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Treatment of Diabetic Ketoacidosis With Intravenous U-500 Insulin in a Patient With Rabson-Mendenhall Syndrome: A Case Report
- Source :
- Journal of pharmacy practice. 30(4)
- Publication Year :
- 2016
-
Abstract
- Rabson-Mendenhall syndrome is a rare genetic disorder resulting from mutations in the insulin receptor and is associated with high degrees of insulin resistance. These patients are prone to complications secondary to their hyperglycemia including diabetic ketoacidosis (DKA). We report the case of a 19-year-old male with Rabson-Mendenhall syndrome presenting with DKA who required doses of up to 500 U/h (10.6 U/kg/h) of insulin. The patient’s insulin infusion was originally compounded with U-100 regular insulin, although to minimize volume, the product was compounded with U-500 insulin. The DKA eventually resolved requiring infusion rates ranging from 400 to 500 U/h. Although numerous opportunities for medication errors exist with the use of U-500 insulin, this case outlines the safe use of concentrated intravenous insulin when clinically indicated for patients requiring extremely high doses of insulin to control blood glucose.
- Subjects :
- Male
medicine.medical_specialty
Pediatrics
Diabetic ketoacidosis
medicine.medical_treatment
030209 endocrinology & metabolism
Diabetic Ketoacidosis
030207 dermatology & venereal diseases
03 medical and health sciences
Young Adult
0302 clinical medicine
Insulin resistance
Internal medicine
medicine
Humans
Hypoglycemic Agents
Insulin
Pharmacology (medical)
Infusions, Intravenous
Donohue Syndrome
biology
business.industry
Genetic disorder
medicine.disease
Insulin receptor
Endocrinology
Treatment Outcome
U 500 insulin
biology.protein
Regular insulin
Rabson–Mendenhall syndrome
business
Subjects
Details
- ISSN :
- 15311937
- Volume :
- 30
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Journal of pharmacy practice
- Accession number :
- edsair.doi.dedup.....7b7e1072f797b4e9181fa1a9ffdceea9