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Diabetic Hypoglycemia - an independent electronic journal dedicated to the advancement of hypoglycemia research and clinical management
Diabetic Hypoglycemia Volume 1, Issue 1, June 2008

Clinical Case Study

Exercise, alcohol and insulin administration

Dr. Miles Fisher

Diabetic Hypoglycemia June 2008, Volume 1, Issue 1: page 12


This issue covers the case of a 38-year old man with an 11-year history of type 1 diabetes, which was generally well controlled. For the past nine years he had followed a basal bolus insulin regimen, and monitored his blood glucose regularly. He had no evidence of diabetic complications. On attending a party he administered his evening insulin injection two hours later than usual. He drank four glasses of wine with a meal, and joined in the dancing that followed. Approximately three hours after retiring to bed, he experienced an attack of hypoglycemia with a subsequent convulsion. An ambulance was called and the paramedics administered intramuscular glucagon without checking his blood glucose. The patient was taken to the local hospital and diagnosed with a compression fracture of the lumbar spine caused by the seizure, which was treated with simple analgesia. His hypoglycemia was caused by a combination of increased physical activity, alcohol, and the delay in his evening insulin injection coupled with the pharmacokinetic actions of human soluble insulin.

Keywords: type 1 diabetes, hypoglycemia, insulin