Hypoglycemic Encephalopathy Caused by Insulin Aspart (Novorapid ®) Overdose During a Suicide Attempt
Bibliographic record
Abstract
We present a case of a 41-year-old man who attempted suicide by injection of 600 units of insulin aspart. On arrival at the ER (after eating high-carbohydrate foods), he was awake and blood glucose was 40 mg / dl. He received a total glucose load of 230 g in the first 15 hours. Head CT was not remarkable. He was discharged on day 14. Three weeks later, he was found in a deep coma. He had injected 900 units of insulin aspart in a suicide attempt 8 hours prior to be found. On arrival, he was comatose and his blood glucose was 19 mg / dl. Head CT revealed low density areas throughout the cerebral cortex and partial cerebral edema. He received a total glucose load of 270 g in the first 22 hours. A repeat head CT examination on day 9, revealed worsening of the findings throughout the cerebral cortex. He fell into an apallic syndrome and was transferred to a local hospital. In the second overdose, the patient rapidly developed a sustained hypoglycemia, and fell into hypoglycemic encephalopathy because of the delay in receiving appropriate treatment. We consider that insulin aspart overdose may, in fact, predispose to hypoglycemic encephalopathy compared with long-acting insulin. doi:10.4021/jmc574w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".