• Everett T Fuller, Michael A Miller, David W Kaylor, and Cliff Janke.
• Department of Emergency Medicine, Darnall Army Community Hospital, Fort Hood, Texas 76544-4752, USA.
• J Emerg Med. 2009 Jan 1;36(1):26-9.

AbstractInsulin glargine (Lantus, Aventis Pharmaceuticals, Bridgewater, NJ) is a long-acting once-daily dosed form of insulin intended to maintain a constant baseline insulin level. As a relatively new medication, there is limited experience in overdoses of Lantus. We present a case of a 37-year-old male insulin-dependent diabetic presenting with refractory hypoglycemia secondary to an intentional overdose of Lantus insulin to illustrate the varied management concerns in overdoses of long-acting insulins. The patient was managed with oral intake, intravenous dextrose bolus, peripheral 10% dextrose solution, 25% dextrose sliding scale via central line, and psychiatry evaluation for suicide attempt. Other potential treatments discussed for possible use with long-acting insulin overdoses include incision and drainage of the injection site, glucagon, and octreotide.

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