Four episodes of transient severe insulin resistance in diabetic ketoacidosis, possibly
of immunological origin, have been described. Severe insulin resistance was diagnosed
when insulin requirement exceeded 100 units per hour. Treatment comprised of doubling
the insulin dose intravenously every two hours till there was a satisfactory response
and administration of steroids when 100 units per hour of insulin were being administered.
Contrary to the usual response, ketosis responded first followed by hyperglycaemia.
When insulin resistance was overcome, plasma glucose continued to fall despite witholding
insulin and late hypoglycaemia occurred in three episodes.
Severe Insulin Resistance
-
Diabetic Ketoacidosis
-
Insulin Steroids
-
Late Hypoglycaemia
