A 32-year-old male with acute organophosphate poisoning developed hyperglycaemia, glycosuria and ketonuria soon after admission to hospital. Serum amylase estimations suggested a diagnosis of acute pancreatitis. He required insulin therapy to control his hyperglycaemia and the organophosphate poisoning was successfully managed by artificial ventilation, an infusion of pralidoxime and intermitte...

Insulin has been in use for nearly a century, but its real clinical worth has been utilized only in the last one and half decade after the landmark study on tight glycaemic control by van Den Berghe. Intravenous (i.v.) insulin is the mainstay of treatment for hyperglycaemia in many acute settings as well as in managing diabetic complications. However, i.v. insulin usage may be associated with n...