Endocrine Abstracts

Introduction: U-300 glargine is a new generation long acting insulin. Nocturnal hypoglicemia and weight gain with U-300 glargine is lower than U-100 glargine. However, it may take 3–4 days for U-300 glargine to reach stable state in plasma. We report a diabetic case with recurrent ketosis after U-300 glargine.

Case presentation: A 20 years old woman with type 1 diabetes mellitus who uses basal and bolus insulin (U-300 glargine and insülin aspart). She applied to emergency clinic with stomachache, diarrhea and nausea. The patient did not use insulin for a few days because of these complaints. As a laboratory results, plasma glucose concentration: 380 mg/dl, 3 positive ketones in urine analysis, PH: 7,07 in venous blood gas analysis, HCO3: 6 mmol/L. She was hospitalized in intensive care unit with diabetic ketoacidosis. Diabetic ketoasidosis improved after fluid, electrolyte replacement and insulin treatment. Urine examination showed ketones to be negative We started her routine basal- bolus insulin treatment with U-300 insulin glargine and insülin aspart. We observed again ketones (+2 positive) in urine analysis 10 hours later under her routine basal bolus treatment.

Conclusion: U300 glargine use may be associated with ketosis relapse in early period after diabetic ketoacidosis has improved, in this respect the physician must be careful.