A case of severe relapsing sulphonylurea-induced hypoglycaemia

Abstract

The authors report a case of a 64-year-old woman who was diagnosed with severe relapsing sulphonylurea-induced hypoglycaemia. Sulphonylureas are frequently used in patients with type 2 diabetes mellitus. They promote insulin secretion independent of the prevailing glucose level and thus are associated with an increased risk of hypoglycaemia. In patients with adequate renal function, gliclazide’s effect lasts 10–24 hours and it is usually completely eliminated within 144 hours postdose. Since our patient suffered from chronic kidney disease, gliclazide’s effect was prolonged and she was experiencing spontaneous hypoglycaemic episodes up to 21 days postomission of gliclazide. This case highlights two important aspects. Primarily, the prolonged effect of sulphonylureas in patients with impaired renal function, hence highlighting the need to be cautious prior to prescribing sulphonylureas in such patients. Secondly, the importance of prolonged observation of patients on sulphonylureas even after the initial hypoglycaemic event is corrected, due to the extended effects of such drugs.

Clinical Efficacy and Safety of ‘Oxy +’ in Type 2 Diabetes: A Pilot Study

“…7 Diabetes can be controlled effectively by reducing overweight and by taking a balanced lifestyle (diet and physical activity) in combination with medication when needed. 8,9 Biguanides, 11 sulfonylureas, 12 thiazolidinediones, α-glucosidase inhibitors, sodium-glucose co-transporter inhibitors, 13 meglitinides, incretins, DPP-4 inhibitors and hormone analoges are commonly used for the treatment of this debilitating disease. 14,15 Long term use of the above-mentioned medications leads to a multitude of complications; hypoglycemia, renal issues, heart problems and GIT disorders.…”

Review of the Case Reports on Metformin, Sulfonylurea, and Thiazolidinedione Therapies in Type 2 Diabetes Mellitus Patients

“…[30] Sulfonylureas are the first-line drugs of choice for patients who cannot tolerate metformin. These drugs may cause mild to severe adverse events in T1DM or T2DM patients [27][28][29][30]. However, it should be noted that although oral hypoglycemic drugs are not recommended during pregnancy, sulfonylureas can be used in gestational diabetes mellitus with a normal outcome of the pregnancy because hyperglycemia often occurs during organogenesis and is linked with an elevated risk of congenital malformations, preeclampsia, premature delivery, intrauterine infections, and perinatal mortality [27].…”