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Insulin coma

MedGen UID:
9496
•Concept ID:
C0021645
•
Disease or Syndrome
Synonyms: Coma, Insulin; Insulin Coma
SNOMED CT: Insulin coma (111558006)

Definition

A hypoglycemia-induced comatose state resulting from a large dose of exogenous insulin. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVInsulin coma

Professional guidelines

PubMed

'A violent thunderstorm': Cardiazol treatment in British mental hospitals.
McCrae N
Hist Psychiatry 2006 Mar;17(65 Pt 1):67-90. doi: 10.1177/0957154X06061723. PMID: 17153475
Practical management of diabetic ketoacidosis and hyperosmolar coma.
Hamblin PS, Topliss DJ, Stockigt JR
Aust N Z J Med 1990 Dec;20(6):836-41. doi: 10.1111/j.1445-5994.1990.tb00437.x. PMID: 2127177
Treatment of schizophrenia; a comparison of three methods: brief psychotherapy, insulin coma and electric shock.
GOTTLIEB JS, HUSTON PE
J Nerv Ment Dis 1951 Mar;113(3):237-46. PMID: 14824956

Recent clinical studies

Etiology

Improving Current Treatments for Schizophrenia.
Maric NP, Jovicic MJ, Mihaljevic M, Miljevic C
Drug Dev Res 2016 Nov;77(7):357-367. Epub 2016 Sep 16 doi: 10.1002/ddr.21337. PMID: 27633376
Variability of Basal Rate Profiles in Insulin Pump Therapy and Association with Complications in Type 1 Diabetes Mellitus.
Laimer M, Melmer A, Mader JK, Schütz-Fuhrmann I, Engels HR, Götz G, Pfeifer M, Hermann JM, Stettler C, Holl RW
PLoS One 2016;11(3):e0150604. Epub 2016 Mar 3 doi: 10.1371/journal.pone.0150604. PMID: 26938444Free PMC Article
Memory of insulin pumps and their record as a source of information about insulin therapy in children and adolescents with type 1 diabetes.
Pańkowska E, Skórka A, Szypowska A, Lipka M
Diabetes Technol Ther 2005 Apr;7(2):308-14. doi: 10.1089/dia.2005.7.308. PMID: 15857233
Severity of symptoms in chronically institutionalized geriatric schizophrenic patients.
Davidson M, Harvey PD, Powchik P, Parrella M, White L, Knobler HY, Losonczy MF, Keefe RS, Katz S, Frecska E
Am J Psychiatry 1995 Feb;152(2):197-207. doi: 10.1176/ajp.152.2.197. PMID: 7840352
Factitious brittle diabetes mellitus.
Schade DS, Drumm DA, Eaton RP, Sterling WA
Am J Med 1985 May;78(5):777-84. doi: 10.1016/0002-9343(85)90283-9. PMID: 3922220

Diagnosis

Atropine coma: a historical note.
Gazdag G, Bitter I, Ungvári G, Gerevich J
J ECT 2005 Dec;21(4):203-6. doi: 10.1097/01.yct.0000180041.13962.e4. PMID: 16301877
Severity of symptoms in chronically institutionalized geriatric schizophrenic patients.
Davidson M, Harvey PD, Powchik P, Parrella M, White L, Knobler HY, Losonczy MF, Keefe RS, Katz S, Frecska E
Am J Psychiatry 1995 Feb;152(2):197-207. doi: 10.1176/ajp.152.2.197. PMID: 7840352
The diabetic dental patient.
Rees TD
Dent Clin North Am 1994 Jul;38(3):447-63. PMID: 7926197
Factitious brittle diabetes mellitus.
Schade DS, Drumm DA, Eaton RP, Sterling WA
Am J Med 1985 May;78(5):777-84. doi: 10.1016/0002-9343(85)90283-9. PMID: 3922220
Diphenylhydantoin and early diabetes.
Vaisrub S
JAMA 1973 Oct 8;226(2):191. doi: 10.1001/jama.226.2.191. PMID: 4740915

