This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Arlan L. Rosenbloom, MD; Beverly P. Giordano, RN

Am J Dis Child. 1977;131(8):881-885.

Abstract
• We have recorded clues to the clinical recognition of chronic insulin overdosage in 101 pediatric patients with diabetes mellitus, identified predisposing circumstances, and reconsidered the traditional strategy of slow reduction in insulin dose. Overtreatment occurred in 70%, overall, and in 90% of those referred for instability; mean overdose was 38% of the readjusted dose. The most common findings were frank hypoglycemic episodes, polyuria/nocturia/enuresis despite increasing insulin dosage, excessive appetite, hepatomegaly, weight gain, headaches, exercise intolerance, marked variation in glucosuria, mood swings, and frequent bouts of rapidly developing ketoacidosis. Overtreatment usually developed because of attempts to achieve metabolic control using glucosuria as principal criterion. One fourth of those observed became overtreated during periods of emotional turmoil when need for increased insulin to counter stressinduced hyperglycemia and ketosis led to chronic increase in dosage. Persistent glucosuria/ketonuria and exacerbation of hypoglycemic symptoms were more frequent with slow than with rapid reduction in insulin dosage.

(Am J Dis Child 131:881-885, 1977)

Author Affiliations
From the North Florida Regional Diabetes Program of the Children's Medical Services Program of the Department of Health and Rehabilitative Services of the State of Florida, and the Division of Genetics, Endocrinology and Metabolism of the Department of Pediatrics, University of Florida, Gainesville.

Footnotes
Read in part before the 16th Annual Meeting of the Ambulatory Pediatric Association, St Louis, April 25, 1976.

Reprint requests to Box J296, J. Hillis Miller Health Center, University of Florida, Gainesville, FL 32610 (Dr Rosenbloom).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Improper Insulin Compliance May Lead to Hepatomegaly and Elevated Hepatic Enzymes in Type 1 Diabetic Patients
Yu and Howard
Diabetes Care 2004;27:619-620.
FULL TEXT  

The Somogyi Phenomenon: Sacred Cow or Bull?
Raskin
Arch Intern Med 1984;144:781-787.
ABSTRACT  

Excessive Insulin Therapy: Biochemical Effects and Clinical Repercussions: Current Concepts of Counterregulation in Type I Diabetes
WILSON
ANN INTERN MED 1983;98:219-227.
ABSTRACT