Surreptitious Administration of Insulin Seen in Case Studies

This possibility may need to be considered for episodes of unexplained hypoglycemia in children
By Monica Smith
HealthDay Reporter

MONDAY, April 12 (HealthDay News) -- Unexplained hypoglycemia in children can be perplexing, and surreptitious administration of insulin -- whether by children themselves or their caregivers -- may need to be considered as a cause, according to three case studies published online April 12 in two different articles in Pediatrics.

Jennifer N. Osipoff, M.D., of the State University of New York in Stony Brook, and colleagues describe two patients, 12- and 13-year old boys, with type 1 diabetes hospitalized for episodes of hypoglycemia. A review of the priming history of their insulin pumps revealed both were receiving additional insulin under the manual-prime function, which went unnoticed at first because the manual-prime function is not included in daily totals. Both children ultimately confessed to using the manual-prime function to self-administer extra insulin.

Rebecca P. Green, M.D., Washington University in St. Louis, and colleagues describe an 8-week-old infant presenting to the emergency room with a blood glucose concentration of 1.8 mmol/L, lethargy and tachycardia, and then had three additional hypoglycemic episodes after admission. Several tests were performed on the infant, and samples obtained during hypoglycemia had a graded reactivity similar to that observed in type 1 diabetes patients prescribed insulin analogs, but a sample obtained from the patient and a control during euglycemia showed equal reactivity among three assays. The data suggested the child was being administered insulin analog, and tandem mass spectrometry confirmed the presence of Humalog. The child was placed in foster care, and hypoglycemia did not reoccur.

"It was fortunate for our young patient that we were able to creatively use laboratory resources to establish and solidify the evidence of exogenous insulin administration, which allowed the patient to be placed in a safe environment," Green and colleagues conclude.

Abstract - Osipoff
Full Text (subscription or payment may be required)
Abstract - Green
Full Text (subscription or payment may be required)

Copyright © 2010 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Blunt Chest Trauma
Journal of Trauma Nursing, November/December 2014
Expires: 12/31/2016 CE:2 $21.95


The School Age Child with Congenital Heart Disease
MCN, The American Journal of Maternal/Child Nursing, January/February 2015
Expires: 2/28/2017 CE:2.5 $24.95


Understanding multiple myeloma
Nursing Made Incredibly Easy!, January/February 2015
Expires: 2/28/2017 CE:2 $21.95


More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles

Comprehensive Care: Looking Beyond the Presenting Problem
Journal of Christian Nursing, January/March 2015
Free access will expire on March 2, 2015.


Pain and Alzheimer dementia: A largely unrecognized problem
Nursing Made Incredibly Easy!, January/February 2015
Free access will expire on February 16, 2015.


Glycemic control in hospitalized patients
Nursing2015 Critical Care, January 2015
Free access will expire on February 16, 2015.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events