Transient extreme insulin resistance in a critically ill patient:A case report  

作　　者：Xiu-Yu Wei Hsiu-Nien Shen 

机构地区：[1]Department of Internal Medicine,Taichung Veterans General Hospital,Taichung 407,Taiwan,China [2]Department of Intensive Care Medicine,Chi Mei Medical Center,Tainan 710,Taiwan,China

出　　处：《World Journal of Clinical Cases》2025年第8期35-40,共6页世界临床病例杂志（英文）

摘　　要：BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is rare.CASE SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of sepsis.Remarkably,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose level.CONCLUSION Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically transient.Clinicians should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.

关 键 词：HYPERGLYCEMIA INSULIN Insulin resistance SEPSIS Critical illness Case report 

分 类 号：R459.7[医药卫生—急诊医学]