Persistent Vegetative State after Diabetic Ketoacidosis Triggered by an Overdose of Psychotropic Agents

Intern Med. 2019 Jan 15;58(2):247-250. doi: 10.2169/internalmedicine.1041-18. Epub 2018 Sep 12.

Abstract

A 28-year-old man with type 1 diabetes mellitus was admitted for shock and coma due to diabetic ketoacidosis. Despite aggressive treatment and management of the patient's underlying clinical issues, the patient remained in a comatose state. Further investigations revealed an excess consumption of psychotropic agents; however, there was no evidence of an insulin overdose. Physicians should be aware that, in patients who are highly dependent upon insulin, an overdose of psychotropic agents can lead to hypoxic-ischemic brain injury.

Keywords: diabetic ketoacidosis; drug overdose; hypoglycemia; hypoxic-ischemic brain injury; persistent vegetative state.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Azepines / poisoning*
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetic Coma / etiology
  • Diabetic Ketoacidosis / complications*
  • Diphenhydramine / poisoning*
  • Drug Overdose / complications*
  • Drug Overdose / etiology
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Male
  • Persistent Vegetative State / chemically induced*
  • Psychotropic Drugs / poisoning*
  • Shock / etiology
  • Suicide, Attempted

Substances

  • Azepines
  • Hypoglycemic Agents
  • Insulin
  • Psychotropic Drugs
  • Diphenhydramine
  • clotiazepam