Evidence mapPaperPMID 33133703Full record

ArticleCase reports in endocrinology2020

Critical Low Catastrophe: A Case Report of Treatment-Refractory Hypoglycemia following Overdose of Long-Acting Insulin.

Rashi Sandooja, John M Moorman, Monisha Priyadarshini Kumar, Karla Detoya

Open access · goldAbstract readCase Reports
In one paragraph

Article in Case reports in endocrinology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Intentional co-ingestion of levothyroxine and insulin in a teenager.Journal of diabetes and metabolic disorders · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Rashi SandoojaDepartment of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA.ORCID https://orcid.org/0000-0003-0927-3884
John M MoormanDepartment of Pharmacy Practice, Northeast Ohio Medical University, Rootstown, OH, USA.ORCID https://orcid.org/0000-0003-1768-8457
Monisha Priyadarshini KumarDepartment of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA.
Karla DetoyaDepartment of Endocrinology, Cleveland Clinic Akron General, Akron, OH, USA.
Cleveland Clinic · USNortheast Ohio Medical University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Overdose of long-acting insulin can cause unpredictable hypoglycemia for prolonged periods of time. The initial treatment of hypoglycemia includes oral carbohydrate intake as able and/or parenteral dextrose infusion. Refractory hypoglycemia following these interventions presents a clinical challenge in the absence of clear guidelines for management. Octreotide has sometimes been used, but its use is generally limited to sulfonylurea overdose. In this case report, we present a case of refractory hypoglycemia following an overdose of 900 units of long-acting insulin glargine that failed to respond to usual modes of therapy mentioned above. Stress-dose corticosteroids were then initiated, followed by subsequent improvement in IV dextrose and glucagon requirements and blood glucose levels. Hence, corticosteroids may serve as an adjunctive therapy in managing hypoglycemia and can be considered earlier in the course of treatment in patients with refractory hypoglycemia to prevent volume overload, especially when large volumes of dextrose infusions are required.

Identifiers

PMID33133703
PMCPMC7591938
OpenAlexW3093938879

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.