Severe insulin resistance treatment with intravenous chromium in septic shock patient.

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.