Insulin shock treatment

Pulmonary edema secondary to hypoglycemia was reported particularly in the 1930s when insulin shock treatment was used for schizophrenia. It is less common nowadays, but has been reported after insulin overdose (16). 

Many victims of mental disease are said to show disturbances of carbohydrate metabolism. Indeed, the physiological and biochemical study of mental diseases is in its early infancy. Preliminary findings suggest that the time is ripe for full-scale attack upon mental diseases by the techniques of these sciences. The insulin shock treatment represents only a first crude application of physiological techniques to therapy of such conditions. More effective methods may be expected to evolve out of this beginning. 

Manfred Sakel of Vienna introduces insulin shock treatment into psychiatry. 

Shock Therapy. The early 20th century saw the development of the first effective biological treatments for depression, the shock therapies. The first shock treatments used injection of horse serum or insulin. A major advance in treatment occurred with the advent of electroconvulsive therapy (ECT) in 1934. Although initially used to treat schizophrenia, ECT was soon found to be highly effective for other psychiatric disorders including depression and mania. ECT remained the primary biological psychiatric treatment until the widespread release of psychiatric medications in the 1950s. 

Shock Therapy. Insulin coma treatments were used in the early 1900s but offered no tangible improvement. Electroconvulsive therapy (ECT) arose in the 1930s and 1940s and was the hrst treatment to provide some relief from psychosis. However, its effects are only temporary and it proved too costly for continuous use. ECT continues to have some use for life-threatening catatonia, but it is mainly used to treat refractory depression or bipolar disorder. 

Other somatic therapies were developed in the first half of the twentieth century, with variable results. Malaria therapy was conceived in 1917, insulin shock in 1927, psychosutgery in 1936, and electroconvulsive treatment (ECT) in 1938. All of these methods, as originally conceived, carried serious risks, and most demonstrated marginal effectiveness. Psychosurgeries were carried out by the thousands in the 1940s, resulting in rather effective behavioral control over agitated psychotic patients... 

The first half of the 20th century brought further attempts to use drugs and other therapies to treat mental illness. For example, tests were conducted on the effectiveness of giving amphetamines to depressed and narcoleptic patients, and carbon dioxide inhalation procedures were used in the treatment of illnesses referred to as psychoses and neuroses. Also used in the treatment of psychoses were antihistamines, insulin shock, and psychosurgery. Electroshock therapy was used to treat severe depression (a procedure still used today). Finally, in 1949 an Australian physician named John Cade discovered that the alkali metal lithuim successfully moderated manic conditions, although concerns about toxic reactions to it prevented its approval for use in the United States until 1970. Lithium remains a mainstay in the treatment of bipolar illnesses today. 

Insulin shock may also occur due to the EDTA treatment lowering the serum glucose. Regular food intake during the chelation treatment will help to prevent this. 

Detection of Diabetes in Children Treatment and Prevention of Diabetes Emergency Treatments Diabetic Coma Hypoglycemia (Insulin Shock)... 

Renal disease or renal dysfunction (eg, as suggested by serum creatinine levels greater than or equal to 1.5 mg/dL [males], greater than or equal to 1.4 mg/dL [females], or abnormal Ccr) that may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction (Ml), and septicemia CHF requiring pharmacologic treatment hypersensitivity to metformin acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma. Treat diabetic ketoacidosis with insulin. 

Diabetic ketoacidosis may either result from or be aggravated by infection, surgery, trauma, shock, emotional stress, or failure to take sufficient amounts of insulin. Treatment is focused on reversing the hypokalemia by administering potassium chloride and on offsetting the acidosis by providing bicarbonate. The dehydration and electrolyte imbalance are treated with appropriate measures and crystalline zinc insulin is administered to counter the hyperglycemia. 

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