Case Report
Copyright ©2012 Baishideng. All rights reserved.
World J Diabetes. Sep 15, 2012; 3(9): 170-173
Published online Sep 15, 2012. doi: 10.4239/wjd.v3.i9.170
Severe insulin resistance treatment with intravenous chromium in septic shock patient
Salim R Surani, Iqbal Ratnani, Bharath Guntupalli, Swetha Bopparaju
Salim R Surani, Texas A and M University, Corpus Christi, TX 78366, United States
Iqbal Ratnani, DeBakey Heart and Vascular Center, Houston, TX 77030, United States
Bharath Guntupalli, Swetha Bopparaju, Pulmonary Associates of Corpus Christi, Texas 78413, United States
Author contributions: All authors contributed in preparation and review of manuscript; all authors have reviewed the final draft.
Correspondence to: Salim R Surani, MD, MPH, MSHM, FACP, FCCP, FAASM, Associate Professor, Texas A and M University, Corpus Christi, 1177 Wheeler Avenue, suite 1, Aransas Pass, TX 78366, United States. srsurani@hotmail.com
Telephone: +1-361-8857722 Fax: +1-361-8507563
Received: June 28, 2012
Revised: August 23, 2012
Accepted: September 5, 2012
Published online: September 15, 2012
Abstract

Insulin resistance has been well documented in critically ill patients. Adequate blood sugar control has been associated with better wound healing, and better outcomes in selected patient populations. Chromium is an essential component of human diet. It is believed to affect changes in glucose uptake. Several studies have shown beneficial effects of oral chromium in diabetic patients with insulin resistance, but role of intravenous chromium infusion has not been completely evaluated. We present a case of extreme insulin resistance in a 62-year-old woman with history of diabetes who suffered a cardiac arrest and respiratory failure, leading to aspiration pneumonia and septic shock requiring greater than 7000 units of insulin over a period of 12 h which was successfully treated with intravenous chromium replacement.

Keywords: Insulin resistance; Chromium; Septic shock; Sepsis; Nutrition