose is rare, and prognosis relies on clinical findings, with a significant plasma insulin EC50 of 46 mIU/l.
Supporting Evidence
- Four patients developed sequelae resulting in two deaths.
- Delay to therapy in excess of 6 hours was identified as an independent prognostic factor.
- Ventilation for longer than 48 hours was also a significant predictor of unfavourable outcomes.
Takeaway
This study looked at people who took too much insulin on purpose and found that how long it took to get help and how long they needed a breathing machine were important for recovery.
Methodology
A prospective study using logistic regression to explore prognostic factors and toxicokinetic/toxicodynamic relationships.
Potential Biases
Potential biases may arise from the retrospective nature of data collection and the small number of patients.
Limitations
The study was conducted at a single center with a small sample size, which may limit the generalizability of the findings.
Participant Demographics
25 patients (14 female, 11 male; median age 46 years; 80% with psychiatric history; 52% with diabetes).
Statistical Information
P-Value
p<0.05
Confidence Interval
95% CI 2.9 to 1,236.7 for delay to therapy; 95% CI 1.9 to 420.6 for ventilation duration.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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