老年2型糖尿病患者睡前误用门冬胰岛素致严重低血糖

摘要

A 77-year-old female patient with type 2 diabetes mellitus mistakenly injected insulin aspart 16 U subcutaneously as glargine insulin before bedtime.One hour later,she developed slow response and paraphasia.Her urgent blood glucose level was 2.8 mmol/L.An Ⅳ injection of 50％ glucose injection 40 ml,mask oxygen absorption,and continuous ECG monitoring were given immediately.Thirty minutes later,her blood glucose level increased to 8.4 mmol/L.The adjusted hypoglycemic regimen was subcutaneous injection of 8,10,and 8 units of insulin aspart 15 minutes before 3 meals,respectively,and glargine insulin 18 U before bedtime.Six days later,her fasting and 2-hour postprandial blood glucose levels were 7.0-8.3 mmol/L and 9.1-10.2 mmol/L,respectively.%1例77岁女性2型糖尿病患者睡前误将门冬胰岛素16 U作为甘精胰岛素皮下注射,1h后出现反应迟钝、言语混乱.急查血糖为2.8 mmol/L,立即予50％葡萄糖注射液40 ml静脉注射,给予面罩吸氧和持续心电监护.30 min后患者血糖为8.4 mmol/L.调整患者的降糖方案为门冬胰岛素8、10、8U分别在3餐前15 min皮下注射,甘精胰岛素注射液18 U睡前皮下注射.6d后,患者空腹血糖7.0 ～ 8.3 mmol/L,餐后2h血糖9.1 ～ 10.2 mmol/L.