Therapy

Improving Current Treatments for Schizophrenia.
Maric NP, Jovicic MJ, Mihaljevic M, Miljevic C
Drug Dev Res 2016 Nov;77(7):357-367. Epub 2016 Sep 16 doi: 10.1002/ddr.21337. PMID: 27633376
Memory of insulin pumps and their record as a source of information about insulin therapy in children and adolescents with type 1 diabetes.
Pańkowska E, Skórka A, Szypowska A, Lipka M
Diabetes Technol Ther 2005 Apr;7(2):308-14. doi: 10.1089/dia.2005.7.308. PMID: 15857233
Hypoglycemic neuropathy.
Mohseni S
Acta Neuropathol 2001 Nov;102(5):413-21. doi: 10.1007/s004010100459. PMID: 11699552
Can delirium relieve psychosis?
Malur C, Fink M, Francis A
Compr Psychiatry 2000 Nov-Dec;41(6):450-3. doi: 10.1053/comp.2000.16565. PMID: 11086151
Electroconvulsive therapy for schizophrenia.
Tharyan P
Cochrane Database Syst Rev 2000;(2):CD000076. doi: 10.1002/14651858.CD000076. PMID: 10796292

Prognosis

Prolonged bilateral reactive miosis as a symptom of severe insulin intoxication.
Gradwohl-Matis I, Pann J, Schmittinger CA, Brunauer A, Dankl D, Duenser MW
Am J Case Rep 2015 Jan 3;16:1-3. doi: 10.12659/AJCR.892324. PMID: 25556593Free PMC Article
Hypoglycemia in type 1 diabetic pregnancy: role of preconception insulin aspart treatment in a randomized study.
Heller S, Damm P, Mersebach H, Skjøth TV, Kaaja R, Hod M, Durán-García S, McCance D, Mathiesen ER
Diabetes Care 2010 Mar;33(3):473-7. Epub 2009 Dec 10 doi: 10.2337/dc09-1605. PMID: 20007944Free PMC Article
Long-term follow-up of patients with a diagnosis of paranoid state and hospitalized, 1913 to 1940.
Stephens JH, Richard P, McHugh PR
J Nerv Ment Dis 2000 Apr;188(4):202-8. doi: 10.1097/00005053-200004000-00002. PMID: 10789996
Factitious brittle diabetes mellitus.
Schade DS, Drumm DA, Eaton RP, Sterling WA
Am J Med 1985 May;78(5):777-84. doi: 10.1016/0002-9343(85)90283-9. PMID: 3922220
Comparative diagnostic considerations and prognostic evaluations of electroshock and insulin coma treatments; a comparison of Norwegian and American psychiatric and psychological concepts.
FORD L, MAZZITELLI H, LANGFELDT G, BOHAN AR
Am J Psychiatry 1955 Apr;111(10):756-62. doi: 10.1176/ajp.111.10.756. PMID: 14361761

Clinical prediction guides

Risk of recurrent severe hypoglycemia remains associated with a past history of severe hypoglycemia up to 4 years: Results from a large prospective contemporary pediatric cohort of the DPV initiative.
Pacaud D, Hermann JM, Karges B, Rosenbauer J, Danne T, Dürr R, Herbst A, Lindauer S, Müther S, Pötzsch S, Raile K, Witsch M, Holl RW; DPV Initiative
Pediatr Diabetes 2018 May;19(3):493-500. Epub 2017 Dec 8 doi: 10.1111/pedi.12610. PMID: 29218766
Pyrotherapy for the Treatment of Psychosis in the 21st Century: A Case Report and Literature Review.
Zuschlag ZD, Lalich CJ, Short EB, Hamner M, Kahn DA
J Psychiatr Pract 2016 Sep;22(5):410-5. doi: 10.1097/PRA.0000000000000181. PMID: 27648506
Hypoglycemic neuropathy.
Mohseni S
Acta Neuropathol 2001 Nov;102(5):413-21. doi: 10.1007/s004010100459. PMID: 11699552
Previous episodes of hypoglycemic coma are not associated with permanent cognitive brain dysfunction in IDDM patients on intensive insulin treatment.
Kramer L, Fasching P, Madl C, Schneider B, Damjancic P, Waldhäusl W, Irsigler K, Grimm G
Diabetes 1998 Dec;47(12):1909-14. doi: 10.2337/diabetes.47.12.1909. PMID: 9836523
Severity of symptoms in chronically institutionalized geriatric schizophrenic patients.
Davidson M, Harvey PD, Powchik P, Parrella M, White L, Knobler HY, Losonczy MF, Keefe RS, Katz S, Frecska E
Am J Psychiatry 1995 Feb;152(2):197-207. doi: 10.1176/ajp.152.2.197. PMID: 7840352

Recent systematic reviews

Electroconvulsive therapy for schizophrenia.
Tharyan P
Cochrane Database Syst Rev 2000;(2):CD000076. doi: 10.1002/14651858.CD000076. PMID: 10796292

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