Correction of Over-Dosed Insulin in a Type-2-Diabetic Associates With a Better Control of Glycemia and Arterial Hypertension: A Case Report
Abstract
Background: An association between hypoglycemia and arterial hypertension is unknown. Here, we report a case of a chronically over-dosed insulin therapy in conjunction with uncontrolled hypertension.Case Presentation: A 73-year-old, male diabetic of Caucasian ethnicity was admitted to a neurological intermediate-care unit of a university hospital for progressive weakness due to diabetic polyneuropathy. Besides obesity (body-mass index: 31 kg/m²) and type-2 diabetes, an uncontrolled arterial hypertension was present. Diabetes therapy consisted of fixed-dose insulin (160 units QD). Symptomatic or documented hypoglycemic episodes were not reported. Hemoglobin A1c was 11.2%. Prior to hospitalization, a urapidil (60 mg thrice a day), was added to his antihypertensive medication with valsartan (160 mg BID) and bisoprolol (5mg BID). During hospitalization, metformin, empagliflozin, and dulaglutide (1.5 mg per week) were added to insulin. An intensified conventional therapy with a cumulative daily dose of 46 units was introduced. 22 months after discharge, the medical therapy consisted of metformin (1 g BID), liraglutide (1.8 mg QD), and insulin glargine (26 units QD). The antihypertensive medication was reduced to bisoprolol and valsartan, urapidil was discontinued. The follow-up visit showed Hemoglobin A1c of 6.6%, and a well-controlled blood pressure. The patient’s physical activity improved with the patient being able to leave his flat alone for the first time within 6 years.…
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