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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
The psychology of insulin coma treatment.
SCOTT RD
Br J Med Psychol 1950;23(1-2):15-44. doi: 10.1111/j.2044-8341.1950.tb00369.x. PMID: 14801374

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
Increasing incidence of hypoglycemic coma in children with IDDM.
Egger M, Gschwend S, Smith GD, Zuppinger K
Diabetes Care 1991 Nov;14(11):1001-5. doi: 10.2337/diacare.14.11.1001. PMID: 1797479

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
Insulin-induced factitious hypoglycemic coma.
Price WA, Zimmer B, Conway R, Szekely B
Gen Hosp Psychiatry 1986 Jul;8(4):291-3. doi: 10.1016/0163-8343(86)90012-5. PMID: 3527869
Hypoglycemia: an overview.
Leggett J, Favazza AR
J Clin Psychiatry 1978 Jan;39(1):51-7. PMID: 204622
ELECTROENCEPHALOGRAMS DURING COMA.
LOEB C
Acta Neurochir (Wien) 1964;12:270-81. doi: 10.1007/BF01402098. PMID: 14293381

Therapy

'A landmark in psychiatric progress'? The role of evidence in the rise and fall of insulin coma therapy.
Freudenthal R, Moncrieff J
Hist Psychiatry 2022 Mar;33(1):65-78. Epub 2021 Dec 22 doi: 10.1177/0957154X211062538. PMID: 34935541Free PMC Article
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
Hypoglycemic neuropathy.
Mohseni S
Acta Neuropathol 2001 Nov;102(5):413-21. doi: 10.1007/s004010100459. PMID: 11699552
Electroconvulsive therapy for schizophrenia.
Tharyan P
Cochrane Database Syst Rev 2000;(2):CD000076. doi: 10.1002/14651858.CD000076. PMID: 10796292
Emergency therapy of diabetic crises: insulin overdose, diabetic ketoacidosis, and hyperosmolar coma.
Macintire DK
Vet Clin North Am Small Anim Pract 1995 May;25(3):639-50. doi: 10.1016/s0195-5616(95)50059-2. PMID: 7660538

Prognosis

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
Increasing incidence of hypoglycemic coma in children with IDDM.
Egger M, Gschwend S, Smith GD, Zuppinger K
Diabetes Care 1991 Nov;14(11):1001-5. doi: 10.2337/diacare.14.11.1001. PMID: 1797479
The effect of insulin coma and E.C.T. on the three-year prognosis of schizophrenia.
LEIBERMAN DM, HOENIG J, AUERBACH I
J Neurol Neurosurg Psychiatry 1957 May;20(2):108-13. doi: 10.1136/jnnp.20.2.108. PMID: 13429378Free PMC Article
The effect of insulin coma and E.C.T. on the short-term prognosis of schizophrenia.
HOENIG J, LEIBERMAN DM, AUERBACH I
J Neurol Neurosurg Psychiatry 1956 May;19(2):130-6. doi: 10.1136/jnnp.19.2.130. PMID: 13346386Free PMC Article
Observations on the relation between insulin coma dosage and prognosis in schizophrenia.
FREUDENBERG RK
J Ment Sci 1952 Jul;98(412):441-9. doi: 10.1192/bjp.98.412.441. PMID: 14938888

Clinical prediction guides

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
Increasing incidence of hypoglycemic coma in children with IDDM.
Egger M, Gschwend S, Smith GD, Zuppinger K
Diabetes Care 1991 Nov;14(11):1001-5. doi: 10.2337/diacare.14.11.1001. PMID: 1797479

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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